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Trial registered on ANZCTR
Registration number
ACTRN12624000197538
Ethics application status
Approved
Date submitted
16/01/2024
Date registered
29/02/2024
Date last updated
23/06/2024
Date data sharing statement initially provided
29/02/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
PREP3: Evaluating whether predictions for upper limb motor outcome after stroke can be improved using non-invasive brain stimulation
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Scientific title
PREP3: A compositional neurophysiological biomarker for predicting upper limb motor outcome after stroke.
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Secondary ID [1]
311304
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HRC 23/374
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Universal Trial Number (UTN)
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Trial acronym
PREP3
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Stroke
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Condition category
Condition code
Stroke
329239
329239
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0
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Ischaemic
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Stroke
329240
329240
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0
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Haemorrhagic
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The recovery of upper limb movement will be observed from within 1 week of stroke until 6 months post-stroke. Information about the participant’s index stroke will be collected from their medical records. Participants within 1 week of stroke will compete the Fugl-Meyer Upper Extremity and the Action Research Arm Test to assess upper limb impairment and activity limitation, respectively, as well as the Oxford Cognitive Screen to assess cognition. Within 1 week of stroke participants will receive non-invasive brain stimulation in the form of transcranial magnetic stimulation. Transcranial magnetic stimulation involves non-invasively stimulating the ipsilesional primary motor cortex to assess functional connectivity of the participant’s corticospinal tract. Responses to transcranial magnetic stimulation are recorded as motor evoked potentials from two hand and two forearm muscles using electromyography. There are no treatment effects from the transcranial magnetic stimulation used in this study. The transcranial magnetic stimulation protocol for this study will only be performed with participants in this study. All together the assessments within 1 week of stroke are expected to take approximately 75 minutes. Follow up assessments will be performed at 3 and 6 months post-stroke. The 3 month post-stroke assessment is the primary end-point for the study and is expected to take approximately 30 minutes. The 3 month post-stroke assessment includes the Fugl-Meyer Upper Extremity and the Action Research Arm Test, as well as the modified Rankin Scale to assess the participant’s level of functional independence. The 6 months post-stroke assessment is expected to take approximately 45 minutes and includes the same assessments as the 3 month post-stroke assessment while adding the Stroke Impact Scale to assess the participant's quality of life.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
No control group as study is obervational
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The primary outcome measure is the total Action Research Arm Test score, which is a measure of upper limb activity limitation, at 3 months post-stroke. The Action Research Arm Test assesses the ability of the paretic upper limb to perform gross, grasp, pinch, and grip tasks. The total Action Research Arm Test is calculated by adding the scores from the gross, grasp, pinch, and grip tasks together.
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Assessment method [1]
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The Action Research Arm Test is a behavioural assessment scored out of 57 via observation from a clinical assessor.
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Timepoint [1]
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The primary outcome measure is the total Action Research Arm Test score at 3 months post-stroke.
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Secondary outcome [1]
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A secondary outcome measure is the total Action Research Arm Test score, which is a measure of upper limb activity limitation, at 6 months post-stroke. The Action Research Arm Test assesses the ability of the paretic upper limb to perform gross, grasp, pinch, and grip tasks. The total Action Research Arm Test is scored out of 57 and is calculated by adding the scores from the gross, grasp, pinch, and grip tasks together.
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Assessment method [1]
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The Action Research Arm Test is a behavioural assessment scored out of 57 via observation from a clinical assessor.
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Timepoint [1]
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A secondary outcome measure is the total Action Research Arm Test score at 6 months post-stroke.
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Secondary outcome [2]
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Separate secondary outcomes are the Fugl-Meyer Upper Extremity score, which is a measure of upper limb activity impairment, at 3 and 6 months post-stroke. The Fugl-Meyer Upper Extremity assesses the ability of the paretic upper limb to perform movements compared to the non-paretic upper limb.
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Assessment method [2]
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The Fugl-Meyer Upper Extremity is a behavioural assessment scored out of 66 via observation from a clinical assessor.
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Timepoint [2]
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The Fugl-Meyer Upper Extremity score will be obtained at 3 and 6 months post-stroke as two separate secondary outcomes.
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Secondary outcome [3]
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The Modified Rankin Scale score at 6 months post-stroke will be used to assess the participant's functional independence. The Modified Rankin Scale includes questions regarding what everyday activities are impacted by the stroke and what symptoms the participant currently has.
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Assessment method [3]
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The Modified Rankin Scale is a questionnaire that is scored ordinally from 0-5.
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Timepoint [3]
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The Modified Rankin Scale score will be obtained at 6 months post-stroke as a secondary outcome.
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Secondary outcome [4]
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The Stroke Impact Scale score at 6 months post-stroke will be used to assess the participant's quality of life. The Stroke Impact Scale includes questions regarding how the stroke has affected the participant's quality of life.
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Assessment method [4]
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The Stroke Impact Scale is a questionnaire that includes 59 questions and is scored from 0-100.
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Timepoint [4]
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The Stroke Impact Scale score will be obtained at 6 months post-stroke as a secondary outcome.
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Eligibility
Key inclusion criteria
Aged 18 or over
Ischaemic or haemorrhagic stroke within the previous week as determined by the patient's clinical team
Upper limb weakness from the index stroke
First-ever stroke or previous stroke with no upper limb weakness
Ability to provide informed consent
SAFE score less than 10 on day 3 post-stroke
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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
No upper limb weakness from the index stroke
Cerebellar stroke
Subarachnoid haemorrhage
Cognitive or communication impairments that prevents informed consent
Contraindications to transcranial magnetic stimulation
Pre-existing conditions precluding informed consent or compliance with study assessments
Inability to complete upper limb assessments
Terminal illness with life expectancy less than 12 months
Residing out-of-area precluding follow-up assessments
Social or personal circumstances that interfere with ability to perform follow-up assessments
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Study design
Purpose
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/03/2024
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Actual
26/02/2024
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Date of last participant enrolment
Anticipated
15/12/2025
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Actual
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Date of last data collection
Anticipated
15/06/2026
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Actual
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Sample size
Target
150
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Accrual to date
12
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Final
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Recruitment outside Australia
Country [1]
26075
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New Zealand
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State/province [1]
26075
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Auckland
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Funding & Sponsors
Funding source category [1]
315558
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Government body
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Name [1]
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Health Research Council
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Address [1]
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South Tower Level 1/110 Symonds Street, Grafton, Auckland
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Country [1]
315558
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Private Bag 92019
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
317650
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314457
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Central Health and Disability Ethics Committee
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Ethics committee address [1]
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133 Molesworth Street, Wellington, 6011
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Ethics committee country [1]
314457
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New Zealand
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Date submitted for ethics approval [1]
314457
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12/10/2023
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Approval date [1]
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30/10/2023
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Ethics approval number [1]
314457
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Summary
Brief summary
Up to 150 participants will be recruited within 1 week of stroke onset over a 2.5 year period. Demographic and stroke characteristics will be collected at the time of recruitment. Approximately one week after stroke basic clinical assessments will be carried out evaluating participants' hand and arm movements. Transcranial Magnetic Stimulation (TMS) is a non-invasive technique that will be used to evaluate the motor pathways of the affected upper limb within the first week of stroke. Follow-up clinical assessments of hand and arm movement will be performed at 3 and 6 months post-stroke. Questionnaires of the participant's level of disability and health-related quality of life will be administered at 6 months post-stroke.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Winston Byblow
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Address
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University of Auckland, 368 Khyber Pass, New Market 1023, Auckland
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Country
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New Zealand
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Phone
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+64 93737599
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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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Winston Byblow
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Address
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University of Auckland, 368 Khyber Pass, New Market 1023, Auckland
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Country
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New Zealand
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Phone
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+64 93737599
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Fax
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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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Winston Byblow
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Address
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University of Auckland, 368 Khyber Pass, New Market 1023, Auckland
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Country
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New Zealand
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Phone
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+64 93737599
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Fax
131652
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Individual participant data collected during the trial after de-identification
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When will data be available (start and end dates)?
Following publication with no end date
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Available to whom?
Researchers who provide a methodologically sound proposal
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Available for what types of analyses?
Any purpose upon reasonable request
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How or where can data be obtained?
Access will be subject to approvals by the Principal Investigator Prof. Winston Byblow who can be contacted at
[email protected]
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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
No additional documents have been identified.
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