NCT03666533

Brief Summary

Stroke affects upwards of 800,000 Americans every year and has an enormous impact on the well-being of the American Veteran population with 6,000 new stroke admissions every year. Many of these stroke survivors are living with walking disabilities. Gait problems result in inability to function independently, high risk of falls and poor quality of life. Unfortunately, current gait rehabilitation treatments are limited and many stroke survivors do not achieve full recovery. Therefore, it is critical to develop new approaches to enhance gait rehabilitation methods. The investigators propose to evaluate a brain stimulation treatment called transcranial Direct Current Stimulation (tDCS) that can be added to physical therapy. tDCS has been applied for arm rehabilitation after stroke with positive results, but gait-related investigations are lacking. The investigators will test whether simultaneous tDCS and gait training produces greater improvement in walking abilities than gait training alone. Adjunct tDCS therapy may improve outcomes, and reduce cost of both rehabilitation and post-stroke care.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
44

participants targeted

Target at P50-P75 for not_applicable stroke

Timeline
Completed

Started Sep 2018

Longer than P75 for not_applicable stroke

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 4, 2018

Completed
7 days until next milestone

First Posted

Study publicly available on registry

September 11, 2018

Completed
2 days until next milestone

Study Start

First participant enrolled

September 13, 2018

Completed
5.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 29, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 29, 2024

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

June 10, 2025

Completed
Last Updated

September 16, 2025

Status Verified

August 1, 2025

Enrollment Period

5.5 years

First QC Date

September 4, 2018

Results QC Date

March 17, 2025

Last Update Submit

August 28, 2025

Conditions

Keywords

Gait therapytranscranial Direct Current Stimulation (tDCS)Neuroplasticitywalking abilitybrain stimulationvirtual reality

Outcome Measures

Primary Outcomes (1)

  • Change in Gait Speed From Baseline (Meters/Second)

    Gait speed will be calculated based on Ten Meter Walk Test

    baseline to post treatment (after 5 weeks of treatment)

Secondary Outcomes (5)

  • Change From Baseline to Post Treatment on Timed up and go (Seconds)

    baseline to post treatment (after 5 weeks of treatment)

  • Change From Baseline to Post Treatment in Functional Gait Assessment (Points)

    baseline to post treatment (after 5 weeks of treatment)

  • Change From Baseline to Post Treatment on Fugl Meyer Lower Limb

    baseline to post treatment (after 5 weeks of treatment)

  • Change From Baseline to Post Treatment on Gait Assessment and Intervention Tool

    baseline to post treatment (after 5 weeks of treatment)

  • Change in Asymmetry of Tibialis Anterior Muscle Motor Evoked Potentials From Baseline

    baseline to after 5 weeks of treatment

Study Arms (2)

Active tDCS

ACTIVE COMPARATOR

active tDCS plus gait training

Other: Active transcranial Direct Current Stimulation

Sham tDCS

SHAM COMPARATOR

sham tDCS plus gait training

Other: Sham transcranial Direct Current Stimulation

Interventions

Active tDCS is combined with gait therapy. Gait therapy includes gait task practice in Virtual Reality setting and overground gait therapy

Also known as: tDCS
Active tDCS

Sham tDCS is combined with gait therapy. Gait therapy includes gait task practice in Virtual Reality setting and overground gait therapy

Also known as: Sham tDCS
Sham tDCS

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Medically and psychologically stable and at least 6 months after first ever unilateral stroke
  • Cognition sufficiently intact to give valid informed consent to participate
  • FMLE score \>15; and ability to actively dorsiflex the paretic ankle in synergy (FMLE item II Flexor synergy-ankle dorsiflexion score 1).
  • Sufficient endurance to participate in the study

You may not qualify if:

  • Activity tolerance is insufficient to complete treadmill training
  • Inability to produce a trace contraction of ankle dorsiflexors in synergy
  • Normal ankle dorsiflexion/knee flexion on FMLE standing items (FMLE item IV score=4)
  • Stroke affecting both sides
  • Contraindications for rTMS according to the most recent TMS-use guidelines
  • Contraindications for MRI
  • Inability to understand English

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Louis Stokes VA Medical Center, Cleveland, OH

Cleveland, Ohio, 44106-1702, United States

Location

Related Publications (1)

  • Pundik S, Skelly MM, McCabe JP, Salameh AI, Anderson T, Duncan KR, Hisel T, Carr SJA. Resting-State Functional Connectivity of Sensorimotor and Default Mode Networks and Lower Limb Performance in Chronic Stroke: A Cross-Sectional Study. Brain Behav. 2025 May;15(5):e70519. doi: 10.1002/brb3.70519.

MeSH Terms

Conditions

Stroke

Interventions

Transcranial Direct Current Stimulation

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

Electric Stimulation TherapyTherapeuticsConvulsive TherapyPsychiatric Somatic TherapiesBehavioral Disciplines and ActivitiesElectroshockPsychological Techniques

Results Point of Contact

Title
Dr. Svetlana Pundik
Organization
Department of Veterans Affairs Northeast Ohio Healthcare system

Study Officials

  • Svetlana Pundik, MD

    Louis Stokes VA Medical Center, Cleveland, OH

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: transcranial Direct Current Stimulation
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 4, 2018

First Posted

September 11, 2018

Study Start

September 13, 2018

Primary Completion

March 29, 2024

Study Completion

March 29, 2024

Last Updated

September 16, 2025

Results First Posted

June 10, 2025

Record last verified: 2025-08

Data Sharing

IPD Sharing
Will share
Shared Documents
STUDY PROTOCOL, CSR

Locations