Studying Fatigue and Movement After Stroke

May 18, 2026 updated by: Vrije Universiteit Brussel

Exploring Neuromuscular Fatigue in Stroke Survivors: Understanding Central-Peripheral Interaction

The goal of this observational study is to learn how neuromuscular fatigue develops after stroke and how changes in brain activity, muscle activity, and their interaction contribute to reduced motor performance in stroke survivors compared to healthy individuals. The study will include adults with a first-ever stroke in the subacute phase and age-matched healthy volunteers.

The main questions it aims to answer are:

  • How does neuromuscular fatigue develop during repeated muscle contractions after stroke compared to healthy individuals?
  • How do brain activity, muscle activity, and brain-muscle interaction change during fatigue after stroke?

Researchers will compare stroke participants and healthy control participants to determine whether fatigue-related changes are more strongly associated with altered brain activity, altered muscle activity, or disrupted brain-muscle communication after stroke.

Participants will:

  • Perform repeated leg muscle contractions until fatigue while seated in an experimental setup
  • Wear non-invasive sensors to record brain activity (EEG) and muscle activity (EMG) during the task
  • Complete the study during a single experimental session in which fatigue-related changes will be measured throughout the task

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Stroke is a leading cause of long-term disability worldwide. Although many stroke survivors can initiate movement, sustaining motor performance during everyday activities often becomes progressively difficult, suggesting abnormal development of neuromuscular fatigue. Neuromuscular fatigue, defined as an exercise-induced reduction in force-generating capacity, arises through interactions between central neural and peripheral muscular mechanisms. However, despite extensive investigation in healthy populations, the neurophysiological mechanisms underlying neuromuscular fatigue after stroke remain poorly understood. Existing studies have focused predominantly on peripheral manifestations of fatigue, with limited investigation of cortical oscillatory dynamics and brain-muscle communication. Here, we propose a multimodal neurophysiological study combining electroencephalography (EEG), electromyography (EMG), and corticomuscular coherence analyses to determine whether fatigability after stroke is driven predominantly by altered central neural processes rather than peripheral muscle failure. Stroke survivors and age-matched healthy controls will perform sustained isometric contractions while neural and muscular activity are recorded across progressive fatigue stages. We hypothesize that stroke survivors will exhibit earlier and greater fatigability, accompanied by altered cortical oscillatory activity, peripheral muscular changes, and disrupted corticomuscular coherence, consistent with a predominant contribution of central oscillatory dysfunction.

Study Type

Observational

Enrollment (Estimated)

120

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Stroke survivors will be recruited from Brussels University Hospital (Brussels, Belgium). Healthy, age-matched controls will be recruited through our research group's network and residential care homes in Belgium.

Description

Inclusion Criteria:

Stroke survivors will be recruited from Brussels University Hospital (Brussels, Belgium). Patients who have a first-ever stroke, ≥18 years, subacute phase: 1 week to 6 months post-stroke, quadriceps (hemiplegic side) strength ≤3/5 (Medical Research Council (MRC)), and Montreal Cognitive Assessment (MoCA) ≥21 will be included.

Exclusion Criteria:

Exclusion criteria include a history of a previous stroke, severe spasticity (Modified Ashworth Scale (MAS) 3-4 in quadriceps/hamstrings), other neurological, motor, musculoskeletal, or orthopedic conditions affecting trunk stability and lower limb mobility, non-cerebral strokes (e.g., brainstem, cerebellar), or dementia (MoCA ≤20), and current or former athletes. Athletes are defined as individuals who participated in organized competitive sports and engaged in structured training ≥3 sessions per week for ≥1 year within the 5 years preceding stroke. Control participants will be excluded if they meet the same exclusion criteria.

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

Cohorts and Interventions

Group / Cohort
Subacute stroke
Stroke survivors will be recruited from Brussels University Hospital (Brussels, Belgium). Patients who have a first-ever stroke, ≥18 years, subacute phase: 1 week to 6 months post-stroke, quadriceps (hemiplegic side) strength ≤3/5 (Medical Research Council (MRC)), and Montreal Cognitive Assessment (MoCA) ≥21 will be included. Exclusion criteria include a history of a previous stroke, severe spasticity (Modified Ashworth Scale (MAS) 3-4 in quadriceps/hamstrings), other neurological, motor, musculoskeletal, or orthopedic conditions affecting trunk stability and lower limb mobility, non-cerebral strokes (e.g., brainstem, cerebellar), or dementia (MoCA ≤20), and current or former athletes.
Healthy participants
Healthy age-matched controls ≥18 years and Montreal Cognitive Assessment (MoCA) ≥21 will be included. Exclusion criteria include other neurological, motor, musculoskeletal, or orthopedic conditions affecting trunk stability and lower limb mobility, non-cerebral strokes (e.g., brainstem, cerebellar), or dementia (MoCA ≤20), and current or former athletes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Absolute and relative spectral power and ERD/ERS magnitude
Time Frame: Outcome measure will be recorded at baseline and throughout the fatiguing contractions in the single experimental session (up to 40 minutes) and compared over 4 fatigue phases.
Fatigue-related changes in sensorimotor cortical activity will be assessed using EEG-derived absolute and relative spectral power in the mu (8-12 Hz), beta (13-30/35 Hz), and gamma (30/35-100 Hz) frequency bands, as well as changes in event-related desynchronization/event-related synchronization (ERD/ERS) magnitude over time. Measurements will be obtained at pre-fatigue baseline and continuously during the fatiguing task, with data segmented into contraction epochs and grouped into four fatigue phases for analysis.
Outcome measure will be recorded at baseline and throughout the fatiguing contractions in the single experimental session (up to 40 minutes) and compared over 4 fatigue phases.
EMG median frequency
Time Frame: Outcome measure will be recorded throughout the fatiguing contractions in the single experimental session (up to 40 minutes) and compared over 4 fatigue phases.
Peripheral manifestations of fatigue will be assessed using shifts in EMG median frequency during repeated contractions. Data will be recorded continuously during the task and analyzed across contraction epochs grouped into four fatigue phases.
Outcome measure will be recorded throughout the fatiguing contractions in the single experimental session (up to 40 minutes) and compared over 4 fatigue phases.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Corticomuscular coherence
Time Frame: Outcome measure will be recorded throughout the fatiguing contractions in the single experimental session (up to 40 minutes) and compared over 4 fatigue phases.
The interaction between cortical and muscular activity will be assessed using CMC, which quantifies synchronization between EEG and EMG signals. Corticomuscular coherence will be assessed from simultaneous EEG and EMG recordings during repeated contractions and analyzed across contraction epochs grouped into four fatigue phases.
Outcome measure will be recorded throughout the fatiguing contractions in the single experimental session (up to 40 minutes) and compared over 4 fatigue phases.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Vrije Universiteit Brussel

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 (Estimated)

September 1, 2026

Primary Completion (Estimated)

October 31, 2029

Study Completion (Estimated)

October 31, 2029

Study Registration Dates

First Submitted

May 11, 2026

First Submitted That Met QC Criteria

May 18, 2026

First Posted (Actual)

May 19, 2026

Study Record Updates

Last Update Posted (Actual)

May 19, 2026

Last Update Submitted That Met QC Criteria

May 18, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NMF_STROKE_FWO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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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