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Completed

NCT Number: NCT01467206

Life After STroke - the LAST Study

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.

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Key information

Age range

18 year–95 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Bærum Hospital, Sandvika, Norway

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About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Long term follow up by a coordinating physiotherapist

Behavioral

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

Standard Care

Behavioral

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

Primary outcomes

  1. Motor Assessment Scale

    Time frame: 18 months after inclusion

    A measure of over all motor function

Secondary outcomes

  1. Barthel Index

    Time frame: 18 months follow up

    A measure of activities of daily living

  2. Modified Rankin Scale

    Time frame: 18 months follow up

    A measure of dependency/independency

  3. Berg Balance Scale

    Time frame: 18 months follow up

    A measure of balance related to basic movement tasks

  4. Timed Up and Go

    Time frame: 18 months follow up

    A measure of balance related to transfer and walking

  5. Sit to stand test

    Time frame: 18 months follow up

    A measure of dynamic muscle strength according to a sit to stand task

  6. Six minute walk test

    Time frame: 18 months follow up

    A measure of endurance

  7. Stroke Impact Scale

    Time frame: 18 months follow up

    A measure of health related quality of life after stroke

  8. EuroQol 5D

    Time frame: 18 months follow up

    A simple measure of health related quality of life for the general population

  9. Fatigue Severity Scale

    Time frame: 18 months follow up

    A measure of the presence of fatigue

  10. One simple question on fatigue from the HUNT3 questionnaire

    Time frame: 18 months follow up

    A simple question used to assess tiredness in teh general Norwegian population

  11. Hospital Anxiety and Depression Scale

    Time frame: 18 months follow up

    A measure of anxiety and depression

  12. Mini Mental State Examination

    Time frame: 18 months follow up

    A measure of cognitive function

  13. Montreal Cognitive Assessment

    Time frame: 18 months follow up

    A measure of cognitive function related to vascular dementia

  14. falls

    Time frame: 6, 12 and 18 months

    Serious falls will be recorded from the patients hospital records

  15. Readmission to hospital

    Time frame: 6, 12 and 18 months

    Number of readmissions to hospital will be recorded from the patients medical records

  16. Death

    Time frame: 6, 12 and 18 months

    Information about death will be collected from the Norwegain Death Registry

  17. Fractures

    Time frame: 6, 12 and 18 months

    Information about fractures during follow up will be collected from the patients medical records

  18. Cardiovascular events

    Time frame: 6, 12 and 18 months

    Information about any cardiovascular events will be collected from the patients medical record

  19. Cerebrovascular events

    Time frame: 6, 12 and 18 months

    Information about any cerebrovascular events during follow up will be collected from teh patient's medical records

  20. International Physical Activity Questionnaire

    Time frame: 6, 12 and 18 months

    A measure of physical activity over the last week

  21. Physical activity assessed by ActivPAL sensor system

    Time frame: 6, 12 and 18 months

    A sensor system to assess the amount of physical activity during a 4-7 day period

  22. Three simple questions on physical activity from the HUNT questionnaire

    Time frame: 18 months

    A simple measure of physical activity

  23. Health costs

    Time frame: 6, 12 and 18 months

    Information about the use of health services will be collected by reviewing the patients' hospital records and records in primary health care system.

  24. National Institutes of Health Stroke Scale

    Time frame: 18 months follow up

    A measure of stroke severity

  25. Modified Ashworth Scale

    Time frame: 18 months follow up

    A measure to rate the degree of spasticity after stroke

  26. Gait speed

    Time frame: 18 months follow up

    A simple measure of maximum gait speed across a 10 metres distance

  27. Trailmaking test A and B

    Time frame: 18 months follow up

    A simple measure of executive cognitive function

  28. DS-14

    Time frame: 18 months follow up

    A standard assessment of negative affectivity, social inhibition, and type D personality, which might be related to poor cardiovascular prognosis.

Other outcomes

  1. VO2-peak

    Time frame: 18 months follow up

    VO2-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

Sponsors and collaborators

Lead sponsor

Norwegian University of Science and Technology

Other

Collaborators

  • Asker & Baerum Hospital
  • Helse Midt-Norge
  • St. Olavs Hospital
  • The Research Council of Norway

Registry information

Official study title

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

Acronym: LAST

Important dates

Study start
2011
Primary completion
2015
Study completion
2015
First posted
Nov 8, 2011
Registry last updated
Apr 13, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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