Stroke Inpatient Rehabilitation Reinforcement of ACTivity

Inclusion Criteria:

- Admission for acute inpatient rehabilitation of a first stroke (or second stroke
after full recovery from prior TIA/Stroke)

- Time from onset of stroke to admission for rehabilitation < 35 days

- Stroke from any cause (thrombotic infarct, cardioembolus, intracerebral hemorrhage)
that includes unilateral hemiparesis. Hemiparesis means less than / equal to 4/5
strength by the British Medical Council scale for hip flexion tested supine and for
knee or ankle flexion and extension (scores less than / equal to 22 of 25 possible
points)

- Ability to follow simple instructions, especially to understand verbal reinforcement
about activity.

- Independent in mobility prior to admission by the Barthel Index.

- Able to walk with no more than physical assistance of 2 persons for at least 5 steps
(for example, 3 strides of the left leg alternating with 2 on the right leg).
Subjects can use any type of assistive device and brace needed.

- Able to understand and repeat information related to the Informed Consent. The
subject signs a Consent form.

Exclusion Criteria:

- Current medical disease that will limit physical therapy at the time of randomization
or limited walking prior to the stroke, such as serious infection, DVT, orthostatic
hypotension, > stage 2 decubitus ulcer of buttocks or legs, congestive heart failure,
claudication, and pain with weight-bearing or walking. Subjects can be entered if a
complication resolves within 7 days of admission screening.

- Aphasia with inability to follow 2-step directions during therapeutic instructions or
answers Yes/No to questions with < 75% accuracy related to personal health and
symptoms.