Incline Training to Personalize Motor Control Interventions After Stroke

This study seeks to develop a theory-based clinical decision-making framework for the
training of walking recovery after stroke based on how different biomechanical patterns of
walking illustrate distinct motor control deficits. Each participant will complete 12
sessions (three times a week for four weeks) of either INCLINE, DECLINE, or CONTROL training.
Clinical and biomechanical outcome measures will be collected pre- and post-training and
after a one-month follow-up period. In addition, the investigators will collect a battery of
clinical outcome measures before and after training. Spatiotemporal variables (including
SSWS) will be collected before and after each session. All clinical and biomechanical
assessments will be conducted by an evaluator blinded to training group allocation.

Inclusion Criteria:

- stroke 6 months

- residual paresis in the lower extremity (Fugl-Meyer LE motor score <34)

- ability to walk without assistance at speeds ranging from 0.2 - 1.0 m/s (with a
support harness for biomechanical testing)

- Pp between 0.47 and 0.53

- Ability to walk on a treadmill without orthotic or assistive device using overhead
harness system

- provision of informed consent, and 8) written approval from the primary physician (see
attached sample of Medical Approval Cover Letter).

Exclusion Criteria:

- history of congestive heart failure, unstable cardiac arrhythmias, hypertrophic
cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during ADLs

- History of COPD or oxygen dependence

- Pre-existing neurological disorders or dementia

- History of major head trauma

- Legal blindness or severe visual impairment

- Severe arthritis or other problems that limit passive ROM

- History of DVT or pulmonary embolism within 6 months

- Severe hypertension with systolic >200 mmHg and diastolic >110 mmHg at rest.