The Life After STroke (LAST) study is a randomized controlled trial aiming to investigate the effect of a long term follow up program for stroke patients compared to standard care on function, disability and health. Patients admitted to the stroke unit at St. Olavs Hospital in Central Norway and Bærum Hospital in the south-eastern part of Norway were screened for inclusion. Those who fulfilled the inclusion criteria were randomized to a control group receiving usual care, or to an intervention group. The intervention group received monthly coaching on physical activity by a physiotherapist for 18 consecutive months after inclusion. Primary endpoint was motor function assessed by Motor Assessment Scale at 18 month follow up. Secondary outcomes were dependency, balance, endurance, health-related quality of life, fatigue, anxiety, depression, cognitive function, burden on caregivers, and health costs. A total of 387 patients were included by the end of June 2014. The intervention period and 18 month follow up was terminate by the end of December 2015. Data has been analysed and the primary results will be published in a highly ranked international scientific journal during the second half of 2016.
Life Early After Stroke, the LEAST study, is a sub-study of the LAST study. The objective of the LEAST study was to assess the quality and amount of early rehabilitation given to patients admitted to 11 Norwegian Stroke Units and to assess the association between early motor activity and outcome 3 months later. The method of Behavioural Mapping was used to obtain motor activity during hospital stay, while ADL function, depression, fatigue and pain were assessed by standardized measures at 3 months follow up. The results from the LEAST study has been published as three scientific papers which were published or accepted for publication in international peer reviewed journals. The LEAST study also makes up the content of a PhD thesis.
Stroke units have shown to be very beneficial for treatment after acute stroke and stroke units focused on very early rehabilitation is most efficient. We also know that physical activity and rehabilitation is of great importance after discharge from hosp ital. However, the most efficient long term folow up program is not yet clearly defined. With an increasing number of stroke patients, it is a great challenge for the health care system to ensure high quality treatment for all patients admitted to a strok e unit and to improve the long term follow up care for this group of patients. In endeavour to comply with these challenges we have designed the LAST (Life After STroke) study. The LAST study comprise two different studies (Study I and Study II). Study I is an observational study that intend to assess the amount and quality of very early rehabilitation in some Norwegian stroke units while Study II is a randomised controlled trial that intends to assess the effect of along term follow up program for stroke patietns. Study I will include 400 acute stroke patints at 10 different stroke units. The physical activity level for the included patients will be recorded by use of a standard method of observation (Behavioural Mapping) during hospital stay and compare d against medical complications and also functional outcomes at 3 months follow up. In Study II, 390 eligible patietns will be included at the outpatient clinic after discharge from hospital and randomised to a control group receiving standard care or to an intervention group receiving a community based follow up program comprising a coordinating physiotherapist who will have contact with the patient on a monthly basis for the next 18 months to ensure a minimum of motor training and to motivate the patien t for doing home exercises. This will be done in endeavour to keep the functional level as high as possible as long as possible and to reduce the use of health services.
BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering