Stroke

Principle Investigator:  Ass.Prof. Julie Bernhardt

Chief Investigators:  A/Prof. Helen Dewey,  Prof. Geoffrey Donnan, Prof. Amanda Thrift, Ass. Prof. Marjory Moodie, Prof. Richard Lindley, Prof. Peter Langhorne

Participating Centres: Patients and staff from 50 Hospitals in Australia, New Zealand, Singapore, Malaysia, Northern Ireland, Scotland, Wales and England.

Coordinating Centre: National Stroke Research Institute (a part of the Florey Neuroscience Institutes)

Australian New Zealand Clinical Trials Registry - ACTRN12606000185561

NHS National Institute for Health Research UKCRN ID 4935

Background:  Stroke presents a major, growing global public health challenge which accounts for 25% of all chronic disability. Treatments that reduce the personal and community burden of stroke are urgently needed, and the commencement of rehabilitation early after stroke may significantly reduce chronic disability. A large (n=2104), high quality, NH&MRC funded clinical trial is at the heart of the AVERT program. AVERT is a randomised controlled trial of very early rehabilitation (intervention) versus standard care (control) with blinded assessment of outcome and intention to treat analysis. A comprehensive cost effectiveness sub study is included. It is hypothesised that early mobilisation of patients in addition to standard care alone, will reduce death and disability at 3 months, reduce the number and severity of stroke complications experienced by patients, result in a better quality of life and is cost effective. If effective (and cost effective) the intervention should be readily adopted within a diverse range of health services both here and overseas, and help reduce the global burden of stroke.

The following publications have arisen from this study:

1. Bernhardt J, Dewey HM, Thrift AG, Collier JM, Lindley RI, Moodie M, et al. Improving outcome after stroke: Protocol for a phase III very early rehabilitation trial (AVERT). 2007 The Lancet.
2. Bernhardt J, Dewey H, Collier J, Thrift A, Lindley R, Moodie M, Donnan G. A very early rehabilitation trial (AVERT). International Journal of Stroke. 2006;1:169-171
3. Cumming T, Bernhardt J, Linden T. The Montreal Cognitive Assessment: Short Cognitive Assessment in a Large Stroke Trial.  Stroke. 2011;42:2642-2644
4. Bernhardt J, Cumming T, Ha J on behalf of the AVERT Collaboration. Safety of early mobilization after thrombolysis: Acquiring evidence in AVERT, but still a way to go. Response to letter by freeman et al regarding article, "Very early mobilization after stroke fast-tracks return to walking. Further results from the phase II AVERT randomized controlled trial". Stroke. 2011;42:e585
5. Bernhardt J on behalf of the AVERT Collaboration. We're also testing early mobilization in patients with acute stroke. Chest. In press 2012

AVERT Newsletters:

February 2012

August 2011

February 2011

September 2010

January 2010

AVERT: stories in the news

Auckland City Hospital. ACH stroke unit part of international rehab trial. NOVA The official newsletter for the Auckland District Health Board. 6 September 2011.

Brain Matter(s). Improving life through brain research. Stroke care for young and old. Newsletter of the Florey Neurosciences Institutes. Spring 2011:5.

Clews, G. Stroke rehab and exercise study gets 1000th patient. Frontline Magazine [serial on the Internet]. 20 July 2011.

Corless, B. Stroke of luck saves pair. Heidelberg Leader. 28 July 2011;Sect. 7.

Epworth Healthcare.Patient of Epworth very glad to be part of international stroke trial. Epwords. Issue 179 - Spring 2011

Musa, S. UKMMC is Part of World Largest Stroke Study. Universiti Kebangsaan Malaysia [serial on the Internet]. 5 July 2011

Poon Chian Hui. Stroke patients get therapy early in SGH trial. The Straits Times. 8 February 2011;Sect. B6.

Singapore General Hospital starts new stroke rehabilitation research. Singapore General Hospital News [serial on the Internet]. 7 February 2011.

2008-2009 Media stories

2004-2007 Media stories

The following major projects are a part of the AVERT program:

A Very Early Rehabilitation Trial: Phase I. What early rehabilitation do stroke patients receive?

A Very Early Rehabilitation Trial: Phase II. Is very early rehabilitation safe and feasible?

Enquiries about AVERT Phase 3 can be directed to the Principal Investigator, Dr Julie Bernhardt at avert@nsri.org.au

Funding for this project was obtained from:

National Health and Medical Research Council (Australia) Project Grant, Singapore Health, Northern Ireland Chest Heart and Stroke, Chest Heart and Stroke Scotland, The Stroke Association UK.