Comparison of Two High-intensity Gait Training Interventions on Contraversive Pushing Behaviors in Individuals Poststroke

Prior treatment

• History of prior stroke
• Concurrent neurologic condition (i.e PD, TBI, MS, etc.)
• Concurrent participation in other lower limb research studies that according to the PI is likely to affect study outcome or confound results

Other illness

• History of peripheral nerve injury
• Unresolved deep vein thrombosis (DVT)

Lab values

• Severe osteoporosis as indicated by physician medical clearance

Other

• Severe aphasia limiting ability to express needs or discomfort verbally or nonverbally
• Severe behavioral neglect as determined by a score of ≥ 21 on Catherine Bergego Scale (CBS) via the Kessler Foundation-Neglect Assessment Process (KF-NAP)16
• Joint contracture or significant spasticity in the lower limbs (Modified Ashworth Scale ≥3)
• Severe knee, hip, or ankle osteoarthritis
• Open wounds on surfaces in contact with exoskeleton or harness
• Unstable spine or unhealed fractures
• Weight bearing precautions
• Pregnancy
  • EksoNR Exclusion Criteria:
• Weight \>220 lbs (100 kg)
• Height below 60 inches or above 76 inches
• Standing hip width of approximately 18 inches or more
• Joint contractures or range of motion deficits that limit normal range of motion during ambulation
• Knee flexion contracture greater than 12°
• Hip flexion contracture greater than 17°
• Inability to achieve 0° neutral ankle dorsiflexion with knee flexion up to 12°
• Bilateral hip flexion less than 110°
• Leg length discrepancy
• Greater than 0.5 in. (1.27 cm) for upper legs
• Greater than 0.75 in. (1.91 cm) for lower legs
• Active heterotopic ossification
• Significant spasticity in the lower limbs (Modified Ashworth Scale ≥3)
• High anxiety or claustrophobia
• Clostridium difficile or other gastrointestinal isolation precautions
• Colostomy
• Uncontrolled autonomic dysreflexia
• Lower limb prosthesis

• Age 18-80 years old
• Unilateral, supratentorial ischemic or hemorrhagic stroke within the past six months
• Medical clearance from primary medical team (signed Medical Clearance form)
• Contraversive pushing behaviors as determined by a score of \>0 on the Scale for Contraversive Pushing
• Adequate cognitive function as determined by the NIH scale: score ≤1 on question 1b and score =0 on question 1c
• Informed consent provided by participant or power of attorney
• English speaking