Stroke Clinical Trial
Official title:
A Double-blind, Sham-controlled, Randomized Clinical Trial on Stroke Treatment Using Transcranial Direct Current Stimulation
The purpose of this study is to determine whether active stimulation of the affected hemisphere will be more effective than simulated current in treatment of stroke
Stroke is defined as an acute neurological dysfunction of vascular origin, with subtle
development of clinical signs of cerebral function disturbs, lasting more than 24h. The
traditional therapy includes drugs and physical rehabilitation, without systematization,
with complicates its replication. The transcranial direct current (DC) stimulation might
promote an increase in the motor function of the hands, when compared with placebo
stimulation.
In fact, some clinical trials point positive effects of transcranial DC stimulation (tDCS)
as a post-stroke intervention, however, in general, they only include patients in the
chronic stage, with cerebral damage in different areas and diverse disabilities, most being
assisted by non-standardized physical therapy treatments. tDCS combined with a standardized
physiotherapy program, noted as constraint-induced movement therapy (CIMT), could be able to
modulate the cortical excitability and promote better functional recovery.
However, no relate of longitudinal studies assessing patients in the acute stage submitted
to tDCS and physiotherapy for more than 6 months have been found. Studies like this would
help us elucidate the action mechanisms of this treatment in the early stages of stroke.
With this in mind, START - tDCS, a phase II/III clinical trial, will be developed to assess
the therapeutic effects of the tDCS in early stage enrolling 40 post-stroke patients. They
will be allocated in 2 groups at random to receive active tDCS or sham, associate to CIMT.
The protocol will be applied in a daily basis for 10 consecutive working days (2 weeks),
after that, the patients will be followed for 1 month. By the end of the study, the
participants that receive tDCS and show better clinical condition will be invited to
participate in bimonthly stimulation for 12 months, as part of a longitudinal study
regarding tDCS for stroke. An increase in the clinical condition will be considered as a
final score higher than 10 points in the Barthel Index, our primary outcome, when compared
with baseline, before the treatment protocol.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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