Effect of Brain Stimulation on Stepping Performance in Stroke Survivors and Healthy Adults (Gait)
Vascular Accident, Brain, CVA (Cerebrovascular Accident), Gait, Hemiplegic
About this trial
This is an interventional treatment trial for Vascular Accident, Brain
Eligibility Criteria
Inclusion Criteria:
- Healthy adults have no ongoing neurological, musculoskeletal issues.
- Individuals with chronic stroke had medical history of a unilateral stroke occurring ≥ 6 months prior to enrollment. MRI or CT evidence from the imaging report shown that the stroke involves the corticospinal tract.
- Individuals with chronic stroke have hemiparesis involving the lower extremity.
- Individuals with chronic stroke have no passive range of motion limitation in bilateral hips and knees. Limitation of ankle passive range of motion to 10 degrees of dorsiflexion or ess.
- Visual acuity can be corrected by glasses or contact lens to 20/20.
- Able to walk independently with/without assistant devices for 10 meters.
- Able to maintain standing position without any assistance for more than 30 sec.
- Evaluation of cognitive status: Mini-mental status examination (MMSE) score ≥ 24.
Exclusion Criteria:
- Pregnant women.
- MRI or CT evidence of involvement of the basal ganglia or cerebellum, evidence of multiple lesions, or evidence of any other brain damage or malignant neoplasm or tumors.
- Have any metal implants, cardiac pacemakers, or history of seizures.
- Ongoing orthopedic or other neuromuscular disorders that will restrict exercise training.
- Any vestibular dysfunction or unstable angina.
- Significant cognitive deficits (inability to follow a 2-step command) or severe receptive or global aphasia*
Sites / Locations
- Texas Woman's UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Sham Comparator
Brain stimulation-induced improvements in leg skill learning
Effects of brain stimulation on functional improvements
Effects of brain stimulation combined with stepping training
To examine the degree of stimulation-induced improvements in learning capacity between three groups: stroke group, healthy young group, and healthy older group. Up to date, most studies have investigated the effects of brain stimulation on hand skill improvements in healthy young adults; little is known about stimulation-induced improvement in the "leg" skill improvement in stroke survivors as well as in older healthy adults. The investigators will answer the question: "Do stroke survivors improve leg skill learning at a comparable rate as healthy young and older adults after brain stimulation "transcranial direct current stimulation" (tDCS)?"
To determine the effect of brain stimulation (tDCS) on functional improvements in stroke survivors. Specifically, the investigators will compare stepping reaction time, cortical neuronal activity, peripheral nerve activity, and walking function in the stroke survivors before and after tDCS, and also compared these findings with results from healthy adults. The investigators will answer the question: "Do stroke survivors shorten stepping reaction time and improve leg muscle activation and gait performance after tDCS, and these improvements are at a similar rate as compared to data collected from healthy young and older adults?"
After enrolling to the study, participants with chronic stroke will be randomly assigned to one of two groups: anodal tDCS or sham tDCS groups. All subjects will then undergo a total of twelve training sessions over four weeks in which subjects will learn a novel visuomotor stepping task immediately after visuomotor learning training while 20-minute tDCS (anodal or sham stimulation) is delivered over the leg area of primary motor cortex.The investigators will measure changes in brain neuronal activity, peripheral nerve activity, and walking performance before and after a 12-session training program, and will follow up one week later.