Time Window for Ischemic Stroke First Mobilization Effectiveness

NCT ID: NCT03938311

Last Updated: 2022-03-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

1500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-13

Study Completion Date

2022-12-31

Brief Summary

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Early mobilization was thought to be effective in patients with acute ischemic stroke. As the essential component of stroke unit care, early mobilization has already been part of routine clinical practice. However, it is uncertain that which and when medical service focusing on functional recovery should be delivered after the emergency interventions for stroke. Besides, the optimal time window, for delivering early mobilization after acute ischemic stroke, has not been verified with strong evidence.

Detailed Description

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The TIME Trial is a pragmatic, investigator-initiated, multi-center, randomized, 3-arm parallel group, clinical trial. This trial will be conducted in 57 general hospitals in mainland China affiliated with the China Stroke Databank Center and will enroll 6033 eligible patients with acute ischemic stroke. Participants will be randomly allocated to either (1) the very early mobilization group in whichmobilization is initiated within 24 hours from stroke onset, (2) the early mobilization group in which mobilization begins between 24 and 72 hours poststroke, or (3) the late mobilization group in which mobilization is started after 72 hours poststroke. The mobilization protocol is otherwise standardized and identical for each comparison group. Mobilization is titrated by baseline mobility level and progress of patients throughout the intervention period. The primary outcome is death or disability assessed with the modified Rankin scale at 3 months poststroke. Secondary outcomes include impairment score of the National Institutes of Health Stroke Scale, dependence in activities of daily living as measured using the modified Barthel Index, cognitive ability assessed with the Mini-Mental State Examination, incidence of adverse events, hospital length of stay, and total medical costs.

Study design: an Investigator-Initiated Prospective Multicenter Randomized 3-Arm Clinical Trial

Sample size: 1500 cases

Conditions

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Brain Ischemia Stroke Rehabilitation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients with acute ischemic stroke fulfilling the inclusion and exclusion criteria will be randomly allocated to either either (1) the very early mobilization group in whichmobilization is initiated within 24 hours from stroke onset, (2) the early mobilization group in which mobilization begins between 24 and 72 hours poststroke, or (3) the late mobilization group in which mobilization is started after 72 hours poststroke.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Pre-admission trial assistants and medical staff aware of group allocation will not have contact with the patients. At each study site, a group of physiotherapists will be responsible for the interventions for all three study groups. Multi-disciplinary physicians, assessors, data analysts, and statisticians will be blinded to the group allocation.

Study Groups

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very early rehabilitation

early mobilization initiates within 24h from the onset of the disease

Group Type EXPERIMENTAL

early rehabilitation

Intervention Type OTHER

The three study groups share a same intervention protocol in addition to the initiation timing of intervention from the stroke onset. The frequency and intensity of the intervention is titrated according to functional activity baseline and monitored daily and adjusted with recovery. Encourage patients to move out of bed as soon as possible.

Definition of bed movement: Encourage and help patients to perform functional actions, focusing on activities such as sitting, standing, walking out of the bed.

relative early rehabilitation

early mobilization initiates between 24-72h from the onset of the disease

Group Type EXPERIMENTAL

early rehabilitation

Intervention Type OTHER

The three study groups share a same intervention protocol in addition to the initiation timing of intervention from the stroke onset. The frequency and intensity of the intervention is titrated according to functional activity baseline and monitored daily and adjusted with recovery. Encourage patients to move out of bed as soon as possible.

Definition of bed movement: Encourage and help patients to perform functional actions, focusing on activities such as sitting, standing, walking out of the bed.

late mobilization group

early mobilization initiates after 72h from the onset of the disease

Group Type EXPERIMENTAL

early rehabilitation

Intervention Type OTHER

The three study groups share a same intervention protocol in addition to the initiation timing of intervention from the stroke onset. The frequency and intensity of the intervention is titrated according to functional activity baseline and monitored daily and adjusted with recovery. Encourage patients to move out of bed as soon as possible.

Definition of bed movement: Encourage and help patients to perform functional actions, focusing on activities such as sitting, standing, walking out of the bed.

Interventions

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early rehabilitation

The three study groups share a same intervention protocol in addition to the initiation timing of intervention from the stroke onset. The frequency and intensity of the intervention is titrated according to functional activity baseline and monitored daily and adjusted with recovery. Encourage patients to move out of bed as soon as possible.

Definition of bed movement: Encourage and help patients to perform functional actions, focusing on activities such as sitting, standing, walking out of the bed.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 1 diagnosed with ischemic stroke through anamnesis, clinical symptoms, and radiographic assessment;
* 2 aged 18 years or older;
* 3 of ischemic stroke within 12 hours before eligibility check;
* 4 able to verbally respond to the instructions;
* 5 with stable vital signs (systolic blood pressure 120-180 mmHg, heart rate 50-100/min, body temperature \<37.5◦C, blood oxygen saturation \>92%)
* 6MMSE score \> 16;
* 7participation in the TIME Trial and sign the consent form.

Exclusion Criteria

* 1 diagnosed with hemorrhagic stroke;
* 2 NIHSS score \< 2;
* 3 pre-morbid modified Ranking Scale (mRS) score of 3-5;
* 4 refusing randomization;
* 5 having severe limb dysfunction or systemic diseases rendering them unable to cooperate in the mobilization intervention;
* 6 having severe cognitive and mental dysfunctions;
* 7 currently enrolled in another trial or having participated in a clinical trial within 6 months before stroke onset.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The First Affiliated Hospital with Nanjing Medical University

OTHER

Sponsor Role collaborator

The Affiliated Hospital of Xuzhou Medical University

OTHER

Sponsor Role collaborator

Nanjing Tongren Hospital

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Soochow University

OTHER

Sponsor Role collaborator

Nanjing Jiangbei People's Hospital

OTHER

Sponsor Role collaborator

The First People's Hospital of Lianyungang

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Zhengzhou University

OTHER

Sponsor Role collaborator

Zibo Central Hospital

OTHER_GOV

Sponsor Role collaborator

Liaocheng People's Hospital

OTHER

Sponsor Role collaborator

Shandong Provincial Hospital

OTHER_GOV

Sponsor Role collaborator

Xingtai People's Hospital

OTHER

Sponsor Role collaborator

The First Hospital of Hebei Medical University

OTHER

Sponsor Role collaborator

Cangzhou Central Hospital

OTHER

Sponsor Role collaborator

Anhui Provincial Hospital

OTHER_GOV

Sponsor Role collaborator

The First Affiliated Hospital of Bengbu Medical University

OTHER

Sponsor Role collaborator

Jingmen No.1 People's Hospital

OTHER

Sponsor Role collaborator

Wuhan University

OTHER

Sponsor Role collaborator

Hainan General Hospital

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Shanxi Medical University

OTHER

Sponsor Role collaborator

Shanghai Pudong Hospital

OTHER

Sponsor Role collaborator

Tianjin Medical University General Hospital

OTHER

Sponsor Role collaborator

Chongqing Three Gorges Central Hospital

OTHER

Sponsor Role collaborator

First Affiliated Hospital of Fujian Medical University

OTHER

Sponsor Role collaborator

First People's Hospital of Yulin

OTHER

Sponsor Role collaborator

First Affiliated Hospital of Xinjiang Medical University

OTHER

Sponsor Role collaborator

China Stroke Databank Center

OTHER

Sponsor Role lead

Responsible Party

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Xiao Lu,MD

Chief Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lu Xiao, MD/PHD

Role: PRINCIPAL_INVESTIGATOR

The First Affiliated Hospital with Nanjing Medical University

Locations

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the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial People's Hospital)

Nanjing, Jiangsu, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Lu Xiao, MD/PHD

Role: CONTACT

+86 025-83718836 ext. 3029

Yan Chengjie, postgraduate

Role: CONTACT

+8615995610375

Facility Contacts

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Yan Chengjie, postgraduate

Role: primary

+8615995610375

Zhang Xintong, Xintong

Role: backup

+8615720802936

References

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Zheng Y, Yan C, Shi H, Niu Q, Liu Q, Lu S, Zhang X, Cheng Y, Teng M, Wang L, Zhang X, Hu X, Li J, Lu X, Reinhardt JD; TIME Trial Collaboration Group. Time Window for Ischemic Stroke First Mobilization Effectiveness: Protocol for an Investigator-Initiated Prospective Multicenter Randomized 3-Arm Clinical Trial. Phys Ther. 2021 May 4;101(5):pzab038. doi: 10.1093/ptj/pzab038.

Reference Type DERIVED
PMID: 33513232 (View on PubMed)

Other Identifiers

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GN-2018R0010

Identifier Type: -

Identifier Source: org_study_id

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