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Trial registered on ANZCTR
Registration number
ACTRN12611000554965
Ethics application status
Approved
Date submitted
25/05/2011
Date registered
31/05/2011
Date last updated
24/02/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
The Out-and-About trial: Improving quality of life after stroke
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Scientific title
Do rehabilitation teams that receive the Out-and-about program provide more outings to community-based stroke patients over 12 months than rehabilitation teams that receive only clinical guidelines?
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Secondary ID [1]
252018
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None
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Universal Trial Number (UTN)
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Trial acronym
Out-and-About
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Rehabilitation provided by physiotherapists, occupational therapists and therapy assistants in community-based rehabilitation teams to community-based people with stroke.
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Condition category
Condition code
Physical Medicine / Rehabilitation
257735
257735
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0
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Occupational therapy
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Physical Medicine / Rehabilitation
257736
257736
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0
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Physiotherapy
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Stroke
257737
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0
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Ischaemic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Guidelines + training: Physiotherapists, occupational therapists and therapy assistants in experimental teams will receive a written copy of the National Stroke Foundation's Clinical Guidelines for Stroke Management 2010 to be utilised for the duration of 12 months. In addition, they will attend a half-day workshop and receive education about providing therapy to people after stroke, as well as feedback about team practice from a medical record audit.
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Intervention code [1]
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Behaviour
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Intervention code [2]
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Rehabilitation
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Comparator / control treatment
Guidelines only: Physiotherapists, occupational therapists and therapy assistants in control teams will receive a written copy of the National Stroke Foundation's Clinical Guidelines for Stroke Management 2010 only.
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Control group
Active
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Outcomes
Primary outcome [1]
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Rehabilitation teams: The proportion of people with stroke receiving four or more outings during therapy. This outcome will be assessed by way of retrospective audits of medical records for clients with stroke (baseline and 12 months).
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Assessment method [1]
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Timepoint [1]
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12 months.
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Primary outcome [2]
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Rehabilitation teams: Number of outings delivered to people with stroke by team members, as assessed by retrospective audits of medical records for clients with stroke (baseline and 12 months).
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Assessment method [2]
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Timepoint [2]
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12 months
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Secondary outcome [1]
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People with stroke: Number of outings, as measured during waking hours for seven consecutive days by use of a personal Global Positioning Device (GPS) carried or worn by the person with stroke. GPS data will be downloaded via Google Maps.
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Assessment method [1]
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Timepoint [1]
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6 months
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Secondary outcome [2]
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People with stroke: Distance travelled outdoors, as measured by data collected from a personal GPS carried or worn by the person with stroke for a consecutive seven day period.
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Assessment method [2]
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Timepoint [2]
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6 months
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Secondary outcome [3]
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People with stroke: Nature of outings (i.e., types of places visited, reason for leaving house). This outcome will be assessed by way of a self-report diary kept for seven days.
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Assessment method [3]
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Timepoint [3]
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6 months
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Secondary outcome [4]
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People with stroke: Walking capacity, measured by the 6-Minute Walk Test (a standardised measure of distance walked over six minutes)
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Assessment method [4]
264596
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Timepoint [4]
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6 months
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Secondary outcome [5]
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Cost effectiveness: Assessed for people with stroke via health service use (calculated from data collected by Medicare Australia, the Department of Veterans Affairs, the New South Wales Department of Health Inpatient Statistics Collections and the Pharmaceutical Benefits Scheme; including data related to GP and specialist consultations) and health benefits (SF-6D data calculated from the SF-36). The cost to deliver the intervention will be assessed by total program costs (cost of the workshop training materials, trainer's time and the opportunity cost of the trainee's time when attending the workshops) and outdoor journey costs (number of outdoor journey sessions delivered to each patient, as counted from file audits).
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Assessment method [5]
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Timepoint [5]
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6 months
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Eligibility
Key inclusion criteria
Rehabilitation Teams:
- A service providing rehabilitation to people with stroke who live in the community
- Employing at least 1 x physiotherapist
- Employing at least 1 x occupational therapist
- Receiving at least 20 x referrals of people with stroke in the previous 12 months
People with stroke:
- Stroke sustained no more than 12 months previous to starting therapy
- Able to walk 10 metres outdoors with/without a walking aid or supervision
- Over 18 years of age
- Living either at home, in a nursing home or hostel
- State that they would like to get out of the house more often than they currently do
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Rehabilitation teams:
- Teams solely providing transitional aged care
People with stroke:
- Severe cognitive deficits
- A level of English comprehension which precludes the ability to provide informed consent and/or to complete baseline measures.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Rehabilitation team recruitment:
Rehabilitation teams will be recruited across New South Wales (NSW). Teams will be contacted, and a meeting conducted, to explain the procedures. The NHMRC Clinical Trials Centre, or a "third party" independent of the trial, will conduct off-site concealed allocation of teams to one of two groups (experimental, control).
Each rehabilitation team will recruit as many patients as possible over 12 months. Given that this is a cluster randomised trial, people with stroke will be experimental or control by virtue of the allocation to condition of the rehabilitation team.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Rehabilitation teams will be randomised using a central computerised randomisation service, administered independently by the NHMRC Clinical Trials Centre or a "third party" independent of the trial. A minimisation method will be used to ensure balance on the following factors: primary mode of service delivery (hospital-based or home-based), type of health sector (public or private), caseload size (high or low), average number of outings conducted at baseline.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2011
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Actual
15/08/2011
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Date of last participant enrolment
Anticipated
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Actual
31/10/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NHMRC
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Sydney
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Address
The University of Sydney
NSW 2006
Australia
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Country
Australia
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Secondary sponsor category [1]
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Government body
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Name [1]
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NHMRC
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
256395
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Sydney South West Area Health Service Human Research Ethics Committee - Concord Repatriation General Hospital Zone
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Ethics committee address [1]
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SSWAHS Human Research Ethics Committee - CRGH Concord Repatriation General Hospital Concord NSW 2139
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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17/12/2009
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Approval date [1]
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20/01/2010
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Ethics approval number [1]
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CH62/6/2009-194
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Summary
Brief summary
The Out-and-about trial aims to change the practice of rehabilitation teams working with people with stroke in New South Wales, as well as increasing community participation in people with stroke. The trial will compare different types of education provided to 20 community rehabilitation teams and 300 people with stroke who they see over 12 months. It is hypothesised that teams that receive one type of education will perform better than teams that receive the other type of education.
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Trial website
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Trial related presentations / publications
PUBLICATIONS: McCluskey, A., Ada, L., Middleton, S., Kelly, P. J., Goodall, S., Grimshaw, J. M., Logan, P., Longworth, M. & Karageorge, A. (2013). Improving quality of life by increasing outings after stroke: study protocol for the Out-and-About trial. International Journal of Stroke, 8: 54–58. doi: 10.1111/j.1747-4949.2012.00966 PUBLICATIONS IN PROGRESS: McCluskey, A., Ada, L., Middleton, S., Kelly, P., Goodall, S., Grimshaw, J., Logan, P., Longworth, M., Karageorge, A. Assisting stroke survivors to get out and about: Are Australian post-inpatient rehabilitation services complying with national stroke guideline recommendations? An observational cohort study. McCluskey, A., Ada, L., Middleton, S., Kelly, P. J., Goodall, S., Grimshaw, J. M., Logan, P., Longworth, M. & Karageorge, A. The Out-and-About program to change the behaviour of community teams and increase outings by stroke survivors: A cluster-randomised trial. Karageorge, A., Vargas, J., McCluskey, A., & Ada, L. Predictors of community outings after stroke: an observational study PRESENTATIONS: McCluskey, A., Ada, L., Kelly, P. K., Middleton, S., Goodall, S., Longworth, M., Grimshaw, J., Logan, P., & Karageorge, A. Frequency of outings by recently discharged stroke survivors. Oral presentation at Smart Strokes 2013 Conference, 22 – 23 August 2013, Brisbane Australia. McCluskey, A., Ada, L., Kelly, P. K., Middleton, S., Goodall, S., Longworth, M., Grimshaw, J., Logan, P., & Karageorge, A. Large variations exist in therapy provided to community stroke survivosr. Oral presentation at Australian 25th National Occupational Therapy Conference, 24 - 26 July 2013, Adelaide Australia. McCluskey, A., et al (2012, May). Low compliance with national stroke guidelines: few physiotherapy or occupational therapy sessions occur outdoors in public streets. Poster session presented at the 7th World Congress for NeuroRehabilitation, Melbourne, VIC, Australia. McCluskey, A., et al (2012, October). Low compliance with national stroke guidelines: few physiotherapy or occupational therapy sessions occur outdoors in public streets. Poster session presented at the 8th World Stroke Congress, Brasilia, Brazil. McCluskey, A., et al (2012, August) A profile of non-inpatient rehabilitation services in NSW: Variations in waiting times, frequency and nature of therapy – Paper presentation at the Stroke Society of Australasia/Smart Strokes National Conference, Sydney, NSW, Australia.
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Public notes
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Contacts
Principal investigator
Name
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Dr Annie McCluskey
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Address
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Cumberland Campus C42
PO Box 170
University of Sydney
Sydney NSW 1825
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Country
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Australia
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Phone
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+61 2 9351 9834
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Annie McCluskey
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Address
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PO Box 170
C42 - Cumberland Campus
The University of Sydney
Lidcombe
NSW 2141
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Country
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Australia
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Phone
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+61 2 9351 9834
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Fax
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+61 2 9351 9177
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Annie McCluskey
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Address
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PO Box 170
C42 - Cumberland Campus
The University of Sydney
Lidcombe
NSW 2141
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Country
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Australia
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Phone
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+61 2 9351 9834
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Fax
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+61 2 9351 9177
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: An observational cohort study.
2015
https://dx.doi.org/10.1186/s12913-015-0952-7
N.B. These documents automatically identified may not have been verified by the study sponsor.
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