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Behavioral Intervention and Guided Stepping Training Early Post-Stroke (BIG STEPS)

3. september 2026 opdateret af: University of Alberta

Behavioral Intervention and Guided Stepping Training Early Post-Stroke (BIG STEPS): A Randomized Controlled Trial Investigating the Effect of a 3-month Behavioral Intervention and Guided Stepping Training in Early Post-stroke Patients.

Low daily steps and prolonged sedentary behavior are associated with reduced functional outcomes and quality of life in patients with stroke. The goal of this research project is to test the effect of increasing daily step counts and reducing sedentary time early after stroke, on functional mobility and global disability outcomes.

The investigators aim to recruit 150 participants, aged 50 years and over, within three months of stroke onset, whom have recently returned or are returning home from hospital and are able to walk 5 meters with or without a gait aid. At baseline, demographic and stroke characteristics will be determined and documented. A battery of impairment, psychosocial, and functional measures will be completed. Step counts (primary outcome) and sedentary time will be determined from activPAL accelerometry.

Following randomization, a sedentary behaviour change and guided stepping intervention (BIG STEPS) will be extended to the experimental arm (early BIG STEPS), the intervention will span 3 months, with final follow-up assessments every 90 days, until the final assessment at 12 months. The waitlist control group (delayed BIG STEPS) will receive the BIG STEPS intervention after a 6 month wait period.

The primary outcome of this study is change in step counts from baseline to 3 months, measured with an activPAL accelerometer. Secondary outcomes include sedentary time, functional mobility, and walking endurance measured every 90 days for 12 months. Patient-reported mood, fatigue, and quality of life outcomes will also be assessed.

The BIG STEPS program will allow individuals with stroke to take an active role in their recovery, encouraging engagement, autonomy and sustained health outcomes. The implementation of a waitlist RCT design allows for the evaluation the critical period for intervention delivery. The results of this trial will help inform future changes in best practice, reducing disability after stroke and improving patient quality of life.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

150

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Canada
    • Alberta
      • Calgary, Alberta, Canada, T2N 2T9
        • Ikke rekrutterer endnu
        • Foothills Medical Center
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Victor Ezeugwu, PhD
      • Calgary, Alberta, Canada, T2E 6V7
        • Ikke rekrutterer endnu
        • Carewest Dr Vernon Fanning Centre
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Victor Ezeugwu, PhD
      • Edmonton, Alberta, Canada, T6G 2B7
        • Rekruttering
        • University of Alberta Hospital
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Victor Ezeugwu, PhD
      • Edmonton, Alberta, Canada, T5H 3V9
        • Rekruttering
        • Royal Alexandra Hospital
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Victor Ezeugwu, PhD
      • Edmonton, Alberta, Canada, T6L 5X8
        • Rekruttering
        • Grey Nuns Community Hospital
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Victor Ezeugwu, PhD
      • Edmonton, Alberta, Canada, T5G 0B7
        • Rekruttering
        • Glenrose Rehabilitation Hospital
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Victor Ezeugwu, PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Aged 50 - or older
  • Had an ischemic or hemorrhagic stroke within the last 3 months
  • Have recently returned or are returning home from hospital
  • Able to walk 5 meters with or without a gait aid

Exclusion Criteria:

  • Previously diagnosed with a mobility limiting musculoskeletal condition
  • Previously diagnosed with a mobility limiting neurological condition
  • Have cardiac conditions (e.g. blood pressure ≥180/100 mmHg)
  • Are without access to an internet-enabled computer or mobile device
  • Are enrolled in another interventional trial such as exercise or neuroprotection trials
  • Have aphasia or are unable to provide consent in English.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Early BIG STEPS
Using baseline accelerometry data, personalized goals of replacing sedentary time with stepping time will be developed. Participants will start the BIG STEP intervention within 3 months of stroke onset.
Adfærdsmæssigt: Behavior and guided stepping training intervention (BIG STEPS)
The BIG STEPS intervention comprises a home-based behavioral intervention aimed at reducing and frequently interrupting prolonged sedentary periods, along with guided stepping training to gradually increase daily steps. Participants will wear an accelerometer throughout the whole day for four consecutive days during each assessment. Using baseline accelerometer data, prolonged periods of sedentary time or minimal activity levels will be identified and used to inform personalized activity and behavior-change recommendations.
Andet: Delayed BIG STEPS
The waitlist control group will complete the BIG STEPS intervention after 6 months.
Adfærdsmæssigt: DELAYED Behavior and guided stepping training intervention
The waitlist control group will complete the BIG STEPS intervention after 6 months. During the waiting period they will receive usual care and educational materials.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Physical functioning: Step Counts
Tidsramme: Difference in changes from baseline to 3 months (post intervention/post waiting)
activPAL derived step counts
Difference in changes from baseline to 3 months (post intervention/post waiting)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Sedentary time
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
activPAL-derived sedentary time.
Change from baseline at 3, 6, 9 and 12 months.
Global Disability
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
Modified Rankin Scale (mRS) 0-5, higher scores mean worse outcome.
Change from baseline at 3, 6, 9 and 12 months.
Functional mobility
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
Timed Up and Go Test (TUG)
Change from baseline at 3, 6, 9 and 12 months.
Gait Speed
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
10-meter walk test (10MWT)
Change from baseline at 3, 6, 9 and 12 months.
Walking Endurance
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
6-Minute walk test (6MWT)
Change from baseline at 3, 6, 9 and 12 months.
Self efficacy
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
Stroke Self Efficacy Questionnaire is a 13-item questionnaire. Higher scores in each subscale indicate higher confidence levels and better self-efficacy.
Change from baseline at 3, 6, 9 and 12 months.

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Stanford Gender-Related Variables for Health Research scale
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
The Stanford Gender-Related Variables for Health Research scale is a 25-item self-report survey that measures how specific gender-related behaviors and roles impact physical and mental well-being.
Change from baseline at 3, 6, 9 and 12 months.
Cognition
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
5-minute Montreal Cognitive Assessment (5-min MoCA)
Change from baseline at 3, 6, 9 and 12 months.
Memory
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
Multifactorial Memory Questionnaire 9 (MMQ-9). T scores will be derived. T scores between 40 and 60 are generally interpreted as average.
Change from baseline at 3, 6, 9 and 12 months.
EuroQol-5 Dimension 5-Level (EQ-5D-5L)
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
The 5-level EQ-5D version (EQ-5D-5L) is a patient-reported quality of life measure. Country-specific valuation set will be used. The EQ-5D VAS score rates perceived health on a scale of 0-100, where higher scores are better.
Change from baseline at 3, 6, 9 and 12 months.
Depression
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
Patient Health Questionnaire (PHQ-9) is a 9-item questionnaire where higher scores represent worse outcome.
Change from baseline at 3, 6, 9 and 12 months.
Fatigue Severity Scale (FSS)
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
Fatigue Severity Scale (FSS) is a 9-item questionnaire with higher scores indicating worse outcome
Change from baseline at 3, 6, 9 and 12 months.
Pittsburgh Sleep Quality Index (PSQI)
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
Pittsburgh Sleep Quality Index (PSQI) scores range from 0 to 21 where higher scores are worse.
Change from baseline at 3, 6, 9 and 12 months.
Modified Caregiver Stress Index
Tidsramme: Change from baseline at 3, 6, 9 and 12 months.
Modified Caregiver Stress Index is a 13-item questionnaire with higher scores indicating greater caregiver burden.
Change from baseline at 3, 6, 9 and 12 months.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Alberta

Samarbejdspartnere

Canadian Institutes of Health Research (CIHR)

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

3. august 2026

Primær færdiggørelse (Anslået)

30. juni 2030

Studieafslutning (Anslået)

30. juni 2031

Datoer for studieregistrering

Først indsendt

3. juli 2026

Først indsendt, der opfyldte QC-kriterier

8. juli 2026

Først opslået (Faktiske)

14. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Pro00140017

Plan for individuelle deltagerdata (IPD)

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