Tele-based ischemic conditioning for chronic stroke: Safety, feasibility, and preliminary neurophysiological and motor effects
- 1Corresponding author at: Department of Physical Therapy, University of Illinois Chicago
- 2Brain Plasticity Laboratory, Department of Physical Therapy, University of Illinois Chicago, Chicago, IL, USA
Abstract
To examine the safety and feasibility of a two-week (seven-session) tele-based ischemic conditioning (tele-IC) intervention in individuals with chronic stroke and to explore secondary neurophysiological and motor outcomes. Methods: Ten individuals with chronic stroke (8 males; age 61.7 ± 7.3 years; time since stroke 11.5 ± 7.5 years; Fugl-Meyer Lower Extremity score 20.5 ± 6.6) completed tele-IC. The primary outcomes were safety and feasibility. Safety was assessed through monitoring of IC-related adverse events and side effects across sessions; feasibility was evaluated through screening-to-enrollment, retention, intervention adherence, tolerability, and acceptability. Secondary exploratory outcomes included corticomotor excitability, transcallosal inhibition, lower-limb strength, paretic ankle motor control, and gait speed. Outcomes were assessed before and 24 h after the intervention. Results: Across 70 tele-IC sessions, no serious adverse events occurred, and all 10 participants completed all seven sessions. Acceptability was high, including ratings for safety (4.9/5), remote assistance (4.8/5), and overall satisfaction (4.8/5). Exploratory analyses showed increased transcallosal inhibition (d_z = 0.929, p = 0.017), changes in bilateral lower-limb strength (d_z = 0.873–1.756), and shorter paretic ankle reaction time (d_z = 0.844, p = 0.049). Corticomotor excitability and gait speed did not significantly change. Conclusions: In this small, uncontrolled pilot study, synchronously supervised tele-IC was delivered with complete intervention adherence, no serious adverse events, and high participant acceptability. Exploratory secondary neurophysiological and motor findings require confirmation in larger controlled trials.
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BibTeX
@article{madhavan2026telebased,
title = {{Tele-based ischemic conditioning for chronic stroke: Safety, feasibility, and preliminary neurophysiological and motor effects}},
author = {Sangeetha Madhavan and Mark Cummings and Danny Mathew},
journal = {Journal of Stroke and Cerebrovascular Diseases},
year = {2026},
month = oct,
doi = {10.1016/j.jstrokecerebrovasdis.2026.108772},
url = {https://doi.org/10.1016/j.jstrokecerebrovasdis.2026.108772},
note = {CC BY},
}
RIS
TY - JOUR
TI - Tele-based ischemic conditioning for chronic stroke: Safety, feasibility, and preliminary neurophysiological and motor effects
AU - Sangeetha Madhavan
AU - Mark Cummings
AU - Danny Mathew
PY - 2026
DA - 2026/10/30
JO - Journal of Stroke and Cerebrovascular Diseases
DO - 10.1016/j.jstrokecerebrovasdis.2026.108772
UR - https://doi.org/10.1016/j.jstrokecerebrovasdis.2026.108772
AB - To examine the safety and feasibility of a two-week (seven-session) tele-based ischemic conditioning (tele-IC) intervention in individuals with chronic stroke and to explore secondary neurophysiological and motor outcomes. Methods: Ten individuals with chronic stroke (8 males; age 61.7 ± 7.3 years; time since stroke 11.5 ± 7.5 years; Fugl-Meyer Lower Extremity score 20.5 ± 6.6) completed tele-IC. The primary outcomes were safety and feasibility. Safety was assessed through monitoring of IC-related adverse events and side effects across sessions; feasibility was evaluated through screening-to-enrollment, retention, intervention adherence, tolerability, and acceptability. Secondary exploratory outcomes included corticomotor excitability, transcallosal inhibition, lower-limb strength, paretic ankle motor control, and gait speed. Outcomes were assessed before and 24 h after the intervention. Results: Across 70 tele-IC sessions, no serious adverse events occurred, and all 10 participants completed all seven sessions. Acceptability was high, including ratings for safety (4.9/5), remote assistance (4.8/5), and overall satisfaction (4.8/5). Exploratory analyses showed increased transcallosal inhibition (d_z = 0.929, p = 0.017), changes in bilateral lower-limb strength (d_z = 0.873–1.756), and shorter paretic ankle reaction time (d_z = 0.844, p = 0.049). Corticomotor excitability and gait speed did not significantly change. Conclusions: In this small, uncontrolled pilot study, synchronously supervised tele-IC was delivered with complete intervention adherence, no serious adverse events, and high participant acceptability. Exploratory secondary neurophysiological and motor findings require confirmation in larger controlled trials.
SN - 1532-8511
ER -