Gentle brain stimulation plus Nordic walking for better walking and balance in Parkinson's
Effects of Transcranial Direct Current Stimulation Over the Supplementary Motor Area Combined With Nordic Walking on Gait and Balance in Parkinson's Disease
This trial will test whether adding a gentle, non-invasive brain stimulation (tDCS) during supervised Nordic walking helps people with Parkinson's walk faster and steadier.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 40 (estimated) |
| Ages | 50 Years to 75 Years |
| Sex | All |
| Sponsor | Universidade Metodista de Piracicaba Academic / other |
| Locations | 1 site (Belém, Pará) |
| Trial ID | NCT07381907 on ClinicalTrials.gov |
What this trial studies
People with Parkinson's who can walk at least 10 meters are randomized to receive either active anodal tDCS over the supplementary motor area or a sham procedure while completing a supervised Nordic Walking program three times per week for four weeks. tDCS is applied concurrently with gait training to prime motor networks during practice, and the primary outcome is walking speed on the 10-Meter Walk Test measured at post-intervention and at a one-month follow-up. Secondary outcomes include balance, motor signs, Parkinson's-specific quality of life, and safety/tolerability. The trial is double-blind, single-center, and conducted at a university outpatient neurorehabilitation facility in Belém, Pará, Brazil.
Who should consider this trial
Good fit: Ideal candidates are people with idiopathic Parkinson's (Hoehn & Yahr II–IV) who have a slowed gait (e.g., ≥6 seconds on the 10-Meter Walk), can walk at least 10 meters with or without a cane/poles, have stable Parkinson's medications, and can follow simple commands (MMSE ≥24).
Not a fit: Patients with implanted cranial devices (e.g., DBS), recent seizures or uncontrolled epilepsy, active skin lesions at electrode sites, severe uncontrolled medical or psychiatric conditions, significant cognitive impairment, or those unable to walk 10 meters without hands-on assistance are unlikely to benefit or be eligible.
Why it matters
Potential benefit: If successful, combining tDCS with Nordic walking could help people with Parkinson's walk faster and reduce balance problems more than walking training alone.
How similar studies have performed: Previous small trials have reported motor and gait improvements with SMA-targeted tDCS or gait training alone, but delivering tDCS concurrently with Nordic walking is a relatively novel approach with limited prior evidence.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Idiopathic Parkinson's disease (e.g., UK Brain Bank criteria) * Hoehn \& Yahr stage II-IV (on medication) * Stable antiparkinsonian medication for ≥4 weeks before enrollment * Slowed gait phenotype (e.g., ≥6 seconds on 10-Meter Walk at preferred speed) * Able to ambulate at least 10 meters with or without a cane/poles (no hands-on assistance from a therapist) * Able to follow simple commands; provides written informed consent (MMSE ≥24 or equivalent cognitive screening) * Willing to maintain stable PD medication and usual care during the 4-week intervention, unless medically required Exclusion Criteria: * Contraindications to tDCS: implanted cranial/brain devices (e.g., DBS), metal in the skull (excluding dental), active skin disease/lesions at electrode sites, uncontrolled epilepsy or history of seizure in the past 12 months * Unstable medical or psychiatric conditions that preclude safe participation (e.g., uncontrolled hypertension, recent cardiovascular events, severe orthostatic hypotension with syncope) * Severe freezing of gait or fall risk that prevents safe participation in supervised Nordic Walking, as judged by the clinical team * Severe musculoskeletal or vestibular disorders that limit walking with poles; severe uncorrected visual impairment * Cognitive impairment incompatible with consent or testing (e.g., MMSE \<24) * Current participation in other interventional trials targeting gait/balance or brain stimulation; recent initiation or dose change of antiparkinsonian medication within 4 weeks.
Where this trial is running
Belém, Pará
- UEAFTO - Unidade de Fisioterapia e Terapia Ocupacional — Belém, Pará, Brazil (Recruiting)
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.