The Use of Transcranial Direct Current Stimulation in the Rehabilitation of Post-Stroke Dysphagia During the Subacute Phase in Hospitalized Patients: A Randomized Clinical Trial

Overview

The purpose of this clinical trial is to determine whether the use of tDCS in dysphagia rehabilitation during the subacute phase of stroke assists in the recovery process while patients are still hospitalized. Patients aged 60 to 80 years who have suffered a stroke and are in the subacute phase of the disease, admitted to the hospital, will be recruited to receive tDCS application contralateral to the lesion for 10 sessions, combined with conventional speech-language therapy for swallowing rehabilitation. The primary question it aims to answer is whether the use of tDCS combined with swallowing rehabilitation accelerates recovery compared to conventional speech-language therapy alone.

This clinical trial will be conducted at a regional hospital located in Belém, Pará (Northern Brazil), from July 2026 to March 2027. The sample will consist of 66 participants who have suffered an ischemic or hemorrhagic stroke and present with oropharyngeal dysphagia as a sequela, classified as mild/moderate, moderate, or moderate/severe according to the Dysphagia Risk Assessment Protocol (PARD) (Padovani, 2007). Patients must be hospitalized and in the subacute phase of the disease (defined as from the 8th day post-onset onwards, confirmed by imaging exams), admitted to the adult ICU, neurological ward, or internal medicine ward. Additionally, they must be hemodynamically stable with a Glasgow Coma Scale score above 13, as specified in the inclusion criteria. The protocol will involve the application of anodal tDCS contralateral to the neurological lesion, using an intensity of 1.4 mA, with the cathodal electrode positioned in the contralateral supraorbital region. The control group will receive sham stimulation, and both groups will receive conventional rehabilitation for dysphagia treatment.