Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of Robot-Assisted Therapy in Sequential Combination With Constraint-Induced Therapy in Stroke Rehabilitation
Brief Summary: The findings of this project will contribute to the understanding of a comprehensive probe for investigation of the effects of monotherapy versus combination rehabilitation intervention after stroke, including the topics of possible underlying mechanisms of motor recovery as well as the beneficial and adverse effects of intense rehabilitation therapy, prognostic factors of the outcomes, and clinimetric properties of the instruments. The overall findings of this project will be significant in the era of knowledge translation and guide the development of innovative and effective interventions for individualized stroke rehabilitation.


Options:
A: Inclusion Criteria:

* Ischemic or hemorrhagic stroke greater than 3 months prior
* Residual hemiparetic gait with observable asymmetry in the gait pattern.
* Women or men aged 21 to 85 years
* Completed all conventional physical therapy.
* Adequate language and neurocognitive function to participate in training, testing, and to give informed consent.
* Minimal ankle flexion in either direction (dorsi- or plantar-)

Exclusion Criteria:

* MMSE score \< 23 (9th grade education or more) or MMSE score \< 17 (8th grade education or less)
* CES-D score \> 16
* Clinical history of orthopedic, chronic pain or severe neuromuscular disorders restricting participation in a short term ankle movement training paradigm.
* Severe or global receptive aphasia which confounds reliable testing and training.
* Women of child-bearing potential, if there is any self-reported chance that they may be pregnant.
B: Inclusion Criteria:

* ≥ 30-days post stroke
* Initial gait speed of \> 0.4 m/s and \< 0.8 m/s
* Adequate cognitive function (MMSE score \>17)
* Subject is willing to be randomized to the control group or the treatment group.
* Ability to sit unsupported for 30 seconds
* Ability to walk at least 10m with maximum 1 person assist,
* Ability to follow a three-step command
* Physician approval for patient participation
* Living in the community post-stroke with ability to travel to the intervention site to participate in the outpatient program and able to perform the home exercise program in the residential facility.
* Willing to carry wireless body sensors through the period of the study and to follow-up time period, post inpatient stroke, cardiac, pulmonary, or any other lower extremity physical rehabilitation
* ≥ 90 days post major orthopedic surgery (i.e. hip, knee, and/or ankle joint replacement)
* ≥ 6 months post coronary artery bypass grafting (CABG) or cardiac valve procedure
* Able and willing to give written consent and comply with study procedures, including follow-up visits
* Cannot not be participating in any other structured outpatient or home health physical therapy program

Exclusion Criteria:

* Serious cardiac conditions (hospitalization for myocardial infarction or heart surgery within 3 months, history of congestive heart failure, documented serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living)
* Severe arthritis or orthopedic problems that limit passive ranges of motion (ROM) of lower extremity (knee flexion contracture of \> 10°, knee flexion ROM \< 90°, hip flexion contracture \> 25°, and ankle plantar flexion contracture \> 15
* Serious medical conditions including myocardial infarction or heart surgery within 3 months, history of congestive heart failure, documented serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living, Severe hypertension, severe weight bearing pain, life expectancy less than one year
* Preexisting neurological disorders such as Parkinson's disease, Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), dementia
* History of major head trauma, Lower extremity amputation, Non-healing ulcers of a lower extremity, Renal dialysis or end stage liver disease, Legal blindness or severe visual impairment, a history of significant psychiatric illness
* History of unexplained, recurring headaches, epilepsy/seizures/skull fractures or skull deficits
* Medications that lower seizure threshold
* History of concussion in last 6 months
* Subject is pregnant, nursing or planning a pregnancy
* Inability to travel 3 times per week for outpatient training programs
* Participating in another clinical trial that, according to the Principal Investigator, is likely to affect study outcome or confound results
C: Inclusion Criteria:

* Clinical diagnosis of an initial supratentorial stroke
* ≤20 weeks post stroke at intervention onset
* Age ≥18 years
* Functional Ambulation Category (FAC) ≤3
* Ability to understand the procedures and provide informed consent

Exclusion Criteria:

* Contraindications for exercise testing outlined by American College of Sports Medicine (ACSM)
* Contraindications for RATE according to the manufacturer
* Concurrent neurological disease
* Concurrent pulmonary disease
* History of dementia
D: Inclusion Criteria:

* 6 months onset from a first-ever unilateral stroke
* An initial UL subsection of the Fugl-Meyer Assessment score of 20 to 50 indicating moderate and moderate to severe UL movement impairment
* No balance problems sufficient to compromise safety when wearing the study's constraint device
* No excessive spasticity in any of the joints of the affected UL (modified Ashworth scale ≤ 3)
* Without upper limb fracture within 3 months
* Be able to follow study instructions and perform study tasks (Mini Mental State Examination ≥ 24)
* Willing to provide written informed consent

Exclusion Criteria:

* Exhibit physician-determined major medical problems or poor physical conditions that would interfere with participation
* Excessive pain in any joint that might limit participation

Answer: D