noninvasive spinal stimulation in stroke

Conditions: Stroke

Summary: this is a randomized control trial that will evaluate the effectiveness of transcutaneous (non-invasive) spinal cord stimulation on gait and balance function for individuals with hemiplegia due to stroke.

objectives: * to determine whether transcutaneous spinal cord stimulation combined with ambulation training modulates corticospinal locomotor networks in individuals with chronic hemiplegic stroke * to determine whether transcutaneous spinal stimulation combined with ambulation training improves locomotor function in individuals with chronic hemiplegic stroke * to determine whether transcutaneous spinal stimulation combined with ambulation training improves symmetry of gait in individuals with chronic hemiplegic stroke * to determine whether transcutaneous spinal stimulation combined with ambulation training improves standing posture and balance in individuals with chronic hemiplegic stroke * to determine whether ambulation efficiency (improved cardiovascular conditioning) improves with transcutaneousnon-invasive spinal stimulation and locomotor training in individuals with chronic hemiplegic stroke

Eligibility criteria:
healthy control group inclusion criteria: * age 18 or older * able and willing to give written consent and comply with study procedures healthy control group exclusion criteria: * no history of cerebrovascular accidents or neurological degenerative pathologies (such as multiple sclerosis, alzheimer's disease, parkinson's disease, etc.) * pregnant or nursing * skin allergies or irritation; open wounds * utilizing a powered, implanted cardiac device for monitoring or supporting heart function (i.e. pacemaker, defibrillator, or lvad) stroke group inclusion criteria: * participants are 18 years of age or older * participants are at least 4 weeks post stroke * participants with hemiplegia secondary to a single stroke * functional ambulation category of 2 or greater - patient needs continuous or intermittent support of one person to help with balance and coordination. * participants are able to provide informed consent * participants are not currently receiving regular physical therapy services stroke group exclusion criteria: * individuals less than18 years of age * individuals less than 4 weeks post stroke * individuals with ataxia * individuals with multiple stroke history * currently taking a selective serotonin reuptake inhibitor (ssri) or tricyclic antidepressant (tca) * botox injection in lower extremity within the last 4 months * modified ashworth score of 3 or greater in lower extremity * pregnancy or nursing * pacemaker or anti-spasticity implantable pumps * active pressure sores * unhealed bone fractures * peripheral neuropathies * painful musculoskeletal dysfunction due to active injuries or infections * severe contractures in the lower extremities * medical illness limiting the ability to walk * active urinary tract infection * clinically significant depression, psychiatric disorders, or ongoing drug abuse * metal implants in their spine tms specific criteria (see safety screening questionnaire for transcranial magnetic stimulation) * medicated with agents known to increase (e.g., amphetamines) or decrease motor system excitability (e.g., lorazepam) * implanted cardiac pacemaker * metal implants in the head or face * suffers unexplained, recurring headaches * had a seizure in the past unrelated to the stroke event, or has epilepsy * skull abnormalities or fractures * suffered a concussion within the last 6 month * cardiorespiratory or metabolic diseases (e.g. cardiac arrhythmia, uncontrolled hypertension or diabetes, chronic emphysema) * pregnant

Keywords: spinal cord stimulation electrical stimulation locomotion