The Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) Study

Inclusion criteria

• Age ≥ 40 years;
• Recent stroke (defined as stroke symptoms occurring within 4 weeks prior to admission into community hospitals);
• Diagnosis of stroke made by clinician and/or supported by brain imaging;
• Able to sit unsupported for 30 seconds;
• Able to stand on the non-paretic leg for >4 sec;
• Able to walk at least 2m with maximum of 1 person assist;
• Able to follow a 3-step command;
• Living in the community before discharge and expected to be discharged home;
• Has a caregiver.

Exclusion criteria

• Has a pacemaker in-situ (because of possible interference of pacemakers by wireless electronic signals);
• Unable to ambulate at least 150 feet prior to stroke, or intermittent claudication while walking less than 200 meters;
• Serious cardiac conditions (hospitalization for myocardial infarction or heart surgery within 3 months, history of severe congestive heart failure, serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living);
• History of serious chronic obstructive pulmonary disease or oxygen dependence;
• Severe weight bearing pain;
• Pre-existing neurological disorders such as Parkinson's disease, Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS) or severe dementia
• History of major head trauma with severe residual deficits;
• Lower extremity amputation;
• Legal blindness or severe visual impairment;
• Severe uncontrolled psychiatric illness such as psychosis, schizophrenia or medication refractory depression;
• Life expectancy less than three months;
• Severe arthritis or orthopedic problems that limit passive ranges of motion of lower extremity (knee flexion contracture of > 10°, knee flexion ROM < 90°, hip flexion contracture > 25°, and ankle plantar flexion contracture > 15°);
• History of sustained alcoholism or drug abuse in the last six months;
• Hypertension with systolic blood pressure greater than 200 mmHg and diastolic blood pressure greater than 110 mmHg at rest, that cannot be medically controlled into the resting range of 180/100 mmHg.