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 will recruit more than 2500 patients from over 50 hospitals in Australia, New Zealand, United Kingdom, India, Taiwan, Singapore and Malaysia into the study, testing a range of evidence-informed mobility-based treatment protocols to determine the optimal approach. Physiotherapists and nurses deliver the training which starts within 48 hours of stroke and continues for the acute stay or 14 days (whichever is sooner).
The main aim of the AVERT DOSE trial is to identify the best early mobility training program for people with ischaemic stroke (i.e. caused by a blood clot in the brain) of mild and moderate severity.
We’re using 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 which show most promise. Recruitment commences in 2019 and with the assistance of over 2500 volunteers we expect to have the information we need to roll out new evidence-based training protocols by 2023.
This trial was developed by Professor Julie Bernhardt and a large team of collaborators. See Florey project members as well as national and international collaborators. Full scientific details of the trial protocol are at the Australian New Zealand Clinical Trials Registry. Additional sub-studies will be completed as a part of the trial. We want to understand the relationships between genetics, brain markers (using diffusion tensor imaging), and other brain tests (motor evoked potential) and recovery. We’re interested in pre-stroke factors including physical activity and work and life experience (cognitive reserve) and outcome following stroke. We’ll also gather 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).
If you have a background in clinical neuro-rehabilitation, allied health, nursing, medicine, mathematics or statistics and are interested in enrolling in post-graduate studies, please contact us at firstname.lastname@example.org. Students will be located at the Heidelberg Campus, Victoria, Australia.
Futher trial information can be found on twitter: @AVERTDOSEtrial or via email on email@example.com
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