AVERT DOSE | Determining the most effective mobility training program early after stroke
Ongoing uncertainty around the world about the safest and most effective early training approaches after stroke prompted this clinical trial. Using our global network of acute hospitals treating people with stroke, we have recruited patients from over 50 hospitals in Australia, United Kingdom, Ireland, India, Brazil, Singapore and Malaysia into the study, testing a range of evidence-informed mobility-based treatment protocols to determine the optimal approach. Physiotherapists and nurses delivered the training, starting within 48 hours of stroke, throughout the patient’s acute stay or 14 days (whichever was sooner).
We used a new trial design approach called an adaptive clinical trial (full name; multi-arm, multi-stage, covariate-adjusted, response-adaptive randomised clinical trial). The design means that as the trial progresses and the outcomes for each person are known, an algorithm that controls where new patients are randomly allocated adjusts to favour recruitment into the treatments that show the most promise. Recruitment commenced in 2019 and concluded in December 2025.
Aim
- Understand the relationships between stroke recovery and genetics, brain markers, and other brain tests.
This trial was developed by Professor Julie Bernhardt and a large team of collaborators. The Trial Protocol and Intervention Protocol outline the details of the research. Summary details can also be found at the Australian New Zealand Clinical Trials Registry. Additional sub-studies will be completed as a part of the trial.
We’re interested in pre-stroke factors including physical activity and work and life experience (cognitive reserve) and outcome following stroke. We have gathered data that allows us to study the cost-effectiveness of the intervention. Grant funding has been awarded by the Australian National Health and Medical Research Council (#1139712). We are currently analysing the data from this study which we aim to publish in May 2026.
The precede to the AVERT DOSE trial, titled AVERT trial, was published in The Lancet.
Research team
Members
Research group
Collaborators
- Professor Leonid Churilov, Melbourne Medical School, University of Melbourne
- Professor Peter Langhorne, Institute of Cardiovascular and Medical Sciences, University of Glasgow
- Professor Jeyaraj Pandian, Department of Neurology, Christian Medical College, Ludhiana, India
- Professor Helen Dewey, Eastern Health Clinical School, Monash University
- Professor Velandrai Shrikanth, Peninsula Clinical School, Monash University
- Associate Professor Coralie English, School of Health Sciences and Priority Research Centre for Stroke and Brain Injury University of Newcastle
- Professor Marj Moodie, Deakin Health Economics, Deakin University
- Professor Sandy Middleton, Nursing Research Institute, Australian Catholic University
- Professor Amanda Thrift, Department of Medicine – School of Clinical Sciences, Monash University
- Ms Anna McRae, Allied Health, Auckland District Health Board, Auckland
- Professor Bent Indredavik, Norwegian University of Science And Technology, The Institute for Neuromedicine, Trondheim, Norway
- Dr Dawn Tan, Physiotherapy Department, Singapore General Hospital
- Dr Julie Luker, Sansom Institute for Health Research, University of South Australia
- Ms Katijjah Md Ali, Department of Physiotherapy, Hospital Canselor Tuanku Muhriz, Kuala Lumur, Malaysia
- Professor Richard Lindley, Sydney Medical School, University of Sydney
- Professor Geoffrey Donnan, Melbourne Brain Institute, University of Melbourne
Contact us
If you’re interested in learning more about this project please contact our team.
