rTMS plus dual-task gait training to improve walking and thinking after stroke
Official title: Effects of Dorsolateral Prefrontal Cortex rTMS Primed Dual-Task Gait Training on Walking and Cognitive Outcomes After Stroke: A Randomized Sham-Controlled Trial
Run by The Hong Kong Polytechnic University · NCT07356687 · Data updated 2026-11-12
This trial will test whether brief rTMS to the dorsolateral prefrontal cortex given before dual-task walking training helps people with chronic stroke walk and think better when doing both at once.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 50 Years and up |
| Sex | All |
| Enrollment | 184 (estimated) |
| Sponsor | The Hong Kong Polytechnic University Academic / other |
| Locations | 1 site (Hong Kong, HongKong) |
| Status | Recruiting |
| Started | January 21, 2026 |
| Main results expected | June 2028 |
| Study ends | January 2029 |
| Registry record updated | July 10, 2026 |
| Trial ID | NCT07356687 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are community-dwelling adults aged 50 or older who are at least 6 months post unilateral ischemic or hemorrhagic stroke, can walk independently for at least one minute (assistive device allowed), have mRS 1–3 and MoCA ≥22, and can follow commands.
✕Probably not a fit
Patients with cerebellar or brainstem strokes, severe aphasia, uncontrolled seizures, pacemakers or other TMS contraindications, inability to tolerate exercise, or those receiving concurrent formal rehabilitation elsewhere are unlikely to benefit from this protocol.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This randomized, double-blind, placebo-controlled trial will allocate community-dwelling adults with chronic unilateral stroke to receive either active or sham rTMS to the dorsolateral prefrontal cortex immediately before the same standardized dual-task gait training program. Participants complete 12 supervised sessions over 3 weeks, with assessments at baseline, immediately after training, and at a 4-week follow-up. Co-primary outcomes are dual-task cost for gait speed and cognitive-task performance during walking, while secondary outcomes include balance, community participation, mood, sleep, and fall incidence. The protocol also measures prefrontal cortex activity during single- and dual-task walking to explore neural mechanisms.
Why it matters
Potential benefit: If successful, combining rTMS with dual-task gait training could improve walking speed and cognitive performance during everyday multitasking, potentially reducing fall risk and increasing independence.
How similar studies have gone: Small prior studies suggest rTMS can modulate prefrontal function and improve cognitive or motor outcomes after stroke, but directly combining DLPFC rTMS with dual-task gait training is a novel approach with limited direct evidence.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Unilateral ischemic or hemorrhagic hemispheric stroke * Age ≥ 50 years -≥ 6 months post-stroke * Medically stable * Able to walk independently ≥ 1 minute (assistive device allowed) * Able to follow commands * mRS 1-3 * MoCA ≥ 22 Exclusion Criteria: * Other neurological disorders * Cerebellar/brainstem injury * TMS contraindications (e.g., pacemaker, intracranial metal, seizure history, pregnancy) * Contraindications to exercise (e.g., unstable angina) * Severe aphasia (NIHSS item 9 ≥ 2) * Pain/illness limiting performance * Concurrent formal rehabilitation elsewhere * RMT cannot be determined * Fails TMS safety screening
Where it's running
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The Hong Kong Polytechnic University
Hong Kong, HongKong, Hong Kong Recruiting
Study contacts
- Study coordinator: Shuning LI
- Email: shunli.li@connect.polyu.hk
- Phone: +852 66770121
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.