Exercise the Mind and Brain. A Multimodal Intervention in Stroke (Mindfit)
1 maart 2022 bijgewerkt door: Maria Mataro Serrat, University of Barcelona
Effects of Combined Therapies of Physical Exercise, Mindfulness and Cognitive Stimulation on Cognition and Neuroplasticity in Chronic Stroke Patients: A Randomized Controlled Trial
The main objective of MindFit Project is to develop an evidence-based multimodal investigation of combined non-pharmacological strategies in chronic stroke patients and clarify the neuroplasticity mechanisms underlying the benefits of physical exercise and mindfulness strategies combined with cognitive training on post-stroke recovery.
The investigators have adopted a multidisciplinary and multimodal approach to provide a more integrative perspective using cognitive, social-psychological, biochemical, and neuroimaging measurements.
Studie Overzicht
Toestand
Voltooid
Conditie
Gedetailleerde beschrijving
The MindFit Project is a multicentric, prospective, parallel, single-blinded, randomized controlled trial with a sample of 141 participants at 3 to 60 months after stroke. Participants are randomly allocated to one of three arms (through a simple randomizing procedure with a 1:1:1 ratio created with a random sequence generator software).
The first group (n=47) receives computer-based cognitive training (CCT) combined with a multicomponent physical exercise program. The second group (n=47) receives CCT combined with mindfulness-based stress reduction therapy. Finally, the third group (n=47), as an active control group, receives only CCT. All interventions last 12 weeks.
Within two weeks before the start of the interventions, and again at 3 months after completing the interventions, medical, cognitive, and physical assessments, neuroimaging, and biological samples collection are performed.
The objectives of this project are:
- To examine the effects of multimodal interventions in a population of chronic stroke patients on various domains: cognition, emotion, physical health, and quality of life.
- To examine specific plasticity effects of each of the three interventions regarding structural and functional magnetic resonance imaging (MRI) and how these changes may contribute to cognitive and emotional benefits.
- To study the molecular mechanisms by which the different types of interventions influence cognitive, emotional and brain benefits.
- To study interventions-induced microbiome changes and to explain how these changes may induce inflammatory and immune responses that may contribute to cognitive, emotional and brain benefits.
- To determine the demographic, clinical and genetic factors that may modulate cognitive, emotional and brain changes: baseline cognitive status; baseline cerebral status (atrophy, total intracranial volume); sex; age, educational level, intelligence.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
141
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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Barcelona, Spanje
- Maria Mataro
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar tot 80 jaar (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
Inclusion Criteria:
- Individuals aged 18-80 years old
- Ischemic or hemorrhagic stroke
- Stroke diagnoses between 3-60 months ago
- To have consent from a physician to engage in an exercise intervention
- Fluency in Catalan or Spanish (I.e., able to understand and speak)
- Accept to take part in the study and sign the informed consent according to the Declaration of Helsinki.
Exclusion Criteria:
- Cognitive impairment (MMSE > 23)
- Severe aphasia (item 9 of the NIHSS scale ≥ 2)
- Severe sensory problems
- Other neurological conditions apart from stroke
- Severe pre-stroke psychiatric disorders (e.g., bipolar disorder, schizophrenia)
- History of alcohol or other toxic abuse
Exclusion criteria only for MRI examination:
- Claustrophobia
- Medical device (e.g., pacemaker implants, stents)
- Other metal objects in the body
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Physical exercise & cognitive training group
The Physical exercise & cognitive training group receives a multicomponent physical exercise program combined with computer-based cognitive training.
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The proposed physical exercise intervention follows the American College of Sports Medicine (ACSM, 2017) and the American Stroke Association (Billinger et al., 2014) recommendations for stroke patients.
The five weekly 45-minute sessions are divided into (1) three sessions guided and supervised telematically by a physical exercise specialist and a physiotherapist; (2) and two autonomous exercise sessions.
The supervised sessions include exercises to work aerobic capacity, muscle strength and endurance, flexibility, agility, and balance.
The intensity of these exercises is prescribed individually according to each participant's initial level and are gradually increased as the program progresses.
Participants are encouraged to walk at a similar intensity on autonomous physical exercise days as performed in the guided sessions (moderate intensity), based on the Borg scale of perceived exertion (Borg, 1982).
An accredited neuropsychologist programs and supervises the computerized cognitive training through the Guttmann Neuropersonal Trainer (GNPT®) platform.
The 12-week program consists of five sessions a week (45 minutes each) that include personalized activities planned to stimulate executive functioning, attention, processing speed, and memory.
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Experimenteel: Mindfulness & cognitive training group
The Mindfulness & cognitive training group receives mindfulness-based stress reduction therapy combined with computer-based cognitive training.
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An accredited neuropsychologist programs and supervises the computerized cognitive training through the Guttmann Neuropersonal Trainer (GNPT®) platform.
The 12-week program consists of five sessions a week (45 minutes each) that include personalized activities planned to stimulate executive functioning, attention, processing speed, and memory.
This intervention follows an adaptation of the scheme and instructions of the official Mindfulness-Based Stress Reduction (MBSR) program designed by Jon Kabat-Zinn.
It includes body scanning, sitting meditation, and gentle hatha yoga techniques.
An accredited mindfulness instructor leads the 12-week online program, which comprises a presentation session, followed by eight intervention sessions (once a week, lasting 2.5 hours) and an intensive practice session interspersed between sessions six and seven.
Apart from the supervised session, the therapist asks participants to carry out some independent practice daily.
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Actieve vergelijker: Cognitive training group
The Cognitive training group, as an active control group, receives only computer-based cognitive training.
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An accredited neuropsychologist programs and supervises the computerized cognitive training through the Guttmann Neuropersonal Trainer (GNPT®) platform.
The 12-week program consists of five sessions a week (45 minutes each) that include personalized activities planned to stimulate executive functioning, attention, processing speed, and memory.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change in immediate verbal attention after receiving treatment
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Forward Digit Span (WAIS III)
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3 months (at baseline, 3 months from baseline)
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Change in verbal digit working memory after receiving treatment
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Backward Digit Span (WAIS III)
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3 months (at baseline, 3 months from baseline)
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Change in verbal memory after receiving treatment
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Rey Auditory Learning Test
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3 months (at baseline, 3 months from baseline)
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Change in visual memory after receiving treatment
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Rey's Complex Figure Test
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3 months (at baseline, 3 months from baseline)
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Change in executive function, verbal fluency after receiving treatment
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Phonetic Fluency is measured using the Controlled Oral Word Association Test, spanish adaptation, and semantic fluency test using the category Animal
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3 months (at baseline, 3 months from baseline)
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Change in executive function, inhibition after receiving treatment
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Stroop Test
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3 months (at baseline, 3 months from baseline)
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Change in executive function, set-switching task after receiving treatment
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Trail Making Test
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3 months (at baseline, 3 months from baseline)
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Change in language, naming after receiving treatment
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Boston naming Test
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3 months (at baseline, 3 months from baseline)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Changes in psychological distress
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Clinical Outcomes in Routine Evaluation (CORE-OM)
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3 months (at baseline, 3 months from baseline)
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Changes in depression and anxiety
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Depression Anxiety Stress Scale (DASS-21)
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3 months (at baseline, 3 months from baseline)
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Changes in wellbeing
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Ryff Scales of Psychological Wellbeing.
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3 months (at baseline, 3 months from baseline)
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Changes in Mindfulness
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Mindful Attention Awareness Scale (MAAS)
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3 months (at baseline, 3 months from baseline)
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Changes in White matter integrity
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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White matter integrity: tractography
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3 months (at baseline, 3 months from baseline)
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Changes in Resting-state connectivity
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Resting state brain activity using fMRI
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3 months (at baseline, 3 months from baseline)
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Changes in brain volumetry
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Grey and white matter volume measured by MRI
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3 months (at baseline, 3 months from baseline)
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Molecular changes: growth factors (BDNF, SDF1-a, VEGF-A, IGF-1, and NGF), cortisol, protein C reactive, IL-6 and homocysteine levels
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Quantification of different biomarkers from blood samples.
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3 months (at baseline, 3 months from baseline)
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Changes in Microbiota data
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Bacterial composition of stool samples in terms of relative abundance
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3 months (at baseline, 3 months from baseline)
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Changes in Sleep
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Pittsburgh Sleep Quality Index (PSQI)
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3 months (at baseline, 3 months from baseline)
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Changes in Fitness
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Senior Fitness Test (SFT)
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3 months (at baseline, 3 months from baseline)
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Changes in stroke specific quality of life
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Stroke-specific Quality of Life Scale (ECVI-38)
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3 months (at baseline, 3 months from baseline)
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Changes in quality of life
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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World Health Organization Quality of Life (WHOQOL-BREF)
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3 months (at baseline, 3 months from baseline)
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Changes in mental fatigue
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Fatigue Assessment Scale (FAS)
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3 months (at baseline, 3 months from baseline)
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Changes in physical activity:
Tijdsspanne: 3 months (at baseline, 3 months from baseline)
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Spanish version of the reduced Minnesota leisure-time physical and activity questionnaire (VREM)
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3 months (at baseline, 3 months from baseline)
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Maria Mataró, PhD, University of Barcelona
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
28 oktober 2020
Primaire voltooiing (Werkelijk)
30 juli 2021
Studie voltooiing (Werkelijk)
30 januari 2022
Studieregistratiedata
Eerst ingediend
31 december 2020
Eerst ingediend dat voldeed aan de QC-criteria
15 februari 2021
Eerst geplaatst (Werkelijk)
18 februari 2021
Updates van studierecords
Laatste update geplaatst (Werkelijk)
2 maart 2022
Laatste update ingediend die voldeed aan QC-criteria
1 maart 2022
Laatst geverifieerd
1 maart 2022
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- University of Barcelona
- 201717.30.31.32 (Ander subsidie-/financieringsnummer: La Marato de TV3)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
NEE
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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