Parent Therapist Partnership to Provide Early, Intensive Exercise in Perinatal Stroke

A prospective, single blind, parallel group, randomized control trial to determine if early, intensive lower extremity activity delivered by a physical therapist and a parent in partnership improves gross motor function more than usual care.

Inclusion Criteria: * children ages 8 months to 3 years * medical history and physical exam consistent with perinatal stroke * hemiparesis in the upper and/or lower extremity * parental agreement to adhere to the training and testing schedule Exclusion Criteria: * bilateral motor impairment * epileptic seizures that could interfere with training * cognitive, behavioural or developmental impairments that preclude participation in the protocol * botulinum toxin A injections or surgery in the lower extremities within the previous six months * concurrent casting during the intervention phase (including constraint-induced movement therapy with casting) * diagnosis associated with neurological/developmental regression * parent unable to communicate (verbal and written) in English or French