Background: Hemiparesis is a common disabling consequence of stroke that leads to abnormal gait patterns marked by asymmetries in step length, stance, and swing phases. Asymmetric gait patterns are correlated with decreased gait velocity and increased susceptibility to falls that can lead to serious injuries and hospitalizations. Objective: In this single group, before and after study, treatment with the iStride TM gait device, designed to improve the gait patterns of individuals with hemiparesis, is adapted to the home environment. Previously tested in clinical settings, this study investigates if using the iStride TM gait device within the home environment can provide safe and effective gait treatment for individuals with hemiparetic gait impairments caused by stroke. Methods: Twelve 30-minute sessions of walking on the device were administered in each participant's home environment. Twenty-one participants who were more than one-year post-stroke received the treatment. The Ten-Meter Walk Test, Timed Up and Go Test, Berg Balance Scale, Functional Gait Assessment, and Stroke Specific Quality of Life Scale were performed before and one week after treatment. Safety, treatment plan compliance, and subjective responses were also recorded during the study period. Results: Results demonstrate statistically significant improvement on all five outcome measures from before treatment to one week after the last treatment session (p < 0.01) using two-tailed paired t-tests. 76% of participants improved beyond the small meaningful change or minimal detectable change on three or more outcome measures. 67% of participants improved clinically in gait speed and on at least one of the fall risk assessment inventories. 81% of the participants were able to perform the treatment in their home without assistance before the end of week three. Conclusions: The results indicate that the iStride TM gait device can facilitate effective, safe, and home-accessible gait treatment opportunities for individuals with hemiparesis from stroke.

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Introduction: In stroke survivors, variables associated with lower quality of life (QOL) include hemiplegia, lower functional status, degree of walking ability, speed of gait, and overall walking dysfunction. The iStride TM Gait Solution, a home-use gait treatment device, has been shown to improve gait speed and other functional parameters in stroke survivors. This analysis discusses the relationship found between gait speed parameters and self-reported QOL after treatment with the iStride TM Gait Solution. Methods: Nineteen subjects were treated with the iStride TM device in their home environment for a targeted 12 sessions over four weeks. QOL was measured using the Stroke Specific Quality of Life Scale (SS-QOL) and gait speed was measured using the 10 Meter Walk Test (10MWT) at comfortable pace. Outcome measures were assessed at baseline and one-week post-treatment. Results: Results showed a statistically significant improvement from baseline to one-week follow-up for 10MWT (p=0.0001) and SS-QOL (p=0.007). The relationship between these variables appeared to be more dependent on the % improvement of gait speed and the ending gait speed being above the mean baseline speed (0.575 m/s) than the absolute improvement in gait speed. For example, subjects starting below the mean gait speed improved 23 points (14.8%) on SS-QOL (gait speed improvement = 0.22m/s) compared to 11.7 points (8%) on SS-QOL (gait speed improvement = 0.33 m/s). In addition, subjects that improved from the home ambulator category to limited community ambulator improved an average of 15.3 points (10.2%) on SS-QOL while subjects improving from limited community ambulator to full community ambulator improved only 4.8 points (4.6%) SS-QOL, despite a 0.16 m/s larger gait speed improvement. Conclusions: The results of this analysis indicate that larger gains in QOL may be achieved by focusing on patients reaching a gait speed above approximately 0.575 m/s. Our findings also support the importance of helping home ambulator stroke survivors achieve limited community ambulator status. These findings may guide clinicians who desire to improve the QOL of their patients to select effective treatment methods targeting gait speed improvement.