Overview
This project will develop a wearable rehabilitation robot suitable for in-bed acute stage rehabilitation. It involves robot-guided motor relearning, passive and active motor-sensory rehabilitation early in the acute stage post-stroke including patients who are paralyzed with no motor output. The early acute stroke rehabilitation device will be evaluated in this clinical trial.
Description
Stroke survivors often experience loss of motor control and impaired function. Immediately after stroke, there is a time-limited window of heightened plasticity during which the greatest gains in recovery occur. Therefore, early intensive sensorimotor rehabilitation post-stroke is critical in improving functional outcomes and minimizing disability. However, acute stroke survivors often receive little active training to improve mobility during their hospital stay and they are left alone during most of the day. Especially for those acute patients with no voluntary motor output, active motor training might be even less, partly due to a lack of rehabilitation protocols to detect potential motor recovering signals sensitively and facilitate neuroplastic changes. To address this unmet clinical need, this project will develop a novel wearable rehabilitation robot suitable for in-bed acute stage rehabilitation with guided motor relearning, passive and active motor-sensory rehabilitation early in the acute stage post-stroke including patients who are paralyzed with no motor output. The early acute stroke rehabilitation device will be evaluated in this clinical trial.
Eligibility
Inclusion Criteria:
- Acute first time unilateral hemispheric stroke (hemorrhagic or ischemic stroke, 24 hours after admission to 1 month post-stroke at the start of the proposed treatment)
- Hemiplegia or hemiparesis
- 0≤Manual Muscle Testing (MMT)<=2
- Age 30-85
- Ankle impairments including stiff calf muscles and/or inadequate dorsiflexion
Exclusion Criteria:
- Medically not stable
- Associated acute medical illness that interferes with ability to training and exercise
- No impairment or very mild ankle impairment of ankle
- Severe cardiovascular problems that interfere with ability to perform moderate movement exercises
- Cognitive impairment or aphasia with inability to follow instructions
- Severe pain in legs
- Severe ankle contracture greater than 15° plantar flexion (when pushing ankle to dorsiflexion)
- Pressure ulcer, recent surgical incision or active skin disease with open wounds present below knee