Importance: Stroke is estimated to affect 6.6 million Americans, and around 795,000 new
cases are reported each year. By 2030, annual stroke-related healthcare costs are
expected to eclipse $240 billion, a staggering 445% increase from the current annual cost
of $53.9 billion. Specialized stroke rehabilitation reduces long-term disability and
stroke-related costs, making cost-efficient efforts to minimize functional deficits faced
by people with stroke (e.g., gait impairment) a high priority. This project will
provision preliminary evidence regarding the clinical use and efficacy of robotic gait
training (RGT) during the subacute phase of stroke recovery as well as observational
findings associated with the safety, tolerability, feasibility, and cost of delivering
RGT during inpatient stroke rehabilitation. Its results will help with developing safe,
tolerable, and cost-effective training protocols to improve walking function after
stroke. Additionally, follow-up assessments after discharge will investigate any
carryover effect of RGT, providing foundational data to evaluate the dose-response
relationship for delivering RGT during inpatient rehabilitation after stroke. Altogether,
this evidence will help stroke rehabilitation programs to assess their planning and
budgeting needs prior to adopting RGT technology, improving outcomes and lowering
lifetime care costs for patients with stroke.
Aims: (1) Evaluate the safety, tolerability, and feasibility of delivering an RGT
intervention that meets the unique needs of people after stroke during inpatient
rehabilitation informed by an Advisory Board comprised of stakeholders living with
stroke. (2) Examine the efficacy of RGT compared to usual care (UC) gait training during
inpatient rehabilitation for people with stroke. (3) Conduct a cost analysis of
delivering RGT during inpatient rehabilitation compared to UC.
Methods: This randomized controlled trial will enroll 54 patients admitted to the Baylor
Scott and White Institute for Rehabilitation following stroke. Participants will be
randomized to either the experimental group receiving RGT or the control group receiving
UC.
Addition to State-of-the-Art: Expected products include a manualized,
stakeholder-informed RGT intervention and cost-analysis template that can be replicated
across early rehabilitation settings nationally for people with stroke.
Sustained Approach: This project builds upon our earlier findings to achieve optimal
walking recovery post-stroke during inpatient rehabilitation. The proposed work will
generate preliminary efficacy, safety, tolerability, feasibility, and cost-analysis data
concerning delivering an RGT intervention during the subacute phase for people with
stroke.
