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Retraining the brain

Brannock Zanghi is like any other 7-year-old kid. He plays soccer, knows TaeKwanDo, loves Mario Brothers, and in his free time, chases family pets. Life is fairly typical – except for one thing. Before he was born, Brannock suffered a stroke in the womb.

This stroke damaged parts of his brain and caused hemiplegia, a  weakness on the right side of his body. Brannock’s brain has trouble sending signals to his leg and hand muscles. As a result, some muscles work too much (spasticity), and some too little. For example, Brannock has trouble picking his foot up and moving his right hand. Think of it as a mixture of his muscles working either too hard or being too weak. Elizabeth, Brannock’s mother realized something was wrong when he was a baby. He had a distinct one-sided crawl. Through multiple MRIs and visits to Brannock’s pediatrician, Elizabeth learned he had suffered a stroke before birth.

Confused and full of questions, Elizabeth had never heard of a stroke happening in the womb. Why did this happen? During a visit with Dr. Patrick Brennan at Floating Hospital for Children’s Physical Medicine and Rehabilitation Program, she learned hemiplegia is actually quite common, and manageable, however, the cause can’t always be explained.

“It was a feeling of relief for me. Dr. Brennan took one look at Brannock and knew exactly what it was,” said Elizabeth.

Dr. Brennan reassured her Brannock was actually doing well. He was developing and growing normally. Plus, there were innovative treatments that could help him walk better. The plan was to see Brannock every six months throughout his childhood. This way, Dr. Brennan could check on how Brannock was growing and developing, and recommend therapies to help with movement.

A partner throughout childhood

Over the years, Dr. Brennan has truly been a partner in Brannock’s care including coordinating physical therapy, evaluating the tightness of his muscles, and recommending and administeringBotox to relieve muscle stiffness. For a child who’s rapidly growing, stiff muscles in the calf can eventually limit the movement of the ankle, which is what happened to Brannock.. , Botox proved to be extremely helpful. It relaxed Brannock’s calf muscles for several months, so that the growth of the calf muscle kept up with the overall growth of his leg, eventually allowing him to regainmotion in his ankle.

“Dr. Brennan has been a constant for us. He’s advocated numerous times for Brannock,” explained Elizabeth.

Using signals to train the brain to walk

On his 7th birthday, Brannock started using a brand new “big kid” treatment. Dr. Brennan suggested to Elizabeth that Brannock try a new medical device called the Bioness Foot Drop System.

This device sends a low-level electrical stimulation to the muscle that picks up Brannock’s foot. The stimulation allows him to place his heel on the ground correctly. Over time, the device would train his brain to improve balance, coordination and walk naturally. “It basically retrains his muscle and his brain to walk heel-toe,” explained Elizabeth.

By creating new pathways to his brain, it is Dr. Brennan and Brannock’s family’s hope that a lasting improvement will be seen after four to six months Further,  it’s more discreet than the traditional brace. “He doesn’t have to wear a thick brace that all the other kids can point to. He can wear Nike shoes and act just like the other kids,” said Elizabeth.

Despite the challenges, Brannock still does most everything  other kids his age does. He meets physical challenges head-on  with a big smile. “He’s been through a lot,” said Elizabeth. Even his regular day-to-day activities present challenges. “He has to find a way to do things that other kids take for granted. But he does it with a quiet determination, and he’s very good natured about it.”

More mature than some adults, Brannock is positive, good-natured and patient. Dr. Brennan always speaks to him like an adult too. “He talks to him directly, instead only us as his parents. He engages Brannock in the discussion, and he always has,” said Elizabeth. “We’re just so pleased with the care we have received at Tufts Medical Center and the progress Brannock has made.” 

A patient at the Cancer Center at Tufts Medical Center.

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