Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of Transcranial DC Stimulation Coupled With Constraint Induced Movement Therapy on Motor Function in Stroke Patients
Brief Summary: The purpose of this study is to determine whether noninvasive brain stimulation associated with motor learning offers an additional benefit than motor learning alone in patients with stroke.

The investigators hypothesis is that active transcranial direct current stimulation (tDCS) combined with constraint induced movement therapy (CIMT) will induce a greater motor function improvement as compared with sham tDCS combined with CIMT.


Options:
A: Inclusion Criteria:

All subjects must be between the ages of 18-90 and must not be pregnant.

Additional Entry criteria for Stroke subject enrollment:

1. First-time clinical ischemic or hemorrhagic cerebrovascular accident - evidenced by a radiological (or physician's) report;
2. Weakness, defined as score of less than 55 (out of 66) on arm motor Fugl-Meyer (FM) scale
3. Stroke onset \>6 months prior to study enrollment.

Exclusion Criteria:

1. Significant pre-stroke disability;
2. Major depression, as defined by Hamilton Depression (HAM-D) scale grater then or equal 17 if needed (history of depression before the stroke);
3. Any substantial decrease in alertness, language reception, or attention that might interfere with understanding instructions for motor testing;
4. Excessive pain in any joint of the paretic extremity (not applicable to severe stroke subjects);
5. Contraindications to single pulse Transcranial Magnetic Stimulation (TMS) (TMS will be used to measure cortical excitability) such as metal head implants

   * history of seizures
   * unexplained loss of consciousness
   * metal in the head
   * frequent or severe headaches or neck pain
   * implanted brain medical devices.
6. Contraindications to tDCS

   * metal in the head
   * implanted brain medical devices
7. Advanced liver, kidney, cardiac, or pulmonary disease;
8. A terminal medical diagnosis consistent with survival \< 1 year;
9. Coexistent major neurological or psychiatric disease as to decrease number of confounders;
10. A history of significant alcohol or drug abuse in the prior 6 months;
11. Use of carbamazepine and amitriptyline;
12. Subjects may not be actively enrolled in a separate intervention study targeting stroke recovery and
13. Subjects may not have already received constraint induced motor therapy and/or tDCS treatment for stroke;
14. History of epilepsy before stroke (or episodes of seizures within the last six months).
15. Subjects with global aphasia and deficits of comprehension
16. Pregnancy
B: Inclusion Criteria:

* Patient with spastic hemiparesis, following a unique stroke episode over a year before enrollment into the study
* Age ≥ 18
* Barefoot walking possible with no assistive device over 10 m
* Fast barefoot ambulation speed between 0.1 m/sec and 1.3 m/sec
* Mean Modified FRENCHAY Score between 2 and 8/10
* Patient having provided a signed consent to participate in this trial

Exclusion Criteria:

* Multiple stroke episodes, clinically of based on brain imaging
* No recent (less than 3 months before enrollment) brain imaging (CT scan or MRI) in case of doubt about multiple stroke episodes
* Concurrent severe condition jeopardizing functional or vital prognosis, or the ability to participate in rehabilitation sessions
* Cognitive, phasic or behavioral condition impeding verbal communication, active participation to a rehabilitation or self-rehabilitation program, or participation in a research study, according to the investigator's judgment
* Person having a tutor or benefiting from a law protection order
* Person not benefiting from French State Health Insurance
C: Inclusion Criteria:

* age between 18 and 86
* patient is contractually capable
* first-ever, ischemic stroke
* minimum time since stroke 9 months
* a paresis of the arm/hand muscles above 3 on the MRC scale

Exclusion Criteria:

* multiple cerebral lesions and associated residual deficits
* severe head trauma in the past
* seizures
* ferromagnetic implants in the head/neck region
* pacemaker
* a psychiatric disorder or neurological disease besides stroke
* intake of illegal drugs
* severe aphasia or cognitive deficits that impede contractual capability
* contraindications for reboxetine (seizures, glaucoma, prostate hyperplasia with urinary retention, cardiac arrhythmias, potential interactions with co-medication)
* pregnancy
* breast-feeding patients
D: Inclusion Criteria:

* Age \>/=18
* Stroke within 45-days
* Residual paresis in the lower extremity (fugl-meyer le motor score \< 34)
* Ability to sit unsupported for 30 seconds
* Ability to walk at least 10 feet with maximum 1 person assist
* Ability to follow a three step command
* Provision of informed consent
* A self-selected 10 meter gait speed less than 0.8 m/s at the 2-month post-stroke assessment
* Successful completion of an exercise tolerance test

Exclusion Criteria:

* Lived in nursing home prior to stroke
* Unable to ambulate at least 150 feet prior to stroke, or experienced intermittent claudication while walking less than 200 meters
* Serious cardiac conditions (history of congestive heart failure, documented serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living). Anyone meeting New York Heart Association criteria for Class 3 or Class 4 heart disease will be excluded
* History of serious chronic obstructive pulmonary disease or oxygen dependence
* Severe weight bearing pain
* Preexisting neurological disorders such as Parkinson's disease, Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), dementia, or previous stroke with residual neurological deficits
* History of major head trauma
* Lower extremity amputation
* Non-healing ulcers on the lower extremity
* Renal dialysis or end stage liver disease
* Legal blindness or severe visual impairment
* A history of significant psychiatric illness defined by diagnosis of bipolar affective disorder, psychosis, schizophrenia or medication refractory depression
* Life expectancy less than one year
* Severe arthritis or orthopedic problems that limit passive ranges of motion of lower extremity (knee flexion contracture of -10°, knee flexion Range of Motion (ROM) \< 90°, hip flexion contracture \> 25°, and ankle plantar flexion contracture \> 15°
* History of sustained alcoholism or drug abuse in the last six months
* Major post-stroke depression as measured by the Patient Health Questionnaire(PHQ-9 \>/= 10) that is not medically managed with antidepressant medication and/or psychotherapy
* History of pulmonary embolism within 6 months
* Uncontrollable diabetes with recent weight loss, diabetic coma, or frequent insulin reactions
* Severe hypertension with systolic greater than 200 mmHg and diastolic greater than 110 mmHg at rest,
* Previous or current enrollment in a clinical trial to enhance stroke motor recovery
* Lives more than 50 miles from the training sites
* Unable to travel 3 times per week for outpatient training programs
* Intracranial hemorrhage related to aneurysmal rupture or an arteriovenous malformation (hemorrhagic infarctions will not be excluded)

Inclusion and exclusion criteria will be determined by a chart review, depression screen and subject interview by study physician or study coordinator. After initial chart and subject interview, each subject's treating physician will be asked to review inclusion and exclusion criteria and provide a letter supporting inclusion in the study. All subjects who meet selection criteria must successfully complete an exercise tolerance test

Answer: A