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Cortical Enhancement of Posture, Movement Planning, and Execution of Upright Reaching Following Stroke

Not Applicable
Completed
Conditions
Stroke
Upper Extremity Paresis
Interventions
Other: Transcranial direct current stimulation
Registration Number
NCT04308629
Lead Sponsor
University of Maryland, Baltimore
Brief Summary

Stroke is the leading cause of disability and diminished quality of living that frequently includes impairments of postural control and upper extremity (UE) function. The interaction of posture and UE coupling in terms of movement planning, initiation, and execution is not well understood. StartReact responses triggered by a loud acoustic stimulus (LAS) during the planning and preparation of goal intended actions has been used to probe the state of brainstem neuronal excitability related to posture and movement sequencing. The purpose of this study is to examine posture and goal-directed movement planning and execution using startReact responses and to evaluate posture and UE movement sequence during reaching while standing in individuals with chronic hemiparesis and healthy controls. Secondly, the investigators will determine the modulatory role of the cortical premotor areas (PMAs) in startReact responses in healthy controls and in persons with stroke by using transcranial direct current stimulation (tDCS) to up- or down-regulate PMAs excitability.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
tDCS over M1Transcranial direct current stimulationOne session of transcranial direct current stimulation (tDCS) over primary motor area (M1)
tDCS over PMAsTranscranial direct current stimulationOne session of transcranial direct current stimulation (tDCS) over premotor areas (PMAs)
Primary Outcome Measures
NameTimeMethod
Change in startReact responseImmediately after the intervention (one session tDCS)

The incidence of StartReact response following an loud acoustic stimulus

Change in the lag between anticipatory postural adjustments and reach onsetImmediately after the intervention (one session tDCS)

The temporal lag between anticipatory postural adjustments (APA) onset and reach onset (unit: seconds)

Secondary Outcome Measures
NameTimeMethod
Change in the reach onset (unit: seconds)Immediately after the intervention (one session tDCS)

The onset of the anterior wrist joint center movement with a threshold of 5% peak velocity

Change in the amount of trunk rotation (unit: radians)Immediately after the intervention (one session tDCS)

The angular displacement of the line connecting both shoulders in the horizontal plane in the direction of the reach at maximum reach normalized by reach distance

Change in the amount of trunk-pelvic rotation difference (unit: radians)Immediately after the intervention (one session tDCS)

The difference between trunk and pelvic angular displacement at maximum reach normalized by reach distance

Change in the amount of pelvic rotation (unit: radians)Immediately after the intervention (one session tDCS)

The angular displacement of the line connecting both hip joint centers in the horizontal plane in the direction of the reach at maximum reach normalized by reach distance

Change in the APA onset (unit: seconds)Immediately after the intervention (one session tDCS)

The onset of the posterior center of pressure displacement with a threshold of 5% peak velocity

Change in the amount of trunk flexion (unit: radians)Immediately after the intervention(one session tDCS)

The angular displacement of the line joining the reaching shoulder and the hip joint center on the same side in the sagittal plane at maximum reach normalized by reach distance

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