- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04577287
The Effects of Anodal and Cathodal tDCS Combined With Conventional Physical Therapy in Patients With Acute Stroke
July 3, 2022 updated by: Mahidol University
The Effects of Anodal and Cathodal Transcranial Direct Current Stimulation 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.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
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.
Study Type
Interventional
Enrollment (Actual)
36
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Nakonpathom
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Salaya, Nakonpathom, Thailand, 73170
- Faculty ofPhysical Therapy, Mahidol University
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
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)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Cathodal tDCS & PT
Cathodal transcranial direct current stimulation (tDCS) will be applied for 20 mins before conventional physical therapy (about 1 hour).
Cathode on the on the motor area (M1) of the affected hemisphere, anode on the supraorbital area of the unaffect hemisphere.Current intensity is fixed at 1.5 mA and current will flow continuously.
Physical therapist will give an intervention program base on the same basic conventional physical therapy treatment.
The scope of intervention is administered to improve motor functions and cerebral hemodynamic .
|
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.
|
Experimental: Anodal-tDCS & PT
Anodal transcranial direct current stimulation (tDCS) will be applied for 20 mins before conventional physical therapy (about 1 hours).
Anode on the motor are (M1) of the affected hemisphere, and cathodal on the supraorbital area of unaffected hemisphere.
Current intensity is fixed at 1.5 mA and current will flow continuously.
Physical therapist will give an intervention program base on the same basic conventional physical therapy treatment.
The scope of intervention is administered to improve motor functions and cerebral hemodynamic .
|
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.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
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.
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20 minutes
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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.
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5 minutes
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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.
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5 minutes
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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
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5 minutes
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Muscle strength
Time Frame: 10 minutes
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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
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10 minutes
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
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
|
15 minutes
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
October 1, 2020
Primary Completion (Actual)
December 1, 2021
Study Completion (Actual)
December 1, 2021
Study Registration Dates
First Submitted
October 1, 2020
First Submitted That Met QC Criteria
October 1, 2020
First Posted (Actual)
October 6, 2020
Study Record Updates
Last Update Posted (Actual)
July 7, 2022
Last Update Submitted That Met QC Criteria
July 3, 2022
Last Verified
July 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SI-2842019
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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