A Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial

Abstract

Background: Mobilising patients early after stroke [early mobilisation (EM)] is thought to contribute to the beneficial effects of stroke unit care but it is poorly defined and lacks direct evidence of benefit.

Objectives: We assessed the effectiveness of frequent higher dose very early mobilisation (VEM) after stroke.

Design: We conducted a parallel-group, single-blind, prospective randomised controlled trial with blinded end-point assessment using a web-based computer-generated stratified randomisation.

Setting: The trial took place in 56 acute stroke units in five countries.

Participants: We included adult patients with a first or recurrent stroke who met physiological inclusion criteria.

Interventions: Patients received either usual stroke unit care (UC) or UC plus VEM commencing within 24 hours of stroke.

Main outcome measures: The primary outcome was good recovery [modified Rankin scale (mRS) score of 0-2] 3 months after stroke. Secondary outcomes at 3 months were the mRS, time to achieve walking 50 m, serious adverse events, quality of life (QoL) and costs at 12 months. Tertiary outcomes included a dose-response analysis.

Data sources: Patients, outcome assessors and investigators involved in the trial were blinded to treatment allocation.

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