Vagal Stimulation in Individuals With Stroke

September 15, 2026 updated by: Nermin KART

Effects of Manual Vagus Nerve Stimulation on Motor, Autonomic, and Cognitive Functions in Individuals With Stroke

The aim of this study is to investigate the effects of manual vagus nerve stimulation (VNS) on motor, autonomic, and cognitive functions in individuals with chronic stroke. Additionally, researchers will assess the safety of this treatment. The primary research questions that this study aims to address are as follows:

Does manual vagus nerve stimulation improve motor function in individuals with chronic stroke? Does manual vagus nerve stimulation influence autonomic functions in individuals with chronic stroke? Does manual vagus nerve stimulation accelerate cognitive recovery in individuals with chronic stroke? Researchers will compare the effects of manual vagus nerve stimulation with a standard rehabilitation program.

Participants in the experimental group will receive manual vagus nerve stimulation three times a week for eight weeks, in addition to the standard rehabilitation program. Participants in the control group will receive only the standard rehabilitation program.

Each participant will:

Attend clinical assessments and evaluation tests. Have their motor skills, autonomic function, and cognitive status recorded at the beginning of the treatment and at the end of the eight-week intervention period.

This study will contribute to a better understanding of the potential of manual vagus nerve stimulation as a novel therapeutic approach for individuals with stroke.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

34

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

    • Şanlıurfa
      • Sanliurfa, Şanlıurfa, Turkey (Türkiye), 63200
        • Nermin Kart

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

No

Description

Inclusion Criteria:

  • Having experienced an ischemic or hemorrhagic stroke
  • Diagnosed with stroke at least six months prior
  • No history of multiple stroke episodes
  • No communication impairments
  • Ability to read and write

Exclusion Criteria:

  • Presence of hearing loss
  • Receiving additional treatment alongside rehabilitation
  • Cardiopulmonary disease
  • Gastrointestinal disease
  • History of a recent trauma
  • Presence of neurological disorders other than stroke
  • Presence of psychological disorders
  • History of a condition that could have previously affected cognitive function

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: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: study group
The participants in the study group consist of individuals with chronic stroke. In addition to the standard rehabilitation program, these individuals will receive manual vagus nerve stimulation (mVNS) as part of the intervention.

Manual Vagus Nerve Stimulation (mVNS)

Manual vagus nerve stimulation (mVNS) is a non-invasive, accessible, and cost-effective alternative to electrical vagus nerve stimulation (VNS). Unlike invasive methods, mVNS targets key vagal pathways through manual techniques that aim to modulate autonomic function, enhance neuroplasticity, and promote recovery.

This study applies mVNS twice a week for eight weeks, using the following techniques:

Suboccipital Inhibition Technique: Both hands are placed under the occiput, applying deep, gliding, and progressive pressure for 10 minutes to relax suboccipital muscles.

Fourth Ventricle Technique: Hands are positioned under the occiput, applying cephalic traction for 10 minutes to aid autonomic nervous system balance.

Diaphragm Release: Hands are placed bilaterally on the anterior lower ribs, applying gentle traction during inspiration and pressure during expiration.

Carotid Sinus Massage: Mechanical pressure is applied above the thyroid cartilag

Other Names:
  • manual vagus nerve stimulation

Passive and Active Joint Movements: Applied to maintain joint range of motion and prevent contractures.

Muscle Strengthening Exercises: Isometric, isotonic, and resistance exercises are used to strengthen weakened muscle groups.

Balance and Gait Training: Supported by proprioceptive exercises and weight-shifting techniques.

Active Comparator: control group
Individuals in this group, consisting of chronic stroke patients, will receive only the standard rehabilitation program without any additional interventions.

Passive and Active Joint Movements: Applied to maintain joint range of motion and prevent contractures.

Muscle Strengthening Exercises: Isometric, isotonic, and resistance exercises are used to strengthen weakened muscle groups.

Balance and Gait Training: Supported by proprioceptive exercises and weight-shifting techniques.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Fugl-Meyer Motor Assessment Total Score
Time Frame: Baseline and Week 8
Motor function will be assessed using the Fugl-Meyer Motor Assessment (FMA). The scale evaluates motor recovery of the upper and lower extremities in individuals with stroke. Total scores range from 0 to 100, with higher scores indicating better motor function.
Baseline and Week 8

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Standardized Mini-Mental State Examination Score
Time Frame: Baseline and Week 8
Cognitive function will be assessed using the Standardized Mini-Mental State Examination (SMMSE). The total score ranges from 0 to 30, with higher scores indicating better cognitive function.
Baseline and Week 8
4-Meter Walk Test Speed
Time Frame: Baseline and Week 8
Walking speed will be assessed using the 4-Meter Walk Test (4MWT). Participants will be instructed to walk a distance of 4 meters, and walking speed will be calculated in meters per second (m/s). Higher walking speed values indicate better walking performance.
Baseline and Week 8
Constipation Severity Scale Score
Time Frame: Baseline and Week 8
Constipation severity will be assessed using the Constipation Severity Scale (CSS). The total score ranges from 0 to 73, with higher scores indicating greater severity of constipation symptoms and therefore a worse outcome.
Baseline and Week 8
Heart Rate
Time Frame: Baseline and Week 8
Baseline and Week 8
Systolic Blood Pressure
Time Frame: Baseline and Week 8
Baseline and Week 8
Diastolic Blood Pressure
Time Frame: Baseline and Week 8
Baseline and Week 8
Oxygen Saturation
Time Frame: Baseline and Week 8
Baseline and Week 8

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)

February 25, 2025

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

January 1, 2027

Study Registration Dates

First Submitted

March 12, 2025

First Submitted That Met QC Criteria

September 15, 2026

First Posted (Actual)

September 16, 2026

Study Record Updates

Last Update Posted (Actual)

September 16, 2026

Last Update Submitted That Met QC Criteria

September 15, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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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