Participants
seizures, stroke, neurological injury or disorder, vascular disorders, fractures, cognitive deficits, lower limb peripheral nerve injury, skin lesions, osteoporosis
STROKE, VASCULAR DISORDERS, PULMONARY DISEASE, SKIN LESIONS, OSTEOPOROSIS
Patients with a recent stroke (on average, less than three weeks post-injury), admitted to an IRF were assessed for eligibility by their treating clinical team (physiatrist and/or physical therapist) between April 2017 and July 2019. Inclusion criteria were: (1) Adult (≥ 18 years of age) after first stroke; (2) able to tolerate ≥ 12 minutes of upright position using a tilt table, standing frame, body weight support (BWS) harness or assistance; (3) medical stability and cardiorespiratory status sufficient to tolerate aerobic exercise protocol. Exclusion criteria were: (1) MAS score 4 in ankle, knee or hip joints; (2) other neurological injury or disorder affecting the central nervous system; (3) previous lower limb peripheral nerve injury; (4) lower limb joint contractures that interfere with walking; (5) open skin lesions or anatomic deformities in the lower limbs and/or torso that may interfere with the Lokomat® exoskeleton or support harness application; (6) bone problems (non-consolidated fractures; unstable spine; and severe osteoporosis with history of fractures; (7) severe cognitive deficits; (8) recent cardiac or active pulmonary disease, labile blood pressure; (9) severe vascular disorders of the lower limbs; (10) scheduled elective surgery or other procedures during the study; (11) uncontrolled seizures; (12) pregnancy. All participants gave written informed consent before start of the study. Demographic and clinical characteristics collected included: sex, hemiparetic side, age, stroke type (hemorrhagic/ischemic), stroke onset date, LOS, days from informed consent form (ICF) signature to discharge and number of completed training sessions. The trial took place in an Inpatient Rehabilitation Facility (IRF) to which patients were transferred after acute care on day 4 to 10 post stroke. For this study, LOS refers to time in the IRF only. The therapist perceived exertion during delivery of supplemental training for both groups was documented using the modified RPE (Borg Scale).