Clinical Research Directory

Inclusion Criteria: * Single, monohemispheric stroke * Chronic stroke (\> 6 months prior) * Severe stroke (Fugl-Meyer Lower Extremity motor scale score \< 21 or 6 Minute Walk Test distance \< 300m) Exclusion Criteria: * Use of anti-spasticity medications * Existence of other neurological disorders * Have brainstem or cerebellar lesions. * Mini-Mental State Examiniation score of \<21, to ensure participants have the cognitive capacity to consent and can understand instructions both in-person and during remote supervision. * Non-English-speaking individuals * Bone, joint or soft tissue injury * Uncontrolled medical conditions (such as uncontrolled hypertension, untreated cardiac disease, or untreated pulmonary disease) * Unable to see the tablet and zoom screen * Unable to move non-paretic ankle (\< 5 degrees of ankle ROM) * Fugl-Meyer Lower Extremity sensory scale score \< 6 TMS exclusion criteria * Previous adverse reaction to TMS * Skull abnormalities or fractures * Concussion within the prior 6 months * Unexplained, recurring headaches * Implanted cardiac pacemaker * Metal implants in the head or face * History of seizures or epilepsy * Use of medications that could alter cortical excitability or increase risk of seizure (e.g., antidepressants, antipsychotics, anxiolytics, anticonvulsants) * Current pregnancy PNS exclusion criteria * Skin hypersensitivity at any sites of stimulation, including the scalp, thoracolumbar spine, and peripheral limbs * History of contact dermatitis at any of the sites of stimulation * History of allodynia and/or hyperalgesia * Active skin infection * Skin lesions * Deep vein thrombosis * Any other skin or scalp condition that could be aggravated by stimulation * Implanted electronic, metallic, or highly conductive devices near site of stimulation that cannot be removed without permission from a health professional