Comparing Effects of Conventional Neurorehabilitation With Exoskeleton With High-intensity Gait Training on Gait, Balance, and Depression Following Stroke and the Impact of Social Determinants of Health and Depression on Patients' Adherence to Physical Therapy

Demographic Questionnaire

时间窗: Pre-intervention

Questions include age, sex, date of birth, race/ethnicity, total income during T the past 12 months, main occupation and when was the last work, language at home, marital status, education level, and if they take any antidepressants.

Newest Vital Sign (NVS)

时间窗: Pre-intervention

The NVS is a 6-question screening tool that identifies participants' risk of low or limited health literacy (HL) based on interpreting an ice cream nutrition label.

Patient Health Questionnaire (PHQ-9)

时间窗: Pre-intervention, After 10 interventions (~5 weeks), After 20 interventions (~10 weeks)

The PHQ-9 is a self-administered depression screening tool with nine items. It has been reported that the PHQ-9 is the best-performing tool for screening for post-stroke depression.

6-Minute Walk Test

时间窗: Pre-intervention, After 10 interventions (~5 weeks), After 20 interventions (~10 weeks)

The 6MWT assesses participants' aerobic capacity/endurance by recording the distance (in meters) that the participants walk in 6 minutes. Assistive devices may be used and will be documented.

Borg rating scale of Perceived Exertion

时间窗: Pre-intervention, After 10 interventions (~5 weeks), After 20 interventions (~10 weeks)

The Borg Rating Scale of Perceived Exertion will be measured in all participants at the completion of 6 minute walk test. It measures exertion on a scale of 0 (no exertion or resting) to 10 (pushing oneself to the max).

Multidimensional Scale of Perceived Social Support (MSPSS)

时间窗: Pre-intervention

The Multidimensional Scale of Perceived Social Support is a 12-item self-administered scale that measures social support. The total score for the MSPSS ranges from 12 to 84, with higher scores indicating higher levels of perceived social support.

Berg Balance Scale (BBS)

时间窗: Pre-intervention, After 10 interventions (~5 weeks), After 20 interventions (~10 weeks)

The Berg Balance Scale is a 14-item clinician-rated measure that assesses static and balance in sitting and standing. It has a maximum score of 56 points. Each item is scored on a 5-point scale from 0 to 4, with 0 indicating the subject is unable to perform the task and 4 being the highest score.

3-Meter Backwards Walk Test (3MBWT)

时间窗: Pre-intervention, After 10 interventions (~5 weeks), After 20 interventions (~10 weeks)

The 3MBWT measures the time (in seconds) it takes for a participant to walk 3 meters backward, hence assessing a backward gait speed. Backward gait speed is used to evaluate neuromuscular control, proprioception, protective reflexes, fall risk, and balance. Use of assistive devices will be documented.

10-meter Walk Test

时间窗: Pre-intervention, After 10 interventions (~5 weeks), After 20 interventions (~10 weeks)

The 10mWT assesses walking speed in meters/second (m/s) over a short distance (10m). Two trials are administered at the patient's comfortable walking speed, followed by 2 trials at their fast walking speed, per Physical Therapist's instruction. The 2 trials for each speed are then averaged and the 2 gait speeds (preferred and fast) are documented in m/s. Assistive devices may be used, and will be documented.

Muscle coactivation index

时间窗: Pre-intervention, After 10 interventions (~5 weeks), After 20 interventions (~10 weeks)

Muscle coactivation index will be calculated based on the EMG signals from 8 leg muscles (bilateral tibialis anterior, medial gastrocnemius, rectus femoris, medial hamstring). Surface electromyographic recordings will be conducted during forward and backward walking tests.

Functional Gait Assessment (FGA)

时间窗: Pre-intervention, After 10 interventions (~5 weeks), After 20 interventions (~10 weeks)

The FGA is used to assess postural stability during walking and assesses an individual's ability to perform multiple motor tasks while walking. The Functional Gait Assessment (FGA) is scored on a 4-point ordinal scale ranging from 0-3, with 0 indicating severe impairment and 3 indicating normal ambulation. The total score is calculated by summing all the items and ranges from 0-30, with lower scores indicating greater impairment.