Early, Intensive, Lower Extremity Rehabilitation Shows Preliminary Efficacy After Perinatal Stroke: Results of a Pilot Randomized Controlled Trial.

This was a pilot randomized controlled trial with 25 randomized children, so it was not designed to prove efficacy. Recruitment ended before the targeted sample size was reached. The Delay and Immediate groups differed in age at baseline, even though the trial was randomized. The primary comparison adjusted for age, but the small sample means the result should be treated cautiously. Usual care was not systematically tracked during the delay period. Treating therapists and parents could not be blinded to group allocation. The Parent-trained cohort was descriptive and not part of the randomized comparison. Weight-bearing during walking was assessed only at the Edmonton site because force plates were available only there. Step counts captured walking activity but did not fully capture other training activities such as standing balance and squatting. Follow-up after the 3-month training period was incomplete for some groups, and the study did not initially plan 3-month follow-up for the Delay and Parent-trained groups. One 3-month bout of intensive training may not be sufficient to have a significant impact on long-term motor function. The study did not establish whether the intervention is feasible or effective for all children with cerebral palsy, or for children outside the included age and stroke criteria.

The authors declared no potential conflicts of interest. Funding came from the Canadian Institutes of Health Research, Alberta Innovates Health Solutions, and a graduate studentship supported by the Stollery Children's Hospital Foundation through the Women and Children's Health Research Institute.

Do not conclude that this pilot proves intensive lower extremity training is established practice for all children with cerebral palsy. The randomized sample was 25 children, the parent-trained cohort was descriptive and not randomized, and the authors state that one 3-month bout may not be sufficient to have a significant impact on long-term motor function.