Brain stimulation plus watching hand movements to improve hand recovery after chronic stroke
Investigating The Neurophysiological Mechanisms Of Transcranial Direct Current Stimulation Combined With Action Observation Therapy On Hand Muscle Neuroplasticity in Chronic Stroke
This project will test whether combining gentle brain stimulation with watching and practicing hand movements helps adults 6–24 months after stroke improve hand function.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 60 (estimated) |
| Ages | 18 Years to 59 Years |
| Sex | All |
| Sponsor | Universiti Malaysia Sabah Academic / other |
| Locations | 2 sites (Kota Kinabalu, Sabah and 1 other locations) |
| Trial ID | NCT07400939 on ClinicalTrials.gov |
What this trial studies
Participants will receive ten sessions of anodal transcranial direct current stimulation (tDCS) over the affected motor cortex combined with supervised action observation therapy (AOT) in clinic over two weeks, followed by eight weeks of daily home-based AOT practice. Two control groups receive either tDCS with a landscape video or AOT with placebo tDCS on the same schedule, allowing comparison of the combined approach to each therapy alone. Neurophysiological changes will be tracked using motor evoked potentials (MEPs) to measure corticospinal excitability and standard clinical tests will measure hand function. Total participation lasts about ten weeks including baseline and follow-up assessments.
Who should consider this trial
Good fit: Adults aged 18–59 with a single unilateral stroke 6–24 months ago who have hand weakness but only mild or less upper-limb spasticity and can follow commands are ideal candidates.
Not a fit: Patients with posterior circulation strokes, severe cognitive impairment, unilateral neglect, homonymous hemianopia, other neurological conditions affecting the hand, or near-normal/very weak (grade 4–5) hand strength are unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, the combined approach could improve corticospinal excitability and translate into better hand function and everyday use for people with chronic stroke.
How similar studies have performed: Previous studies have shown modest benefits from tDCS or action observation therapy alone, but combining them is relatively novel and not yet proven to be superior.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults aged 18 to 59 years * Single episode of unilateral stroke and weakness in hand muscles 6 to 24 months post-stroke * No excessive spasticity of the upper limb, defined as grade two or less on Modified Ashworth Scale Exclusion Criteria: * Patients diagnosed with posterior circulation infarction * Unable to follow commands due to poor cognitive function * Unilateral neglect * Homonymous hemianopia * Other existing neurological disorders that lead to poor hand function * Grade four or five hand muscle strength.
Where this trial is running
Kota Kinabalu, Sabah and 1 other locations
- Hospital Universiti Malaysia Sabah (HUMS) — Kota Kinabalu, Sabah, Malaysia (Recruiting)
- Queen Elizabeth Hospital — Kota Kinabalu, Sabah, Malaysia (Enrolling_by_invitation)
Study contacts
- Principal investigator: Fatimah Ahmedy — Universit Malaysia Sabah
- Study coordinator: Candace Goh Xiao Huey, Msc.
- Email: candace@moh.gov.my
- Phone: +60-162316345
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.