Helping Stroke Victims Get Back on Their Feet

Pictured: Professor John Handrakis teaches PT students how to use an ultrasound device in one of his labs.

Someone who has had a stroke may experience difficulty going from standing to sitting and completing everyday motions that require squatting. Now a team of researchers, including John Handrakis, D.P.T, professor of physical therapy, has received a grant from the Veterans Affairs Rehabilitation Research and Development (VA RR&D) for a study to help veterans with chronic stroke get back on their feet.

The $199,469 grant will fund the two-year study “Use of a Powered Orthotic Exoskeleton to Promote Mobility through Improved Squat, Knee Flexion and Loading of the Paretic Leg in Persons with Chronic Stroke.” Handrakis, a board-certified neurologic clinical specialist, will collaborate with a research team at the James J. Peters VA Medical Center in the Bronx, N.Y., led by its health sciences specialist Pierre Asselin, M.S. The researchers will train veterans to squat with the use of a powered exoskeleton, a wearable motorized leg brace that increases limb movement and strength.

According to the U.S. Department of Veteran Affairs, approximately 15,000 U.S. veterans suffer a stroke each year. A stroke occurs when the blood supply fails to reach part of the brain, preventing brain tissue from receiving oxygen and nutrients. Brain cells, including those responsible for motor functions like walking, balance, and coordination, can begin to die in minutes. Persons with stroke commonly experience muscle weakness, either in one side of the body or in a particular arm or leg, impacting their ability to complete daily tasks such as walking, bending, or lifting.

An example of an exoskeleton.

“Although patients may be able to walk post-stroke, the majority of them experience significant mobility changes, such as altered gait pattern, decreased ability to bear weight on the affected leg, and have issues with squatting during regular activity,” said Handrakis. “These limitations not only reduce their independence but often decrease physical activity, which can put these persons at an increased risk for a cardiovascular incident.”

The powered exoskeleton will monitor hip movement to “know” when the machine’s motors should support knee movement while walking, sitting down, and standing. The researchers will also monitor changes in quality of life and energy expenditure.

“By bracing the joints and using biomechanics, we anticipate that the powered exoskeleton will reduce stress on the body and help to restore motion,” said Handrakis. “In addition, it could increase motivation and confidence in persons with stroke, enabling them to walk for longer periods of time and distances to places that were previously inaccessible.”

The RR&D is a research-focused rehabilitative branch of the U.S. Department of Veterans Affairs that helps veterans’ overcome debilitating injuries and maximize physical and social independence through innovative research.