Improving hand motor control in stroke patients using brain and electrical stimulation

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This pilot study focuses on stroke patients with chronic upper limb hemiplegia and aims to evaluate the effects of non-invasive brain stimulation combined with functional electrical stimulation on hand motor control and corticospinal excitability. The study will specifically investigate the timing and delivery of transcranial direct current stimulation (tDCS) alongside contralaterally controlled electrical stimulation. Participants will undergo assessments to determine their eligibility based on specific motor function criteria and will receive targeted interventions to enhance their rehabilitation outcomes.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age ≥ 21
2. ≥ 6 months since first clinical hemorrhagic or nonhemorrhagic stroke
3. Able to follow 3-stage commands and remember 2 of 3 items after 30 minutes
4. Full volitional elbow extension/flexion and hand opening/closing of unaffected limb
5. Adequate active movement of shoulder and elbow to position the paretic hand in the workspace for table-top task practice
6. Patient must be able to sit unassisted in an armless straight-back chair for the duration of the screening portion of the eligibility assessment
7. Medically stable
8. ≥ 10° finger extension
9. Unilateral upper limb hemiparesis with finger extensor strength of ≤ grade 4/5 on the manual muscle test AND a score of

   ≥1 and ≤ 11/14 on the hand section of the upper extremity Fugl-Meyer Assessment
10. Skin intact on hemiparetic arm, hand and scalp
11. While relaxed, surface neuromuscular electrical stimulation of finger extensors and thumb extensors and/or abductors produces a functional degree of hand opening without pain.
12. No significant visual or hearing impairment

Exclusion Criteria:

1. Co-existing neurological condition other than prior stroke involving the hemiparetic upper limb (e.g., peripheral nerve injury, Parkinson's disease, spinal cord injury, traumatic brain injury, multiple sclerosis).
2. Uncontrolled seizure disorder
3. Use of seizure lowering threshold medications at the discretion of the study physician (Dr. Rich Wilson)
4. Cardiac pacemaker or other implanted electronic device and/or stent
5. Pregnant
6. Intramuscular botox injections in any upper extremity muscle in the last 3 months
7. Insensate arm, forearm, or hand
8. Severely impaired cognition and communication
9. Uncompensated hemi-neglect (extinguishing to double simultaneous stimulation)
10. Severe shoulder or hand pain (unable to position hand in the workspace without pain)
11. Metal implant in the head

Where it's running

• MetroHealth Medical Center
  Cleveland, Ohio, United States Recruiting

Study contacts

• Principal investigator: David A Cunningham, PhD — MetroHealth Medical Center
• Study coordinator: David A Cunningham, PhD
• Email: Dxc536@case.edu
• Phone: (216) 957-3349

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

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• Remote Ischaemic Conditioning for Fatigue After Stroke 2

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.