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NCT Number: NCT04577287

The Effects of Anodal and Cathodal tDCS Combined With Conventional Physical Therapy in Patients With Acute Stroke

The objective of the study is thus to compare the effects 5 consecutive sessions of anodal and cathodal tDCS combined with conventional physical therapy on upper and lower limb motor performance in acute stroke at immediate, and 1-month followup.

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Key information

Conditions

Stroke, Acute Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Stroke Vascular Diseases

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Faculty ofPhysical Therapy, Mahidol University

Salaya, Nakonpathom, 73170, Thailand

About this study

Stroke is a major cause of long-term disability in stroke survivors that related with motor impairment. After stroke, the cortical excitability of ipsilesional hemisphere is decreased; in contrast, the cortical excitability of contralesional hemisphere is increased. Conventional physical therapy is beneficial to motor recovery, but early rehabilitation was not always help the patients get full recovery. tDCS is an adjuvant tools which deliver weak direct current through scalp to promote motor recovery in stroke rehabilitation. The anodal-tDCS increases cortical excitability, while the cathodal-tDCS decreases cortical excitability. Previous studies demonstrated that both monocephalic techniques of tDCS can improve motor function in chronic, subacute, and acute phase, but it is still inconclusive that which monocephalic montages had better effect, especially in acute phase. There are several studies supported the benefits of monocephalic tDCS combined with rehabilitation programs on upper and lower limbs motor function in acute stroke. However, there is no evidence that directly compared the effect of monocephalic tDCS in acute stroke patients. The objective of the study is to compare the effects of anodal and cathodal tDCS combined with conventional physical therapy for 5 sessions on motor performance in acute stroke at immediate, and 1-month follow-up.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Acute ischemic stroke patients who have aged between 18 and 75 years
  • Having a first ever-ischemic stroke that are confirmed by MRI/CT scan
  • Post stroke onset 2-10 days
  • Be able to follow command
  • Be able to walk with or without assistive device (Modified Ranking Scale ≤ 4)
  • Free of any neurological antecedent or unstable condition (such as epilepsy) or cancer.
  • Be able to initiate the upper limb movement

Exclusion criteria

  • Recurrent stroke
  • National Institute of Health Stroke Scale ≥ 20 points
  • Presence of intracranial metal implantation, cochlear implant, or cardiac pacemaker
  • Having excessive pain in any joint of the lower limb (numerical pain rating score > 4/10)
  • Having an open wound or wound infraction on scalp
  • Having neglect or psychological diseases (such as schizophrenia, major depression)

Treatment and study plan

Transcranial Direct Current Stimulation

Device

Cathodal/Anodal tDCS will be applied in 1.5 mA, 20 mins before conventional physical therapy for 5 days. All experiments will be performed in random order for each subject.

Primary outcomes

  1. Fugl-Meyer Assessment

    Time frame: 20 minutes

    gold standard and widely used tool to assess sensorimotor in stroke. The item from upper limb and lower limb section will be used. The items are rated on a 3-point ordinal scale as follows: 0 = unable to perform; 1 = partial ability to perform; and 2 = near normal ability to perform.

  2. Wolf Motor Function Test

    Time frame: 5 minutes

    The participants will be asked to perform 2 items that consist of reaching a can and reaching a pen because two tasks is the most common reaching task of hand functions in daily living activities.

  3. Five Times Sit to Stand Test

    Time frame: 5 minutes

    Subjects will sits on the chair and place their back against the chair. Timing will begin at "GO", the subjects will be asked to walk 3m, turn, walk back, and sit down. The stopwatch stops when the patient's buttocks touch the seat.

  4. Time-up and go test

    Time frame: 5 minutes

    The TUG test is a commonly used screening tool to measure basic mobility correlating to dynamic balance. Start from sitting, stand up, walk 3 meters, turn around, walk back 3 meters and sit down. Timed to complete the task represent the body transfer and gait performance

  5. Muscle strength

    Time frame: 10 minutes

    The strength of UE (shoulder flexor, shoulder extensor, elbow extensor, wrist extensor) and LE (hip extensor, hip flexor, knee extensor and ankle dorsiflexor) will be assessed by hand-held dynamometer

Secondary outcomes

  1. Hemodynamic response (VMR%)

    Time frame: 15 minutes

    cerebral blood flow velocity (CBFV), cerebral vasomotor reactivity (VMR) that is the capability of cerebral small vessels to respond to a stimulus

Sponsors and collaborators

Lead sponsor

Mahidol University

Other

Registry information

Official study title

The Effects of Anodal and Cathodal Transcranial Direct Current Stimulation Combined With Conventional Physical Therapy in Patients With Acute Stroke

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Oct 6, 2020
Registry last updated
Jul 7, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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