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Biomarkers and Perfusion - Training-Induced Changes After Stroke (BAPTISe)

5 juin 2019 mis à jour par: Alexander H Nave, Charite University, Berlin, Germany

Biomarkers and Perfusion - Training-Induced Changes After Stroke (BAPTISe): Protocol of an Observational Study Accompanying a Randomized Controlled Trial

The purpose of this observational study is to examine the effects of 4-weeks of physical fitness training in patients with subacute ischemic stroke on cerebral imaging and blood-derived biomarkers.

Aperçu de l'étude

Statut

Complété

Description détaillée

This biomarker-driven study uses an observational design to examine a subgroup of patients in the randomized, controlled trial "Physical Fitness Training in Subacute Stroke" (PHYS-STROKE). In PHYS-STROKE, 215 patients with subacute stroke (hemorrhagic and ischemic) receive either 4-weeks of physical training (aerobic training, 5 times a week, for 50 minutes) or 4-weeks of relaxation sessions (5 times a week, for 50 minutes). A convenience sample of 100 of these patients with ischemic stroke will be included in BAPTISe and will receive magnetic resonance imaging (MRI) scans and blood tests before and after the PHYS-STROKE intervention. Imaging scans will address parameters of cerebral perfusion and vessel size imaging. Blood tests will determine several parameters such as immunity, inflammation (including neopterin, MMP-9), metabolism (including ApoCIII, oxidized LDL, HOMA-index, uric acid, CK-MB, cystatin c, and leptin), cytokines (osteopontin, adiponectin), and endothelial function (SDF1-alpha, ADMA, sICAM, sVCAM, E-selectin, P-selectin). Additionally, we will assess the association between functional outcomes (co-primary outcome measures of PHYS-STROKE) and biomarkers including imaging results.

Type d'étude

Observationnel

Inscription (Réel)

100

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

      • Berlin, Allemagne, 10117
        • Charité - Universitätsmedizin Berlin

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

Patients recruited for this study are collected at the rehabilitation hospital and are participating in the PHYS-STROKE trial.

La description

Inclusion Criteria:

  • Age: > 18 years
  • Diagnosis of subacute ischemic stroke (within 5-45 days after stroke onset)as determined by initial MRI/CT scan of the brain
  • Cortical, sub-cortical, or brainstem affection
  • Barthel Index (BI) <65 at inclusion
  • Able to sit for at least 30 seconds (unsupported or supported, i.e., holding onto supports such as the edge of the bed)
  • Ability to perform aerobic exercise, determined by by responsible physician
  • Provision of written informed consent

Exclusion Criteria:

  • Lacking ability to comply with study requirements
  • Stroke due to intracranial haemorrhage
  • Previous subarachnoid hemorrhage or other hemorrhagic stroke
  • Progressive stroke
  • Not able to receive magnetic resonance imaging scans, including perfusion imaging
  • Unable to perform the required exercises due to medical, musculoskeletal, or neurological problems
  • Required help of at least 1 person to walk before stroke due to neurological (e. g., advanced Parkinson's disease, Amyotrophic Lateral Sclerosis, Multiple Sclerosis) or non-neurological co-morbidities (e. g. heart failure, orthopaedic problems)
  • Life expectancy < 1 year as determined by responsible physician
  • Drug or alcohol addiction within the last six months
  • Significant current psychiatric illness defined as medication-refractory of bipolar affective disorder, psychosis, schizophrenia or suicidality
  • Current participation in another interventional trial

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Cohortes et interventions

Groupe / Cohorte
Physical Fitness
Patients from this group underwent 4 weeks of aerobic fitness training additional to normal supportive care, 5 times a week, for 50 minutes
Relaxation
Patients of this group received 4-weeks of relaxation sessions additional to normal supportive care, 5 times a week, for 50 minutes.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Cerebral perfusion
Délai: baseline and 4-weeks

Magnetic resonance imaging (MRI)-based cerebral perfusion are assessed before and after the 4-weeks of physical fitness training.

Primary and secondary endpoints are specified after completion of the interim analysis after inclusion of the first 24 patients (first stage). In a second stage the study is conducted with specified primary and secondary endpoints with recruitment of up to 76 remaining patients.

baseline and 4-weeks
Blood-derived biomarkers
Délai: baseline and 4-weeks

Changes in blood biomarkers are assessed before and after the 4-weeks intervention of physical fitness training.

Primary and secondary endpoints are specified after completion of the interim analysis after inclusion of the first 24 patients (first stage). In a second stage the study is conducted with specified primary and secondary endpoints with recruitment of up to 76 remaining patients.

baseline and 4-weeks

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
next cerebrovascular event
Délai: 6 months
Patients re-admitting hospital with suspected transient ischemic attack (TIA), stroke, or other cerebrovascular event within 6 months post stroke
6 months
functional outcome
Délai: directly after the end of intervention and 3 months post stroke
functional outcome assessed via functional scores such as Barthel Index and walking speed (co-primary endpoints of PHYS-STROKE) as well as the modified Rankin Scale (mRS)
directly after the end of intervention and 3 months post stroke

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
functional outcome
Délai: 3 months
Analyzing how changes in imaging measures and blood-derived biomarkers are related to each other and to differences in functional outcome, in particular gait speed, Barthel index (co-primary endpoints of PHYS-STROKE) and modified Rankin Scale
3 months
endothelial function assessment
Délai: measurement before and after the 4 weeks intervention
the endothelial function of included patients will be assessed prospectively before and after the 4 week intervention with the Endopat2000 device. First measurement was conducted in January 11th 2014. Results will be correlated with imaging and blood-derived biomarkers as well as differences between intervention groups.
measurement before and after the 4 weeks intervention
Clinical biomarkers including vital Parameters
Délai: measurements at baseline and all follow-up time points (measurement before and after the 4 weeks intervention, at 3 months and at 6 months after stroke)
systolic and diastolic blood pressure, resting heart rate, body-mass-index, and waist-to-hip-ratio over time compared between study groups
measurements at baseline and all follow-up time points (measurement before and after the 4 weeks intervention, at 3 months and at 6 months after stroke)

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Martin Ebinger, MD, Center for Stroke Research Berlin
  • Chercheur principal: Alexander H Nave, MD, Center for Stroke Research Berlin

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 octobre 2013

Achèvement primaire (Réel)

1 juillet 2017

Achèvement de l'étude (Réel)

1 novembre 2017

Dates d'inscription aux études

Première soumission

27 septembre 2013

Première soumission répondant aux critères de contrôle qualité

4 octobre 2013

Première publication (Estimation)

7 octobre 2013

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

7 juin 2019

Dernière mise à jour soumise répondant aux critères de contrôle qualité

5 juin 2019

Dernière vérification

1 juin 2019

Plus d'information

Termes liés à cette étude

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INDÉCIS

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