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Life After STroke - the LAST Study

Life After STroke - the LAST Study. A Norwegian Multi Centre Randomized Controlled Trial

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01467206
Acronym
LAST
Enrollment
380
Registered
2011-11-08
Start date
2011-11-30
Completion date
2015-12-31
Last updated
2020-04-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cerebral Hemorrhage, Cerebral Infarction

Keywords

Stroke, Physiotherapy, Motor training, Rehabilitation

Brief summary

The LAST study is a Norwegian multi site randomised controlled trial that intends to assess the effect of a long term follow up program after stroke. The program consists of a coordinating physiotherapist who will encourage and motivate included patients to perform at least 60 minutes of intensive motor training every week and 30 minutes of physical activity every day for 18 months after inclusion. The primary hypothesis is that patients receiving a long term follow up program after stroke will have better motor function at end of follow up than patients receiving standard care. A total of 390 home dwelling stroke patients living in the municipality of Trondheim, Asker and Bærum will be included at the out-patient clinic at St. Olavs Hospital or Bærum Hospital three months after their stroke. Included patients will be randomised to an intervention group receiving the long term follow up program or to a control group receiving standard care. Motor function, mental health and physical functioning in daily life will be assessed at inclusion and 18 months later. The LAST study is funded by the Norwegian Research Council, the Norwegian University of Science and Technology and the Central Norway Regional Health Authority and will conclude at the end of 2015.

Detailed description

Supplement to the Life After Stroke - the LAST study ClinicalTrials.gov ID: NCT01467206 Changes in the planned statistical analysis, November 9, 2015 The original plan for statistical analysis was published in; Askim T, Langhammer B, Ihle-Hansen H, Magnussen J, Engstad T, Indredavik B. A Long-Term Follow-Up Programme for Maintenance of Motor Function after Stroke: Protocol of the life after Stroke-The LAST Study. Stroke Res Treat. 2012;2012:392101. doi: 10.1155/2012/392101. Epub 2012 Nov 22. Original plan for statistical analysis Reporting will follow the CONSORT statement for parallel group randomized trials \[40\]. Descriptive statistics will be performed in order to present the population and the characteristic of the two groups. All analyses will be analysed as intention-to-treat analysis according to the CONSORT instructions. Analysis of covariance (ANCOVA) will be used to study differences between groups according to the primary endpoint, motor assessment scale at 18 months after inclusion. The ANCOVA model will include stroke severity, age, pre stroke disability, treatment group, and motor function at baseline as covariates. Mann-Whitney U test will be used for secondary data not being normal distributed. In all analyses we will control for potential confounding factors, investigate effect modifications, and present both unadjusted and adjusted effects with 95% confidence intervals. Subanalysis will be performed according to the stratification variables (stroke severity, age above 80 and recruitment site) to explore trends within subgroups of patients. Revised plan for statistical analysis Reporting will follow the CONSORT statement for parallel group randomized trials \[40\]. Descriptive statistics will be performed in order to present the population and the characteristic of the two groups. All analyses will be analysed as intention-to-treat analysis according to the CONSORT instructions. Analysis of covariance (ANCOVA) will be used to study differences between groups according to the primary endpoint, motor assessment scale at 18 months after inclusion. The ANCOVA model will include stroke severity, age, pre stroke disability, treatment group, and motor function at baseline as covariates. Similar ANCOVA analyses will be used for the relevant secondary endpoints. Mann-Whitney U test will be used for secondary data not being normal distributed. Subanalysis will be performed according to the stratification variables (stroke severity, age above 80 and recruitment site), gender, and cognitive status (Mini Mental State below 25), to explore trends within subgroups of patients. Missing values will be handled using single imputation (typically for items on instrument scales), or by multiple imputation, as appropriate.

Interventions

BEHAVIORALLong term follow up by a coordinating physiotherapist

Monthly meetings with an coordinating physiotherapist who motivate and encourage the patient to do 60 minutes of weekly exercise and 30 minutes of daily physical activity

BEHAVIORALStandard care

Standard care as it is given to all stoke patients after stroke

Sponsors

St. Olavs Hospital
CollaboratorOTHER
Asker & Baerum Hospital
CollaboratorOTHER
The Research Council of Norway
CollaboratorOTHER
Helse Midt-Norge
CollaboratorOTHER
Norwegian University of Science and Technology
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 95 Years
Healthy volunteers
No

Inclusion criteria

* Diagnosis of stroke according to WHO's definition of stroke * Living in the city of Trondheim or the municipalities of Asker or Bærum * Included 2.5 - 4 months after stroke * Modified Rankin Scale 0 - 4 * Living at home * Mini Mental State Examination \> 20 or \> 16 if aphasia * Provide informed consent

Exclusion criteria

* Are already included in the study * Are included in other experimental studies * Unstable coronary function * Uncompensated heartfailure * Other diseases that make it difficult to complete the intervention

Design outcomes

Primary

MeasureTime frameDescription
Motor Assessment Scale18 months after inclusionA measure of over all motor function

Secondary

MeasureTime frameDescription
Barthel Index18 months follow upA measure of activities of daily living
Modified Rankin Scale18 months follow upA measure of dependency/independency
Berg Balance Scale18 months follow upA measure of balance related to basic movement tasks
Timed Up and Go18 months follow upA measure of balance related to transfer and walking
Sit to stand test18 months follow upA measure of dynamic muscle strength according to a sit to stand task
Six minute walk test18 months follow upA measure of endurance
Stroke Impact Scale18 months follow upA measure of health related quality of life after stroke
EuroQol 5D18 months follow upA simple measure of health related quality of life for the general population
Fatigue Severity Scale18 months follow upA measure of the presence of fatigue
One simple question on fatigue from the HUNT3 questionnaire18 months follow upA simple question used to assess tiredness in teh general Norwegian population
Hospital Anxiety and Depression Scale18 months follow upA measure of anxiety and depression
Mini Mental State Examination18 months follow upA measure of cognitive function
Montreal Cognitive Assessment18 months follow upA measure of cognitive function related to vascular dementia
falls6, 12 and 18 monthsSerious falls will be recorded from the patients hospital records
Death6, 12 and 18 monthsInformation about death will be collected from the Norwegain Death Registry
Fractures6, 12 and 18 monthsInformation about fractures during follow up will be collected from the patients medical records
Cardiovascular events6, 12 and 18 monthsInformation about any cardiovascular events will be collected from the patients medical record
Cerebrovascular events6, 12 and 18 monthsInformation about any cerebrovascular events during follow up will be collected from teh patient's medical records
International Physical Activity Questionnaire6, 12 and 18 monthsA measure of physical activity over the last week
Physical activity assessed by ActivPAL sensor system6, 12 and 18 monthsA sensor system to assess the amount of physical activity during a 4-7 day period
Three simple questions on physical activity from the HUNT questionnaire18 monthsA simple measure of physical activity
Health costs6, 12 and 18 monthsInformation about the use of health services will be collected by reviewing the patients' hospital records and records in primary health care system.
National Institutes of Health Stroke Scale18 months follow upA measure of stroke severity
Modified Ashworth Scale18 months follow upA measure to rate the degree of spasticity after stroke
Gait speed18 months follow upA simple measure of maximum gait speed across a 10 metres distance
Trailmaking test A and B18 months follow upA simple measure of executive cognitive function
DS-1418 months follow upA standard assessment of negative affectivity, social inhibition, and type D personality, which might be related to poor cardiovascular prognosis.
Readmission to hospital6, 12 and 18 monthsNumber of readmissions to hospital will be recorded from the patients medical records

Other

MeasureTime frameDescription
VO2-peak18 months follow upVO2-peak is obtained by use of a symptom limited treadmill test to measure cardiovascular fitness. This measure is only used in the Trondheim arm of the study

Countries

Norway

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 27, 2026