When Blowing Kisses is a Monumental Feat

An in utero stroke left Allie without the use of her right arm, but early, targeted therapy is helping her get it back.

Seeing 2-year-old Allie Schwalbe’s arm wrapped in a cast during therapy, you might assume she has a broken arm. But it’s actually her other arm that poses a challenge.

Allie suffered a stroke in utero that left her with limited movement in her right arm, and she now undergoes therapy that constrains her unaffected arm to encourage the use of the weakened one. It’s called constraint-induced movement therapy.

Not only does this therapy prevent favoring one arm, which would result in further weakening the other, but the repetitive movement of the therapy actually helps repair the brain, in a process known as neuroplasticity.

When Allie first started therapy at Kennedy Krieger at 11 months old, she had no use of her right arm. “She flailed it, but she wasn’t grabbing anything,” says her mother, Michelle. Within a week of therapy, she began gaining control of her arm. Allie’s therapist, Jordan Sachse, made therapy fun for Allie, so she thought she was playing.

“When Allie saw Jordan, she would get so excited and start jumping up and down,” says Michelle. “You could tell how much Allie loved therapy.”

Allie continued therapy three days a week for three months, and made huge progress. She began moving her arm purposefully and playing with toys. “It was just a world of difference,” says Michelle.

Eight months later, she started another round of therapy, and Allie figured out how to open her hand and pick up objects. Now, she can string beads, walk around with a bucket collecting objects, and do all sorts of activities that come naturally to other kids. “She claps for herself. You can tell she’s just thrilled with the whole thing,” her mother says about the therapy.

She may never gain full use of her arm, but she’s come a long way. “Nothing cures hemiplegia or completely reverses the damage from stroke, but constraint-induced movement therapy can help patients like Allie regain function in their arms,” says Teressa Garcia Reidy, occupational therapist. “Allie has responded very, very well.”

Reidy and her team recently published a study on the benefits of using constraint-induced movement therapy in a clinical setting in the journal Physical & Occupational Therapy in Pediatrics. The study found the therapy benefited patients with a variety of causes of hemiparesis.

“We’re doing research with patients that’s very applicable to other clinics—it’s not just in a lab, it’s real practice-based clinical research,” she says.

Although Kennedy Krieger has been offering constraint-induced movement therapy for several years, the program for infants is new, and it is one of the few in the country offering therapy to very young patients. Michelle made multiple inquiries and couldn’t find a program that could help Allie, until she found Kennedy Krieger.

“We are always looking for new ways to serve the needs of patients,” explains Reidy, “and we realized there was a need for constraint-induced movement therapy for younger kids like Allie.” When Allie started therapy at 11 months, she was the youngest patient in the program.

“We didn’t want to wait and miss out on the progress she could make,” Michelle explains. Without this therapy, she says, “I don’t think Allie would have nearly as much functionality as she does…When she first started therapy, Allie had no use of her right arm. Now she waves, blows kisses, and gives high fives. I can’t thank Kennedy Krieger enough.”

“Nothing cures hemiplegia or completely reverses the damage from stroke, but constraint-induced movement therapy can help patients like Allie regain function in their arms. Allie has responded very, very well.”

– Teressa Garcia Reidy, occupational therapist, pictured with Jordan Sachse, occupational therapist

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