Cortical Priming to Optimize Gait Rehabilitation in Stroke: a Renewal

Launched by UNIVERSITY OF ILLINOIS AT CHICAGO · Jul 15, 2020

Keywords

ClinConnect Summary

This clinical trial is exploring a new way to help people who have had a stroke improve their walking ability. The study looks at using brain stimulation, known as cortical priming, alongside traditional rehabilitation methods to see if it can lead to better walking outcomes for stroke survivors. Researchers want to learn how this brain stimulation works and how it can help improve movement after a stroke.

To participate in this trial, individuals must be over 18 years old and have experienced their first stroke more than three months ago. They should still have difficulty walking, but be able to walk for at least five minutes, even with support if needed. The study is currently looking for participants who can meet these criteria, and everyone is welcome regardless of gender. Participants will undergo rehabilitation and brain stimulation treatments, and they will help researchers understand how these methods work together to improve walking after a stroke.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age greater than 18 years
• • First ever monohemispheric stroke \> 3 months since onset
• • Residual hemiparetic gait deficits (e.g. abnormal gait pattern)
• • Able to walk for 5 minutes at self-paced speed. Handheld assistive device is acceptable.
• • Walking speed lesser than 1.2 m/s
• • Lower limb Fugl-Meyer Motor score between 15-30
• • At least 5 deg of ankle dorsiflexion necessary to perform the ankle-tracking task
• Exclusion Criteria:
• • General exclusion criteria
• • Severe osteoporosis
• • Contracture-limiting range of motion of lower limb
• • Score of more than 2 on the Modified Ashworth Scale (indicating increased muscle tone through ankle range of motion)
• • Uncontrolled anti-spasticity medications during the study period
• • Score less than 6 on the Fugl-Meyer Sensory Assessment Scale for the Lower Limb
• • Cardiorespiratory or metabolic diseases (e.g. cardiac arrhythmia, uncontrolled hypertension or diabetes, chronic emphysema)
• • Unhealed decubiti, persistent infection
• • Significant cognitive or communication impairment (Mini-Mental State Examination (MMSE)\<21), which could impede the understanding of the purpose of procedures of the study or prevent the patient from performing the ankle-tracking task.
• • Lesions involving the brainstem and cerebellum
• • Failure to pass the graded exercise stress test
• • TMS exclusion criteria
• • Implanted cardiac pacemaker
• • Metal implants in the head or face
• • Unexplained, recurring headaches
• • History of seizures or epilepsy
• • Currently under medication that could increase motor excitability and lower seizure threshold
• • Skull abnormalities or fractures
• • Concussion within the last 6 months
• • Currently pregnant
• • tDCS exclusion criteria
• • Skin hypersensitivity
• • History of contact dermatitits
• • History of allodynia and/or hyperalgesia
• • Any other skin or scalp condition that could be aggravated by tDCS