Characterising Arm Recovery in People With Severe Stroke "CARPSS"

Recruiting

Phase N/A Results N/A

Trial Description

The main goal of this program of research is to advance our understanding of how the severely damaged brain changes over the first 12-months post stroke. The investigators will determine 'who recovers', 'who does not recover', and 'why'

Detailed Description

The main goal of this program of research is to advance our understanding of how the severely damaged brain changes over the first 12-months post stroke. The prevalence and severity of stroke related arm disability is increasing and the prospect of optimal recovery is poor. Studies have demonstrated that stroke survivors with severe disability lack early indicators (<7-days to <1-month post-stroke) of a good prognosis, such as active movement at the shoulder and wrist and integrity of the corticospinal tract. This has propagated the clinical belief that this cohort are unlikely to functionally benefit from rehabilitation efforts. However, it is possible that indicators of potential for recovery - either neuroanatomical or clinical - may present in individuals with severe stroke later, that is beyond the early time-period. Indeed, there is increasing evidence of the potential for ongoing improvements in motor performance in response to intensive interventions that are undertaken 6-months or more post-stroke. This therefore, implies that there is some degree of untapped recovery potential. However, as very few studies have longitudinally explored the potential indicators of recovery in a severe cohort, the dynamic capacity of the severely damaged remains unknown. Thus, there is a need to determine 'who recovers', 'who does not recover', and 'why' to be able to promote optimal arm recovery in people with severe impairment after stroke. We will assess stroke survivors <4-weeks, 3-months, 6-months and 12-months post stroke using a range of neuroimaging and clinical outcome measures. The findings from this study will build the foundations for more personalized health care options for people with severe arm impairment post stroke.

Conditions

Interventions

  • Longitudinal evaluation of recovery Other
    Intervention Desc: Stroke survivors will be assessed at four time frames post stroke to evaluate neuroplastic and clinical changes in arm recovery over the first 12-months post stroke.
    ARM 1: Kind: Experimental
    Label: Longitudinal evaluation of recovery
    Description: Stroke survivors with subacute and severe upper limb disability

Trial Design

  • Observation: Cohort
  • Perspective: Prospective
  • Sampling: Probability Sample

Trial Population

Stroke survivors with subacute and severe upper limb disability will be evaluated longitudinally.

Outcomes

Type Measure Time Frame Safety Issue
Primary 3T Magnetic Resonance Imaging (MRI) up to 12-months No
Secondary Shoulder abduction and finger extension (SAFE) 12-months No
Secondary Fugl-Meyer Assessment (arm and sensory) <4wks, 3-months, 6-months, 12-months No
Secondary Motor Assessment Scale items 6,7,8 <4wks, 3-months, 6-months, 12-months No
Secondary REACH (Rating of Everyday Arm Use in the Community and Home) <4wks, 3-months, 6-months, 12-months No
Secondary Accelerometry <4wks, 3-months, 6-months, 12-months No
Secondary PASS (Postural Assessment Scale for Stroke patients) <4wks, 3-months, 6-months, 12-months No
Secondary 10-metre walk test <4wks, 3-months, 6-months, 12-months No
Secondary Montreal Cognitive Assessment (MoCA) <4wks, 3-months, 6-months, 12-months No
Secondary Dose of upper limb training <4wks, 3-months, 6-months, 12-months No
Secondary National Institute of Stroke Severity Scale <4-weeks No
Secondary Oxfordshire Bamford Classification <4-weeks No
Secondary Myelin water fraction imaging (WMI) <4wks, 3-months, 6-months, 12-months No
Secondary Meaningful arm recovery questionnaire <4wks, 3-months, 6-months, 12-months No

Sponsors