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

3 de setembro de 2026 atualizado por: 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.

Visão geral do estudo

Tipo de estudo

Intervencional

Inscrição (Estimado)

150

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Locais de estudo

    • Alberta
      • Calgary, Alberta, Canadá, T2N 2T9
        • Ainda não está recrutando
        • Foothills Medical Center
        • Contato:
        • Contato:
        • Investigador principal:
          • Victor Ezeugwu, PhD
      • Calgary, Alberta, Canadá, T2E 6V7
        • Ainda não está recrutando
        • Carewest Dr Vernon Fanning Centre
        • Contato:
        • Contato:
        • Investigador principal:
          • Victor Ezeugwu, PhD
      • Edmonton, Alberta, Canadá, T6G 2B7
        • Recrutamento
        • University of Alberta Hospital
        • Contato:
        • Contato:
        • Investigador principal:
          • Victor Ezeugwu, PhD
      • Edmonton, Alberta, Canadá, T5H 3V9
        • Recrutamento
        • Royal Alexandra Hospital
        • Contato:
        • Contato:
        • Investigador principal:
          • Victor Ezeugwu, PhD
      • Edmonton, Alberta, Canadá, T6L 5X8
        • Recrutamento
        • Grey Nuns Community Hospital
        • Contato:
        • Contato:
        • Investigador principal:
          • Victor Ezeugwu, PhD
      • Edmonton, Alberta, Canadá, T5G 0B7
        • Recrutamento
        • Glenrose Rehabilitation Hospital
        • Contato:
        • Contato:
        • Investigador principal:
          • Victor Ezeugwu, PhD

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

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.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição cruzada
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
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.
Outro: Delayed BIG STEPS
The waitlist control group will complete the BIG STEPS intervention after 6 months.
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.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Physical functioning: Step Counts
Prazo: 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)

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Sedentary time
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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.

Outras medidas de resultado

Medida de resultado
Descrição da medida
Prazo
Stanford Gender-Related Variables for Health Research scale
Prazo: 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
Prazo: 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
Prazo: 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)
Prazo: 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
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 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.

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

3 de agosto de 2026

Conclusão Primária (Estimado)

30 de junho de 2030

Conclusão do estudo (Estimado)

30 de junho de 2031

Datas de inscrição no estudo

Enviado pela primeira vez

3 de julho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

8 de julho de 2026

Primeira postagem (Real)

14 de julho de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

4 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

3 de setembro de 2026

Última verificação

1 de setembro de 2026

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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