Study of Transcranial Electrical Stimulation with Cognitive-Motor Dual-Task Gait Training to Improve Brain Activity, Spinal Nerve Function, Thinking, and Movement in Adults After Stroke

What this Trial Is About

Researchers are investigating the effects of transcranial electrical stimulation tES, which includes transcranial direct current stimulation tDCS and transcranial alternating current stimulation tACS, combined with conventional physical therapy and cognitive-motor dual-task gait training in individuals who have experienced a stroke. The study focuses on those in the sub-acute phase at least 2 weeks after stroke onset up to chronic phase within 5 years post-stroke. The goal is to understand how these treatments affect brain activity, spinal motoneuron excitability, cognition, and motor performance, potentially improving rehabilitation approaches for stroke survivors. Participants will be randomly assigned to one of three groups active tDCS, active tACS, or sham stimulation, each followed by conventional physical therapy and cognitive-motor dual-task gait training. Each session includes 20 minutes of the assigned brain stimulation, 1 hour of physical therapy, and 30 minutes of gait training, with a total of 12 sessions over 4 weeks 3 sessions per week. Electrodes are placed over the affected side of the brains motor cortex, and stimulation parameters differ between tDCS and tACS to target neural plasticity and brain wave activity. Throughout the study, participants will undergo assessments at baseline, immediately post-intervention, and at 1- and 3-month follow-ups. These evaluations include brain activity measured by EEG, spinal motoneuron excitability via H-reflex tests, cognitive tests like the Montreal Cognitive Assessment and Stroop test, and motor function tests such as the Fugl-Meyer assessment and Timed Up and Go test. Researchers will also monitor walking performance under dual-task conditions to assess cognitive-motor interference, gathering a comprehensive picture of treatment effects and safety over time.

Effects of tES Combined With CMDT Gait Training on Cognition, Cortical Activity, Spinal Motoneuron Excitability and Motor Performance in Stroke Individuals