Evidence map›Paper›PMID 26888985›Full record

Trial reportNeurology2016

Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT).

Julie Bernhardt, Leonid Churilov, Fiona Ellery, Janice Collier, Jan Chamberlain, Peter Langhorne, Richard I Lindley, Marj Moodie, Helen Dewey, Amanda G Thrift and 2 more

Erratum issued 3 registry-linked trialsAbstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 74 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04488692 nacompletednot on this mapstarted 2020, after this paper: background citation

The Effect of Two Models of an Early Intervention Program on Functional Recovery at Three Months to Acute Stroke Patients: A Randomized Controlled Trial

TypeinterventionalSponsorChung Shan Medical UniversityRan2020 to 2022Enrolled142ConditionsAcute StrokeArmsEarly intervention (Mobility functional training), Sham intervention
NCT04778475 nacompletednot on this mapstarted 2021, after this paper: background citation

Impact of Intense Physical Therapy on Functional Mobility Outcomes in the Acute Stroke Population (<24 Hours Post-stroke)

TypeinterventionalSponsorMedical University of South CarolinaRan2021 to 2022Enrolled100ConditionsMobility Limitation, Physical Disability, Stroke, AcuteArmsIntensive therapy, Standard of care therapy
NCT07411534 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Individual vs Co-Treatment in Acute Stroke Rehabilitation and Evaluation

TypeinterventionalSponsorVanderbilt University Medical CenterRan2026 to 2027Enrolled567ConditionsStroke, Stroke AcuteArmsCo-treatment, Individual Treatment
3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Julie BernhardtFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia. julie.bernhardt@florey.edu.au.
Leonid ChurilovFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Fiona ElleryFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Janice CollierFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Jan ChamberlainFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Peter LanghorneFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Richard I LindleyFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Marj MoodieFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Helen DeweyFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Amanda G ThriftFrom The Florey Institute of Neuroscience and Mental Health (J.B., L.C., F.E., J. Collier, J. Chamberlain, H.D., G.D.), La Trobe University (J.B.), Melbourne, Australia; Institute of Cardiovascular and Medical Sciences (P.L.), University of Glasgow, UK; George Institute for Global Health and Westmead Hospital Clinical School (R.I.L.), University of Sydney; Deakin Health Economics (M.M.), Faculty of Health, Deakin University, Burwood; and Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences (H.D.), and Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health (A.G.T.), Monash University, Clayton, Australia.
Geoff Donnan
AVERT Collaboration Group

Funding

Department of Health 12/01/16
6 · The paper itself

Abstract

objectiveOur prespecified dose-response analyses of A Very Early Rehabilitation Trial (AVERT) aim to provide practical guidance for clinicians on the timing, frequency, and amount of mobilization following acute stroke.

methodsEligible patients were aged ≥18 years, had confirmed first (or recurrent) stroke, and were admitted to a stroke unit within 24 hours of stroke onset. Patients were randomized to receive very early and frequent mobilization, commencing within 24 hours, or usual care. We used regression analyses and Classification and Regression Trees (CART) to investigate the effect of timing and dose of mobilization on efficacy and safety outcomes, irrespective of assigned treatment group.

resultsA total of 2,104 patients were enrolled, of whom 2,083 (99.0%) were followed up at 3 months. We found a consistent pattern of improved odds of favorable outcome in efficacy and safety outcomes with increased daily frequency of out-of-bed sessions (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.18, p < 0.001), keeping time to first mobilization and mobilization amount constant. Increased amount (minutes per day) of mobilization reduced the odds of a good outcome (OR 0.94, 95% CI 0.91 to 0.97, p < 0.001). Session frequency was the most important variable in the CART analysis, after prognostic variables age and baseline stroke severity.

conclusionThese data suggest that shorter, more frequent mobilization early after acute stroke is associated with greater odds of favorable outcome at 3 months when controlling for age and stroke severity. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that shorter, more frequent early mobilization improves the chance of regaining independence after stroke.

Indexed as

AgedAged, 80 and overAge FactorsBrain IschemiaCerebral HemorrhageDisability EvaluationEarly AmbulationFemaleHumansMaleMiddle AgedOdds RatioRecovery of FunctionSeverity of Illness IndexStrokeStroke Rehabilitation

Identifiers

PMID26888985
PMCPMC4898313

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.