Development of Walk Assist Device to Improve Community Ambulation
Stroke
About this trial
This is an interventional treatment trial for Stroke focused on measuring Stroke, Gait, Stride Management Assist, Mild-moderate Stroke, post 30 days or longer
Eligibility Criteria
Inclusion Criteria:
- ≥ 30-days post stroke
- Initial gait speed of > 0.4 m/s and < 0.8 m/s
- Adequate cognitive function (MMSE score >17)
- Subject is willing to be randomized to the control group or the treatment group.
- Ability to sit unsupported for 30 seconds
- Ability to walk at least 10m with maximum 1 person assist,
- Ability to follow a three-step command
- Physician approval for patient participation
- Living in the community post-stroke with ability to travel to the intervention site to participate in the outpatient program and able to perform the home exercise program in the residential facility.
- Willing to carry wireless body sensors through the period of the study and to follow-up time period, post inpatient stroke, cardiac, pulmonary, or any other lower extremity physical rehabilitation
- ≥ 90 days post major orthopedic surgery (i.e. hip, knee, and/or ankle joint replacement)
- ≥ 6 months post coronary artery bypass grafting (CABG) or cardiac valve procedure
- Able and willing to give written consent and comply with study procedures, including follow-up visits
- Cannot not be participating in any other structured outpatient or home health physical therapy program
Exclusion Criteria:
- Serious cardiac conditions (hospitalization for myocardial infarction or heart surgery within 3 months, history of congestive heart failure, documented serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living)
- Severe arthritis or orthopedic problems that limit passive ranges of motion (ROM) of lower extremity (knee flexion contracture of > 10°, knee flexion ROM < 90°, hip flexion contracture > 25°, and ankle plantar flexion contracture > 15
- Serious medical conditions including myocardial infarction or heart surgery within 3 months, history of congestive heart failure, documented serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living, Severe hypertension, severe weight bearing pain, life expectancy less than one year
- Preexisting neurological disorders such as Parkinson's disease, Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), dementia
- History of major head trauma, Lower extremity amputation, Non-healing ulcers of a lower extremity, Renal dialysis or end stage liver disease, Legal blindness or severe visual impairment, a history of significant psychiatric illness
- History of unexplained, recurring headaches, epilepsy/seizures/skull fractures or skull deficits
- Medications that lower seizure threshold
- History of concussion in last 6 months
- Subject is pregnant, nursing or planning a pregnancy
- Inability to travel 3 times per week for outpatient training programs
- Participating in another clinical trial that, according to the Principal Investigator, is likely to affect study outcome or confound results
Sites / Locations
- Rehabilitation Institute of Chicago
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Stride Management Assist (SMA) System
Impairment based therapy
Participants will be randomized into either the SMA group or impairment based (IPT) group. The SMA group (task specific training) will be trained to simulate the demands of overground walking using the Stride Management Assist Device in outpatient physical therapy.
Impairment based therapy will include traditional functional mobility training physical therapy. It will match the SMA group in intensity but will be focused on balance and other functional goals rather than explicitly on walking in outpatient physical therapy.