Purpose <p>This study investigates the immediate effects of simultaneous cerebrospinal Direct Current Stimulation (csDCS), as a novel non-invasive brain stimulation (NIBS) technique, in combination with Motor Imagery (MI), Virtual Reality (VR), and pedaling concurrently applied in post-stroke patients.</p> Methods <p>Four post-stroke patients were selected and randomly assigned to two groups, which received csDCS under two protocols (conventional and periodic) within a pre- and post-stimulation study design, with sham serving as a baseline condition. In the conventional group, participants underwent 20&#xa0;min of stimulation, whereas the periodic group received two 13-min sessions with a 20-min rest. The anode electrode was placed over the M1 region of the affected hemisphere, and the cathode electrode on the T11 vertebra of the spinal cord. Outcome measures involved scalp topography recorded from eight electrodes, along with the corresponding relative power at each region on Mu and Beta band from four EEG datasets to compare pre- and post- stimulation. To assess statistical significance, the Friedman test was applied to compare pre- and post-stimulation values, and Cohen’s d was used to evaluate the effect size of the stimulation.</p> Result <p>Mu rhythm modulation across patients was variable and lacked consistent statistical significance. In contrast, Beta rhythm analysis revealed more pronounced and stable patterns alongside with significant and consistent results across patients.</p> Conclusion <p>These findings highlight the promising role of combined csDCS and VR-MI interventions in stroke rehabilitation. Further validation with larger, homogeneous cohorts is needed to confirm the clinical efficacy of this protocol.</p>