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Trial registered on ANZCTR
Registration number
ACTRN12611000755932
Ethics application status
Approved
Date submitted
19/07/2011
Date registered
19/07/2011
Date last updated
23/03/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
TRIO: Does targeted rehabilitation improve outcomes after stroke?
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Scientific title
TRIO: Does targeted upper limb rehabilitation improve upper limb function and quality of life after stroke?
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Secondary ID [1]
262626
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Nil
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Universal Trial Number (UTN)
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Trial acronym
TRIO
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Stroke
268322
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Condition category
Condition code
Neurological
268453
268453
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0
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Other neurological disorders
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Stroke
268493
268493
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0
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Ischaemic
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Stroke
268494
268494
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0
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Haemorrhagic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The prognosis group will have a number of measures made, to predict their potential for recovering hand and arm function after stroke. These measures include simple bedside tests of movement, neurophysiological and neuroimaging measures. The simple beside measures of hand and arm strength will be made within 1 week of stroke. The neurophysiological measures involve using transcranial magnetic stimulation to test the pathways from the movement area of the brain to the weak arm muscles. These measures will be made within 2 weeks of stroke. The neuroimaging measures involve a short magnetic resonance imaging (MRI) scan, which will take place within 2 weeks of stroke. This information will be provided to therapy teams and to the patients, to guide rehabilitation planning and goal-setting. Standard rehabilitation therapies will be provided, though the intensity and duration of these therapies may be modified by prognosis information.
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Intervention code [1]
266998
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Rehabilitation
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Intervention code [2]
267000
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Diagnosis / Prognosis
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Comparator / control treatment
A benchmark group will be used for comparison. The prognosis measures will also be made in this group, but this information will not be used to plan rehabilitation. This group will be made up of patients recruited in the first 18 months of the study. In the second 18 months of the study, recruited patients will form the prognosis group.
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Control group
Historical
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Outcomes
Primary outcome [1]
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Upper limb function, measured with the Action Research Arm Test
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Assessment method [1]
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Timepoint [1]
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12 weeks after stroke
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Primary outcome [2]
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Upper limb impairment, measured with the Fugl-Meyer Scale
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Assessment method [2]
269236
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Timepoint [2]
269236
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12 weeks after stroke
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Primary outcome [3]
269237
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Upper limb pain-free passive range of motion, measured with goniometry
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Assessment method [3]
269237
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Timepoint [3]
269237
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12 weeks after stroke
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Secondary outcome [1]
279187
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Use of the affected upper limb in activities of daily living, measured with the Motor Activity Log
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Assessment method [1]
279187
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Timepoint [1]
279187
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6 months after stroke
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Secondary outcome [2]
279188
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Independence in activities of daily living, measured with the modified Rankin Scale
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Assessment method [2]
279188
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Timepoint [2]
279188
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6 months after stroke
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Secondary outcome [3]
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Quality of life, assessed with the Stroke Impact Scale
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Assessment method [3]
279189
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Timepoint [3]
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6 months after stroke
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Secondary outcome [4]
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Patient satisfaction with the rehabilitation process, measured with a 5-point Likert scale
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Assessment method [4]
279190
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Timepoint [4]
279190
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6 months after stroke
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Eligibility
Key inclusion criteria
Over 18 years of age
Unilateral upper limb weakness as a result of stroke
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Cerebellar stroke
Severe cognitive or communication impairment that precludes informed consent
Contraindications to magnetic resonance imaging or transcranial magnetic stimulation
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients will be screened for eligibility, provided with information about the study, and enrolled if they provide their written informed consent. Patients enrolled in the first 18 months will form the benchmark group, and patients enrolled in the second 18 months wirll form the prognosis group.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
Patients enrolled in the first 18 months will form the benchmark group, and patients enrolled in the second 18 months wirll form the prognosis group.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2012
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Actual
26/03/2012
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Date of last participant enrolment
Anticipated
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Actual
29/10/2015
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Date of last data collection
Anticipated
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Actual
6/04/2016
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Sample size
Target
240
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Accrual to date
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Final
192
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Recruitment outside Australia
Country [1]
3709
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New Zealand
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State/province [1]
3709
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Auckland
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Health Research Council
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Address [1]
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P O Box 5541
Wellesley St
Auckland 1141
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Country [1]
267475
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Private Bag 92019
Auckland 1142
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Country
New Zealand
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Auckland City Hospital
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Address [1]
266517
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2 Park Rd
Grafton
Auckland 1001
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Country [1]
266517
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
269440
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Northern Region Ethics Committee
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Ethics committee address [1]
269440
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Private Bag 92522 Wellesley St Auckland 1141
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Ethics committee country [1]
269440
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New Zealand
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Date submitted for ethics approval [1]
269440
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20/07/2011
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Approval date [1]
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24/08/2011
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Ethics approval number [1]
269440
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Summary
Brief summary
Stroke is a leading cause of adult disability. In this project a team of clinicians and scientists will evaluate the benefits of a new process for prescribing rehabilitation after stroke, called “Targeted Rehabilitation, Improved Outcomes” (TRIO). The project will implement an algorithm for determining individual patients’ potential for recovering hand and arm movement, and setting appropriate rehabilitation goals. This algorithm uses a combination of simple bedside tests, neurophysiology and neuroimaging, to measure the amount of damage to key pathways in the brain. The research team will evaluate the benefits for patient outcomes of using this algorithm as part of rehabilitation prescription.
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Trial website
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Trial related presentations / publications
Stinear CM, Byblow WD, Ackerley SJ, Barber PA, Smith M-C. (2017) Predicting recovery potential for individual patients increases rehabilitation efficiency after stroke. Stroke (in press). https://doi.org/10.1161/STROKEAHA.116.015790
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Public notes
This study found that using the PREP algorithm to predict how well the hand and arm would recover after stroke modified the therapy delivered and helped patients to leave hospital one week sooner, on average. More information can be found at www.prepforstrokerehab.wikispaces.com
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Contacts
Principal investigator
Name
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A/Prof Cathy Stinear
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Address
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Dept of Medicine, University of Auckland
Private Bag 92019
Auckland 1142
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Country
32874
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New Zealand
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Phone
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+6499233779
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Fax
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Email
32874
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[email protected]
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Contact person for public queries
Name
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Cathy Stinear
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Address
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Department of Medicine
University of Auckland
Private Bag 92019
Auckland 1142
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Country
16121
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New Zealand
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Phone
16121
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+64 9 92 33 779
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Fax
16121
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Email
16121
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[email protected]
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Contact person for scientific queries
Name
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Cathy Stinear
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Address
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Department of Medicine
University of Auckland
Private Bag 92019
Auckland 1142
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Country
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New Zealand
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Phone
7049
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+64 9 92 33 779
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Fax
7049
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Predicting Recovery Potential for Individual Stroke Patients Increases Rehabilitation Efficiency.
2017
https://dx.doi.org/10.1161/STROKEAHA.116.015790
Embase
Proportional Motor Recovery after Stroke: Implications for Trial Design.
2017
https://dx.doi.org/10.1161/STROKEAHA.116.016020
N.B. These documents automatically identified may not have been verified by the study sponsor.
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