Grant: Doctoral: Vanier Canada Graduate Scholarships

400,000 Canadians currently live with disability as a result of stroke, amounting to a staggering economic burden of $2.8 billion annually. Walking ability, or lack thereof, is a key determinant of disability and can impact whether an individual returns home after stroke; individuals who do not regain the ability to walk are more likely to go to nursing homes and develop secondary complications. However not all stroke patients, especially those requiring more physical assistance, have the opportunity for early walking practice due to therapist and safety limitations. A possible solution is the use of a powered robotic exoskeleton in therapy, a new technology which straps to the lower limbs to safely automate walking regardless of leg weakness. This device will afford patients the opportunity to practice walking during the early window after stroke when the greatest recovery of the brain occurs. In this study we will compare the effectiveness of an exoskeleton-based rehabilitation program to standard stroke rehabilitation. We hypothesize that individuals who are able practice walking, by means of the exoskeleton, during the period when the brain experiences the most recovery will experience greater functional improvements than individuals receiving standard care; those receiving standard care will still receive mobility and walking training, though guided by the patient's strength, therapist discretion, and safety regulations. We will also interview therapists and patients who use the exoskeleton for rehabilitation, in order to explore their experience and perception of the device. Using an exoskeleton for rehabilitation has the potential to provide treatment to patients with severe stroke who are not yet able to walk. If the exoskeleton program generates greater recovery of walking, it may become an integral component of physical therapy care. It would also have implications at various levels, from patient health outcomes to the national economic burden of stroke.