Combined Functional Electrical and Transcranial Direct Current Stimulation for Foot Drop

Combined Functional Electrical and Transcranial Direct Current Stimulation for Foot Drop: A Case Series

This study aims to determine if combining the treatments of transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) will better help persons with stroke who have difficulty lifting their toes. As part of the treatment, subjects will receive electrical stimulation through pads on their scalp (similar to what one may have received in physical therapy previously to an arm or leg). This protocol is called transcranial direct current stimulation (tDCS). Subjects will also receive electrical stimulation through pads on their leg. This is called functional electrical stimulation (FES). During treatment sessions, subjects will also perform leg activity/strengthening exercises. The aim is to evaluate whether combining FES and tDCS within a PT session would reduce foot drop as indicated by improvements in the amount of toe clearance and ankle motion persons with stroke.

Inclusion Criteria: To participate, you must be:

• 18 years or older
• Have had 1 or more strokes (> 6 months) affecting ankle dorsiflexion.
• Discharged from all rehabilitative services.
• Can walk independently with/without using an assistive device such as a cane without an ankle-foot orthosis (AFO) for 15 minutes.

Exclusion Criteria: You must not have:

• An inability to repeat and understand 2-step commands.
• Peripheral neuropathy
• Damage to the skull or scalp, such as a fracture History of seizures or epilepsy Extremely high or low blood pressure or heart rate Chest pain or shortness of breath when you are resting Botox injections to your leg or foot in the last 4 months