rTMS Combined With BWSTT in Stroke With Body Weight Supported Treadmill Training (BWSTT) After Stroke

The purpose of this pilot study is to examine the feasibility and efficacy of 5Hz repetitive
transcranial magnetic stimulation (rTMS) applied to bilateral motor areas as an adjuvant
intervention to task-specific body weight supported treadmill training (BWSTT) in individuals
with subacute stroke.

Five individuals with a diagnosis of subacute stroke will be recruited and assigned to either
high frequency or sham rTMS group.Both groups will receive a comprehensive assessment of
their motor function, gait performance and neurophysiological function before the training.
Both groups will then go through a 10 week (24 sessions) of gait training with body weight
supported treadmill. For the high frequency rTMS group, they will receive 5 Hz rTMS applied
to bilateral motor areas prior to each gait training session. For the sham rTMS group, they
will receive a sham stimulation prior to the gait training sessions. All participants will
receive another comprehensive assessment after the training concludes. The assessor will be
blinded to the intervention.

Inclusion Criteria:

1. 18-80 years old

2. < 2 months post stroke at the time of enrollment

3. first time stroke:

4. able to walk > 25 feet with or without assistive device and with no more than moderate
assistance:

5. able to follow 1-step commands

6. able to communicate verbally

Exclusion Criteria:

1. severe medical problems (e.g. recent cardiac infarct, heart failure, cancer)

2. presence of conditions that could affect gait training (e.g. amputation, severe
arthritis)

3. bilateral stroke

4. non-ambulatory prior to stroke

5. BMI > 40

6. any contraindications to TMS (e.g. history of seizure, cardiac pacemaker, metal or
magnetic implants)

7. pregnant or potentially to be pregnant