Mechanized Gait Trainer Combine Transcranial Galvanic Stimulation (tDCS) in Chronic Stroke

NCT ID: NCT01040299

Last Updated: 2012-03-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-07-31

Study Completion Date

2010-10-31

Brief Summary

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Transcranial galvanic stimulation (tDCS), seems to promote motor recovery after stroke by stimulating (anodal) or inhibiting (cathodal) neural circuits in the brain. In the treatment of severe lower limb paresis after stroke, the GangTrainer GT1 (GT) proved to be effective, but nevertheless only a few patients could use their affect lower limb functionally in daily life on deambulation after robot training. Therefore the present study intends to combine both approaches, tDCS + GT, apply at the same time every day for two weeks in order to improve the effectiveness of GangTrainer therapy in the gait rehabilitation.

Detailed Description

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Transcranial galvanic stimulation (tDCS), seems to promote motor recovery after stroke by stimulating (anodal) or inhibiting (cathodal) neural circuits in the brain. In the treatment of severe lower limb paresis after stroke, the GangTrainer GT1 (GT) proved to be effective. Therefore the present study intends to combine both approaches, tDCS + GT, apply at the same time every day for two weeks in order to improve the effectiveness of GangTrainer therapy in the gait rehabilitation. The rehabilitation programme are compose 3 kinds of locomotor training interventions (experimental group, control group 1 and control group 2).

During intervention experimental group, patients receive a total of 10 treatments of repetitive locomotor training with electromechanical gait device (duration 30 min) + tDCS (duration first 7 min) with the anodal electrode is place over the presumed lower limb area of the lesioned hemisphere, and the cathodal electrode is place above the controlateral orbital. The anodal stimulation is expected to facilitate the activity of the lower limb motor area side directly, while the cathodal stimulation of the non-lesioned hemisphere is expected to facilitate the lesioned side indirectly by decreasing inhibitory inputs. The control group 1 receive a total of 10 treatments with only GT (duration 30 min) with sham-stimulation, and the control group 2 receive a total of 10 treatments with convectional physiotherapy

Conditions

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Hemiparesis Cerebrovascular Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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GangTrainer and tDCS

The experimental group patients receive a total of 10 treatments of repetitive locomotor training with electromechanical gait device (duration 30 min) + tDCS (duration first 7 min) with the anodal electrode is place over the presumed lower limb area of the lesioned hemisphere, and the cathodal electrode is place above the controlateral orbital.

Group Type EXPERIMENTAL

GangTrainer and tDCS

Intervention Type DEVICE

The experimental group patients receive a total of 10 treatments of repetitive locomotor training with electromechanical gait device (duration 30 min) + tDCS (duration first 7 min) with the anodal electrode is place over the presumed lower limb area of the lesioned hemisphere, and the cathodal electrode is place above the controlateral orbital.

control group1

The control group 1 receive a total of 10 treatments with only GT (duration 30 min) with sham-stimulation.

Group Type SHAM_COMPARATOR

control group1

Intervention Type DEVICE

The control group 1 receive a total of 10 treatments with only GT (duration 30 min) with sham-stimulation.

control group2

The control group 2 receive a total of 10 treatments with convectional physiotherapy.

Group Type ACTIVE_COMPARATOR

Control group2

Intervention Type OTHER

The control group 2 receive a total of 10 treatments with convectional physiotherapy.

Interventions

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GangTrainer and tDCS

The experimental group patients receive a total of 10 treatments of repetitive locomotor training with electromechanical gait device (duration 30 min) + tDCS (duration first 7 min) with the anodal electrode is place over the presumed lower limb area of the lesioned hemisphere, and the cathodal electrode is place above the controlateral orbital.

Intervention Type DEVICE

control group1

The control group 1 receive a total of 10 treatments with only GT (duration 30 min) with sham-stimulation.

Intervention Type DEVICE

Control group2

The control group 2 receive a total of 10 treatments with convectional physiotherapy.

Intervention Type OTHER

Other Intervention Names

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GangTrainerGT1 convectional physiotherapy

Eligibility Criteria

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Inclusion Criteria

* European Stroke scale between 75-85
* First time supratentorial, ischaemic or hemorrhagic stroke.
* Diagnosis of ischemic brain injury or intracerebral hemorrhage by MRI or computed tomography \> 6 months after the onset of stroke.
* Age \< 80 years.
* Ability to stand upright, supported or unsupported, for 1 minute.
* Patients with ischaemic or haemorrhagic stroke.
* In-patient participating in a comprehensive rehabilitation programme.
* patients written informed consent of participation in the study approved by the local ethical committee.
* absence of cardiac, psychological and orthopedic conditions that might interfere with the result.

Exclusion Criteria

* Preceding epileptic fits.
* an EEG suspect of elevated cortical excitability.
* a sensitive scalp skin.
* severe cognitive impairment.
* metallic implants within the brain.
* previous brain neurosurgery.
* medications altering the level of cortical excitability
* medications with a presumed positive or negative effect on brain plasticity.
Minimum Eligible Age

20 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universita di Verona

OTHER

Sponsor Role lead

Responsible Party

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Nicola Smania, MD

professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nicola Smania Nicola Smania, Doctor

Role: PRINCIPAL_INVESTIGATOR

Locations

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Azienta Ospedaliera, SSO Rehabilitation Unit, Verona

Verona, Italy, Verona, Italy

Site Status

Countries

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Italy

References

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Hesse S, Werner C, Schonhardt EM, Bardeleben A, Jenrich W, Kirker SG. Combined transcranial direct current stimulation and robot-assisted arm training in subacute stroke patients: a pilot study. Restor Neurol Neurosci. 2007;25(1):9-15.

Reference Type BACKGROUND
PMID: 17473391 (View on PubMed)

Pohl M, Werner C, Holzgraefe M, Kroczek G, Mehrholz J, Wingendorf I, Hoolig G, Koch R, Hesse S. Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: a single-blind, randomized multicentre trial (DEutsche GAngtrainerStudie, DEGAS). Clin Rehabil. 2007 Jan;21(1):17-27. doi: 10.1177/0269215506071281.

Reference Type RESULT
PMID: 17213237 (View on PubMed)

Dias D, Lains J, Pereira A, Nunes R, Caldas J, Amaral C, Pires S, Costa A, Alves P, Moreira M, Garrido N, Loureiro L. Can we improve gait skills in chronic hemiplegics? A randomised control trial with gait trainer. Eura Medicophys. 2007 Dec;43(4):499-504.

Reference Type RESULT
PMID: 18084173 (View on PubMed)

Other Identifiers

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GT-1-tDCS

Identifier Type: -

Identifier Source: org_study_id

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