NCT01916486

Brief Summary

The investigators will conduct a randomized controlled trial study to provide preliminary evidence of efficacy of exercise training or a complex mental and social activities program for improving cognitive function in older adults with chronic stroke, compared with a stretch and relaxation program.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
120

participants targeted

Target at P75+ for not_applicable stroke

Timeline
Completed

Started Nov 2013

Longer than P75 for not_applicable stroke

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 23, 2013

Completed
13 days until next milestone

First Posted

Study publicly available on registry

August 5, 2013

Completed
3 months until next milestone

Study Start

First participant enrolled

November 1, 2013

Completed
5.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2019

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2020

Completed
Last Updated

August 28, 2020

Status Verified

August 1, 2020

Enrollment Period

5.8 years

First QC Date

July 23, 2013

Last Update Submit

August 26, 2020

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change from baseline in cognitive function as measured by the Alzheimer's Disease Assessment Scale Cognitive Subscale Plus (ADAS-Plus) at 6 months

    ADAS-Cog 13 + additional measures of executive functions. For ADAS-Cog 13, higher scores indicate greater impairment.

    Baseline and 6 months

Secondary Outcomes (24)

  • Change from baseline in executive functions as measured by the Stroop Test.

    Baseline, 3 months (for subset of cognitive outcomes), 6 months, and 12 months

  • Change from baseline in executive functions as measured by the Tower of London Test.

    Baseline, 3 months (for subset of cognitive outcomes), 6 months, and 12 months

  • Change from baseline in processing speed and executive functions as measured by the Trail Making Tests (Parts A & B).

    Baseline, 3 months (for subset of cognitive outcomes), 6 months, and 12 months

  • Change from baseline in category fluency.

    Baseline, 3 months (for subset of cognitive outcomes), 6 months, and 12 months

  • Change from baseline in memory and executive functions as measured by the verbal digits forward and backward tests.

    Baseline, 3 months (for subset of cognitive outcomes), 6 months, and 12 months

  • +19 more secondary outcomes

Study Arms (3)

Exercise training

EXPERIMENTAL

Twice-weekly for the 6-month duration.

Behavioral: Exercise training

Complex mental and social activities

EXPERIMENTAL

Twice-weekly for the 6-month duration.

Behavioral: Complex mental and social activities

Control: stretching and relaxation program

ACTIVE COMPARATOR

Twice-weekly for the 6-month duration.

Behavioral: Control: stretching and relaxation program

Interventions

The EX Program will provide objective progression in the guided exercises of each participant.

Also known as: EX Program
Exercise training

The Cog-Plus Program will engage participants in activities promoting cognitive function and socialization.

Also known as: Cog-Plus Program
Complex mental and social activities

The CON Program consist of stretches, deep breathing and relaxation techniques, general posture education, and general core control exercises in the sitting position.

Also known as: CON Program
Control: stretching and relaxation program

Eligibility Criteria

Age55 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Aged 55 years or over;
  • Have a history of a single stroke of at least one year prior to study enrolment;
  • Mini-Mental State Examination (MMSE) (5) score of ≥ 20 at screening, including a perfect score on the 3-step command to ensure intact comprehension and ability to follow instructions;
  • Have subjective cognitive complaints;
  • Community-dwelling;
  • Lives in Metro Vancouver;
  • Able to comply with scheduled visits, treatment plan, and other trial procedures;
  • Must be able to read, write, and speak English in which psychometric tests are provided with acceptable visual and auditory acuity;
  • Stable on a fixed dose of cognitive medications (e.g., donepezil, galantamine, rivastigmine, memantine, etc.) that is not expected to change during the 12-month study period, or, if they are not on any of these medications, they are not expected to start them during the 12-month study period;
  • Able to walk for a minimum of six metres with rest intervals with or without assistive devices;
  • Have an activity tolerance of 60 minutes with rest intervals;
  • Not currently participating in any regular therapy or progressive exercise; and
  • Provide a personally signed and dated informed consent document indicating that the individual (or a legally acceptable representative) has been informed of all pertinent aspects of the trial. In addition, an assent form will be provided at baseline and again at regular intervals.

You may not qualify if:

  • Diagnosed with dementia of any type;
  • Diagnosed with another type of neurodegenerative or neurological condition (ie. Parkinson's disease) that affects cognitive function and mobility;
  • At high risk for cardiac complications during exercise and/or unable to self-regulate activity or to understand recommended activity level (i.e., Class C of the American Heart Risk Stratification Criteria);
  • Have clinically significant peripheral neuropathy or severe musculoskeletal or joint disease that impairs mobility, as determined by his/her family physician;
  • Taking medications that may negatively affect cognitive function, such as anticholinergics, including agents with pronounced anticholinergic properties (e.g., amitriptyline), major tranquilizers (typical and atypical antipsychotics), and anticonvulsants (e.g., gabapentin, valproic acid, etc.); or
  • Have aphasia as judged by an inability to communicate by phone.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of British Columbia

Vancouver, British Columbia, Canada

Location

Related Publications (3)

  • Liu-Ambrose T, Falck RS, Dao E, Best JR, Davis JC, Bennett K, Hall PA, Hsiung GR, Middleton LE, Goldsmith CH, Graf P, Eng JJ. Effect of Exercise Training or Complex Mental and Social Activities on Cognitive Function in Adults With Chronic Stroke: A Randomized Clinical Trial. JAMA Netw Open. 2022 Oct 3;5(10):e2236510. doi: 10.1001/jamanetworkopen.2022.36510.

  • Falck RS, Best JR, Davis JC, Eng JJ, Middleton LE, Hall PA, Liu-Ambrose T. Sleep and cognitive function in chronic stroke: a comparative cross-sectional study. Sleep. 2019 May 1;42(5):zsz040. doi: 10.1093/sleep/zsz040.

  • Best JR, Eng JJ, Davis JC, Hsiung R, Hall PA, Middleton LE, Graf P, Goldsmith CH, Liu-Ambrose T. Study protocol for Vitality: a proof-of-concept randomised controlled trial of exercise training or complex mental and social activities to promote cognition in adults with chronic stroke. BMJ Open. 2018 Mar 17;8(3):e021490. doi: 10.1136/bmjopen-2018-021490.

MeSH Terms

Conditions

Stroke

Interventions

ExerciseRelaxation Therapy

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

Motor ActivityMovementMusculoskeletal Physiological PhenomenaMusculoskeletal and Neural Physiological PhenomenaMind-Body TherapiesComplementary TherapiesTherapeuticsBehavior TherapyPsychotherapyBehavioral Disciplines and Activities

Study Officials

  • Janice J Eng, PhD, PT

    University of British Columbia

    PRINCIPAL INVESTIGATOR
  • Teresa Liu-Ambrose, PhD, PT

    University of British Columbia

    PRINCIPAL INVESTIGATOR
  • Peter Hall, PhD

    University of Waterloo

    PRINCIPAL INVESTIGATOR
  • Charlie Goldsmith, PhD

    Simon Fraser University

    PRINCIPAL INVESTIGATOR
  • Jennifer Davis, PhD

    University of British Columbia

    PRINCIPAL INVESTIGATOR
  • Laura Middleton, PhD

    University of Waterloo

    PRINCIPAL INVESTIGATOR
  • Ging-Yuek Robin Hsiung, MD

    University of British Columbia

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

July 23, 2013

First Posted

August 5, 2013

Study Start

November 1, 2013

Primary Completion

August 1, 2019

Study Completion

February 1, 2020

Last Updated

August 28, 2020

Record last verified: 2020-08

Locations