Print Send My Information

Purpose

Our proposed study, "NEUROBALANCE Stroke,"; aims to evaluate the effectiveness of a combined intervention involving robotic balance training and noninvasive brain stimulation in improving balance function and postural control in individuals with chronic stroke. The study will recruit 45 participants who have had a stroke at least 6 months before enrolment and experience persistent balance and gait deficits. Participants will be randomized into three groups: (1) robotic balance training with active brain stimulation, (2) robotic balance training with sham brain stimulation, and (3) standard-of-care rehabilitation. The study will involve 15 training sessions over 5 weeks, with assessments conducted at baseline, post-training, and two months post-training to evaluate balance recovery and retention. The primary focus is understanding how this intervention affects brain and muscle activity during balance tasks and how these changes translate into functional improvements in clinical outcome measures of balance function. Additionally, participant feedback on brain stimulation and exercise engagement will be collected to inform future studies. The findings may guide the development of personalized training protocols and contribute to broader rehabilitation strategies.

Conditions

Eligibility

Eligible Ages
Between 18 Years and 75 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. Aged between 18-75 years 2. Diagnosed with a cortical/subcortical ischemic stroke at least 6 months before the screening, as confirmed by the neurological exam or an MRI. 3. Have complaints of impaired balance and poor postural control determined by a BBS score of ≤50. 4. Ability to stand upright with or without support for at least 20 seconds 5. Ability to walk with or without a walking aid for at least ten meters 6. Not planning to change medication in the next four months 7. Minimum Cognitive Ability to understand the verbal instructions and comply with the study procedures, as determined by the University of California, San Diego, Brief Assessment of Capacity to Consent Instrument (UBACC).

Exclusion Criteria

  1. Currently undergoing any regular physical therapy program or research studies focusing on balance functions. 2. Having a brainstem stroke. 3. Contraindication for MRI scan (presence of metal implants, claustrophobia) 4. Affected by the peripheral nerve injury, neuromuscular conditions, or orthopedic issues of lower limbs before stroke, or have any persistent pain or difficulty maintaining blood pressure while upright. 5. Have a scalp or skin condition (e.g., psoriasis or eczema) * on the scalp near the stimulation site 6. Having severe visual impairment (e.g., spatial neglect) or hearing problems that may affect study compliance 7. Any other neurological injury or psychiatric conditions (e.g., severe anxiety or schizophrenia etc.) 8. Contraindications to MRI, including the presence of non-titanium metallic implants, claustrophobia, etc. 9. Not be pregnant or thinking of becoming pregnant 10. Diagnosed with alcohol or substance abuse in the last 3 years 11. Contraindications to TMS, including the presence of metallic implants in the head and a history of seizures or medication-resistant epilepsy or ongoing use of anti-seizure/seizure threshold-lowering medications.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
Triple (Participant, Investigator, Outcomes Assessor)
Masking Description
The mode of HD-tDCS (active/sham) will be masked for the participant, the study investigator, and the outcomes assessor.

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
RBT + Active HD-tDCS Group 		Participants will engage in balance and postural control training on a robotic balance platform called Hunova (Movendo, Italy). Before balance training, the current intensity of 2 mA will be delivered to the leg motor area identified using individual MRI-guided neuronavigated transcranial magnetic stimulation (nTMS), and the stimulation will be turned ON for 20 minutes.
  • Device: Combined (Robotic balance training and high-definition transcranial direct current stimulation)
    The robotic platform will train the participants to maintain dynamic balance in the sagittal and transverse planes (mediolateral and anterior-posterior directions) and engage in core stability and trunk control with seated balance exercises. In addition, high-definition transcranial direct current stimulation (HD-tDCS) will be used as an adjuvant to robotic balance training by priming the corticospinal circuits.
Sham Comparator
RBT + Sham HD-tDCS Group 		Participants will engage in balance and postural control training on a robotic balance platform called Hunova (Movendo, Italy). Before balance training, the current intensity of 2 mA will be delivered to the leg motor area identified using individual MRI-guided neuronavigated transcranial magnetic stimulation (nTMS), and the stimulation will be turned ON transiently for 30 s to provide a sensation of stimulation.
  • Device: Combined (Robotic balance training and high-definition transcranial direct current stimulation)
    The robotic platform will train the participants to maintain dynamic balance in the sagittal and transverse planes (mediolateral and anterior-posterior directions) and engage in core stability and trunk control with seated balance exercises. In addition, high-definition transcranial direct current stimulation (HD-tDCS) will be used as an adjuvant to robotic balance training by priming the corticospinal circuits.
Other
SOC Control Group 		The standard of care (SOC) control group participants will perform dose-matched conventional physical therapy exercises delivered by a trained PT.
  • Other: Standard of Care Balance Training
    Participants in this group will receive a standard-of-care balance training (dose matched to the experimental group) administered by the Physical therapist.

Recruiting Locations

Kessler Foundation
West Orange, New Jersey 07052
Contact:
Vikram Shenoy Handiru, PhD
9733243578
vshenoy@kesslerfoundation.org

More Details

NCT ID
NCT07113041
Status
Recruiting
Sponsor
Kessler Foundation

Study Contact

Vikram Shenoy Handiru, PhD
9733243578
vshenoy@kesslerfoundation.org

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.

For help using this page: trialstoday@researchmatch.org or call 855-514-7001

ResearchMatch is funded in part by the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program, led by the NIH’s National Center for Advancing Translational Sciences (NCATS), grants UL1TR000445 and 1U54RR032646-01, and grant U24TR001579 from NCATS and the National Library of Medicine. The content of this website is solely the responsibility of ResearchMatch and Vanderbilt University and does not necessarily represent the official views of the NIH, NCATS, or NLM.

Vanderbilt University Medical Center