Transcranial Direct Current Stimulation (tDCS), activeSham transcranial Direct Current StimulationStandardized Nordic Walking program
Transcranial Direct Current Stimulation (tDCS), active: Anodal tDCS over SMA (FCz) with saline-soaked sponge electrodes (5×7 cm); cathode supraorbital contralateral; 2.0 mA for 20 minutes, 30-s ramp-in/out; delivered during NW; 12 sessions over 4 weeks (3×/week).
Sham transcranial Direct Current Stimulation: Same montage and timing as active; brief ramp-in/out then 0 mA for the remainder; delivered during NW; 12 sessions over 4 weeks.
Standardized Nordic Walking program: 30-minute supervised session (5-min warm-up; 20-min continuous walking with poles at moderate perceived exertion; 5-min cool-down); technique cues for pole use and cadence; performed each visit in both arms; 12 sessions over 4 weeks.
Study summary
Parkinson's disease can cause slow or unsteady walking and balance problems that raise the risk of falls. This study will test whether adding a gentle, non-invasive brain stimulation called transcranial direct current stimulation (tDCS) during a supervised Nordic Walking program improves mobility in people with Parkinson's disease. Participants will be randomly assigned to receive either active tDCS or an inactive (sham) procedure that feels the same but does not deliver current, while both groups complete the same supervised walking program. Sessions occur three times per week for four weeks. We will measure walking speed with a 10-Meter Walk Test as the main outcome, and also evaluate balance, motor symptoms, quality of life, and any side effects. We expect that tDCS given during the walking sessions will help people walk faster and feel steadier compared with the walking program alone.
Eligibility
Sex
ALL
Min age
50 Years
Max age
75 Years
Healthy volunteers
No
Inclusion Criteria:
* Idiopathic Parkinson's disease (e.g., UK Brain Bank criteria)
* Hoehn \& Yahr stage II-IV (on medication)
* Stable antiparkinsonian medication for ≥4 weeks before enrollment
* Slowed gait phenotype (e.g., ≥6 seconds on 10-Meter Walk at preferred speed)
* Able to ambulate at least 10 meters with or without a cane/poles (no hands-on assistance from a therapist)
* Able to follow simple commands; provides written informed consent (MMSE ≥24 or equivalent cognitive screening)
* Willing to maintain stable PD medication and usual care during the 4-week intervention, unless medically required
Exclusion Criteria:
* Contraindications to tDCS: implanted cranial/brain devices (e.g., DBS), metal in the skull (excluding dental), active skin disease/lesions at electrode sites, uncontrolled epilepsy or history of seizure in the past 12 months
* Unstable medical or psychiatric conditions that preclude safe participation (e.g., uncontrolled hypertension, recent cardiovascular events, severe orthostatic hypotension with syncope)
* Severe freezing of gait or fall risk that prevents safe participation in supervised Nordic Walking, as judged by the clinical team
* Severe musculoskeletal or vestibular disorders that limit walking with poles; severe uncorrected visual impairment
* Cognitive impairment incompatible with consent or testing (e.g., MMSE \<24)
* Current participation in other interventional trials targeting gait/balance or brain stimulation; recent initiation or dose change of antiparkinsonian medication within 4 weeks.
Primary outcome measure(s)
Gait speed (m/s) on the 10-Meter Walk Test (10MWT) — Baseline; Post-intervention (4 weeks); 1-month follow-up Preferred-pace 10MWT on a straight walkway with flying start; speed computed as distance/time (central 10 m if applicable), averaged across ≥2 trials. Higher values indicate better performance. The primary endpoint is the post-intervention assessment; maintenance is examined at 1 month. Minimally important change will be reported for clinical relevance.
Trial sites (1)
Facility
City
Region
Status
UEAFTO - Unidade de Fisioterapia e Terapia Ocupacional
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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