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Trial registered on ANZCTR
Registration number
ACTRN12613000764730
Ethics application status
Approved
Date submitted
4/07/2013
Date registered
9/07/2013
Date last updated
5/11/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
The strokeIMPACT translation trial: IMproving Physical ACtivity via Treadmill training - Translating the evidence
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Scientific title
How feasible and effective is it for physiotherapists to deliver a high intensity treadmill training and self-management program to stroke patients undergoing rehabilitation?
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Secondary ID [1]
282786
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Nil
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Universal Trial Number (UTN)
U1111-1145-2834
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Trial acronym
IMPACT translation (Improving Physical Activity via Treadmill Training - translation)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
People with stroke
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Condition category
Condition code
Stroke
289878
289878
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0
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Ischaemic
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Stroke
289879
289879
0
0
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Haemorrhagic
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Neurological
289880
289880
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
(1) Treadmill walking - 30 minute sessions, 3 times a week for up to 8 weeks at 60% heart rate reserve. Maximum possible total dose of treadmill training is 12 hours. Participants will be individually monitored throughout the treadmill sessions by a physiotherapist.
(2) Chronic Disease Self Management (CDSM) - During the same period that participants are receiveing treadmill training, they will also receive a CDSM program. This will involve 5-10 minute sessions, 3 times a week for up to 8 weeks. The sessions will be delivered individually to the participants by the treating physiotherapist prior to or during the treadmill sessions. Participants will be taught behaviour change techniques such as goal setting and action planning to encourage initiation and maintenance of physical activity.
(3) Usual care - Participants will also receive usual physiotherapy and rehabilitation during this time although treadmill training will replace over-ground gait retraining.
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Intervention code [1]
287463
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Rehabilitation
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Intervention code [2]
287464
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Prevention
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Intervention code [3]
287465
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Behaviour
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Feasibility - Feasibility will be determined by: the number of stroke patients suitable for the intervention; compliance with the treadmill protocol; adverse events (for example, falls or patient-reported fatigue); participant satisfaction (assessed using a Likert Scale questionnaire designed specifically for this study).
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Assessment method [1]
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Timepoint [1]
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Monitored daily throughout the 8 week intervention
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Primary outcome [2]
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Physical activity - Actual activity levels (steps per day) measured over a 4 day period using an accelerometer (ActivPal)
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Assessment method [2]
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Timepoint [2]
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Week 8, week 26
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Secondary outcome [1]
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Walking ability (speed and endurance) as measured by the 6-minute walk test and the 10m walk test
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Assessment method [1]
303611
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Timepoint [1]
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Weeks 0,8,26
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Secondary outcome [2]
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Cardiorespiratory fitness (VO2 peak, Heart rate, blood pressure and rate pressure product) measured during the 6-minute walk test by a fully portable compact metabolic system using breath by breath analysis
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Assessment method [2]
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Timepoint [2]
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Weeks 0, 8, 26
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Secondary outcome [3]
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Lipid profile and inflammatory markers (TC, HDL, LDL, TRG, hs-CRP) will be taken via a fingerstick and analysed on a point of care device
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Assessment method [3]
303613
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Timepoint [3]
303613
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Weeks 0, 8, 26
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Secondary outcome [4]
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Self-efficacy of walking ability will be measured using the Ambulatory Self-Confidence Questionnaire
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Assessment method [4]
303614
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Timepoint [4]
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Weeks 8 and 26
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Secondary outcome [5]
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Health realted quality of life will be measured using the EuroQual-5D + VAS questionnaire
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Assessment method [5]
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Timepoint [5]
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Weeks 8 and 26
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Secondary outcome [6]
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Participation will be measured using the Impact on Participation and Autonomy Questionnaire (IPAQ)
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Assessment method [6]
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Timepoint [6]
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Weeks 8 and 26
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Secondary outcome [7]
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Subjectively measured physical activity will be measured by the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)
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Assessment method [7]
303617
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Timepoint [7]
303617
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Weeks 8 and 26
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Secondary outcome [8]
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Burden of care will be assessed using the Caregiver Burden Scale
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Assessment method [8]
303618
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Timepoint [8]
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Weeks 8 and 26
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Secondary outcome [9]
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Translation of treadmill training into clinical practice will be determined using a clinical practice audit of treatment during physiotherapy sessions. Therapist perceptions of barriers and facilitators to implementation of treadmill training will be determined using focus groups and semi-structured interviews
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Assessment method [9]
303619
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Timepoint [9]
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Throughout the 8 week intervention (focus groups will be conducted prior to the commencement of the intervention and semi-structured interviews will be conducted with therapists after they have had participants complete a full 8 weeks of the intervention).
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Eligibility
Key inclusion criteria
Within 2 months of stroke.
Aged over 18 years.
Able to walk independently for 10m with or without an aid. Able to understand 3-stage commands
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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
Unable to walk independently prior to current stroke
Co-morbidities that might limit walking (e.g., arthritis, Parkinson's disease, brain injury)
Unstable cardiac status
Unable to understand instructions
Unable to provide informed consent
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Study design
Purpose of the study
Treatment
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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)
Non-randomised pre-post intervention study
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
A sample size of 60 will be recruited to this study. This sample will be primarily one of convenience and aim to recruit people with a range of ages, stroke severity and functional ability post stroke across both genders. This sample size would enable us to detect an effect size of 0.5; which reflects a difference in physical activity of 1200 steps per day with 80% power at a two-tailed significance level of 0.05. This number is also sufficiently powered to detect clinically minimally important differences in secondary outcome measures.
Within groups statistical analysis will be performed on all outcome measures at all time points. Results will be reported as point measures and measures of variability. Primary and secondary outcome measures will be analysed using paired samples t-tests or repeated measures ANOVA or nonparametric analyses as appropriate. Results will be accepted as statistically significant at p< 0.05. SPSS 19.0 will be used and statistical significance will be set at 0.05 level of significance.
Qualitative component: Interviews will be transcribed verbatim and will analysed using a symbolic interactionism framework to explore therapist perception of the evidence regarding retraining walking and fitness, high-intensity treadmill training and the barriers and facilitators to implementing this. Interviews will be conducted prior to commencement of and on completion of the treadmill intervention with therapists across both facilities.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/11/2013
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Actual
14/09/2013
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
1204
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The Prince Charles Hospital - Chermside
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Recruitment hospital [2]
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Brighton Day Surgery - Brighton
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Recruitment postcode(s) [1]
7068
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4032 - Chermside Centre
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Recruitment postcode(s) [2]
7365
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4017 - Brighton
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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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Office of Health and Medical Research
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Address [1]
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Health and Medical Research
PO Box 2368
Fortitude Valley QLD 4006
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Country [1]
287558
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Australia
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Primary sponsor type
University
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Name
University of Queensland
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Address
St Lucia
Brisbane, QLD
4072
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Country
Australia
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Secondary sponsor category [1]
286309
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University
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Name [1]
286309
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Griffith University
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Address [1]
286309
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Gold Coast campus
Southport
Queensland 4222
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Country [1]
286309
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
289535
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University of Queensland Medical Research Ethics Committee
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Ethics committee address [1]
289535
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St Lucia Brisbane QLD 4072
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Ethics committee country [1]
289535
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Australia
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Date submitted for ethics approval [1]
289535
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Approval date [1]
289535
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20/11/2012
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Ethics approval number [1]
289535
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2012001247
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Summary
Brief summary
Stroke is a leading cause of disability amongst Australians. After stroke, activity levels are low, with few people able to exercise at an intensity which will reduce the risk of future cardiovascular events. This project examines the feasibility and effectiveness of usual physiotherapy staff in rehabilitation implementing a combined high intensity treadmill training program with a self management approach to improve activity levels, mobility, cardiovascular risk profile in stroke survivors, increasing their independence and reducing the burden of care. In addition, this project will investigate the barriers and facilitators to physiotherapists implementing this approach to stroke management as part of their clinical practice.
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Trial website
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Trial related presentations / publications
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Public notes
This trial is related to the StrokeIMPACT trial (ACTRN12613000744752).
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Contacts
Principal investigator
Name
41238
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Prof Sandra Brauer
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Address
41238
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Therapies Building (84a)
University of Queensland
St Lucia Campus QLD
4072
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Country
41238
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Australia
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Phone
41238
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+617 3365 2317
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Fax
41238
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+617 3365 2775
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Email
41238
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[email protected]
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Contact person for public queries
Name
41239
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Sandra Brauer
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Address
41239
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Therapies Building (84a)
University of Queensland
St Lucia Campus QLD
4072
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Country
41239
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Australia
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Phone
41239
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+617 3365 2317
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Fax
41239
0
+617 3365 2775
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Email
41239
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[email protected]
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Contact person for scientific queries
Name
41240
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Sandra Brauer
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Address
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Therapies Building (84a)
University of Queensland
St Lucia Campus QLD
4072
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Country
41240
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Australia
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Phone
41240
0
+617 3365 2317
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Fax
41240
0
+617 3365 2775
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Email
41240
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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
High-intensity treadmill training and self-management for stroke patients undergoing rehabilitation: a feasibility study.
2021
https://dx.doi.org/10.1186/s40814-021-00941-w
N.B. These documents automatically identified may not have been verified by the study sponsor.
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