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

5. juni 2019 oppdatert av: 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.

Studieoversikt

Status

Fullført

Forhold

Detaljert beskrivelse

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.

Studietype

Observasjonsmessig

Registrering (Faktiske)

100

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Tyskland
      • Berlin, Tyskland, 10117
        • Charité - Universitätsmedizin Berlin

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

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

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Cerebral perfusion
Tidsramme: 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
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
next cerebrovascular event
Tidsramme: 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
Tidsramme: 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

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
functional outcome
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)

Samarbeidspartnere og etterforskere

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Sponsor

Charite University, Berlin, Germany

Etterforskere

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

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. oktober 2013

Primær fullføring (Faktiske)

1. juli 2017

Studiet fullført (Faktiske)

1. november 2017

Datoer for studieregistrering

Først innsendt

27. september 2013

Først innsendt som oppfylte QC-kriteriene

4. oktober 2013

Først lagt ut (Anslag)

7. oktober 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

7. juni 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

5. juni 2019

Sist bekreftet

1. juni 2019

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • BAPTISe
  • BMBF-G.2.15 (Annet stipend/finansieringsnummer: G.2.15)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

UBESLUTTE

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