Worldwide trial publishes initial findings

A trial funded by the HTA Programme comparing rehabilitation treatments for patients after they have had a stroke, has published its initial findings in The Lancet, this week. Results were also presented at the inaugural European Stroke Organisation Conference in Glasgow.

A Very Early Rehabilitation Trial (AVERT) compares usual stroke rehabilitation methods to a rehabilitation treatment that starts within 24 hours of a patient having a stroke. The trial, involving 2104 patients, is running in 56 hospitals worldwide including Australia, New Zealand, Singapore, Malaysia and the UK.

Normal treatment methods after a stroke usually involve a period when the patient remains immobile and restricted to bed rest. However, previous research evidence from three smaller trials suggested that frequent ‘out of bed’ activity and movement might reduce the potential for a patient developing complications following a stroke and improve longer-term quality of life.

The AVERT trial wants to establish if starting rehabilitation treatment very early after a stroke affects the numbers of patients that develop ongoing disability, if there is an improvement in patient quality of life over the longer term and if there are any differences in patient mortality.

Patients involved in the trial are randomly assigned normal stroke treatment or receive the very early rehabilitation treatment for a period of up to two weeks.

Lead investigator Professor Peter Langhorne from Glasgow University said, “We found that early rehabilitation was safe, with low death and low complications rates in the vast majority of patients. This is a testament to the modern stroke unit care these patients received.

However, we also found that patients in the early but lower dose group were more likely to make a good recovery by 3 months after stroke.

This tells us that we must be cautious with very early intensive rehabilitation and further exploration of the results is underway to determine which approach is best for individual patients.

The value of conducting this trial won’t be fully realised for some time, but the high quality of the trial and comprehensive nature of the data gathered is a testament to the commitment of the patients, families, hospital and research staff involved.”

 

The project will publish its full report in Health Technology Assessment in 2017.

Find out more about the project via NIHR website and read the initial findings in The Lancet article.



More articles     Posted on: 20 April 2015