The Health December 2020 | Page 15

| Hot Topic | december , 2020 | The Health


The AVERT DOSE rehabilitation trial

Hospital Canselor Tuanku Muhriz ( HCTM ) is currently participating in AVERT DOSE , a new international stroke rehabilitation trial .
Stroke Physiotherapy Specialist from HCTM Dr Katijjahbe Mohd Ali is the Lead Principal Investigator for the AVERT DOSE Trial in Malaysia .
She explained : “ We are trying to find the best way to reduce disability after a stroke .”
The study design was developed and led by Professor Julie Bernhardt from the Florey Institute of Neuroscience and Mental Health .
Four evidence-based mobility therapies will be delivered by physiotherapists and nurses to patients within the first few days following a stroke .
Therapy commences within 48 hours of a stroke , continues for 14 days or until discharge from hospital . Assessors will visit participants at home , three and six months after a stroke , and measure their disability .
Participants are eligible if they are 18 or above , have had a mild-to-moderate stroke caused by a blood clot , and present to hospital and commence therapy within 48 hours of the onset of their stroke .
More than 2,500 patients from over 50 hospitals in Malaysia , Australia , New Zealand , United Kingdom , Ireland , India , Taiwan and Singapore will ultimately take part in the study .
The trial has a novel , adaptive design where patient outcomes help to direct new patients into treatment arms showing the most promise as the study continues . after a stroke .
“ It is intervention provided by a specialised training therapist to a patient to get to regain people function ,” she explained .
According to Dr Katijjahbe , the Acute Stroke Unit ( SCU ) at HTCM is the first of its kind in Malaysia .
“ The staff of SCU working along a multi-discipline team ( MDT ) are committed to contributing to the best evidence-based care for our stroke patients .
“ Stroke rehabilitation is essentially a multi-disciplinary approach because it depends on the type of ability affected .
“ If a patient has a physical disability , the physiotherapist is called in . If there is a speech disability , then a speech language pathologist is called in . And , if there is connective disability that ’ s where clinical psychology comes in .
“ So , this is a team approach . The better the team works together , then better the outcome for the patient . We are passionate about helping to reduce the burden of stroke on stroke survivors and their families .”
HCTM is also taking part in AVERT DOSE , a new international stroke rehabilitation trial developed by Professor Julie Bernhardt from the Florey Institute of Neuroscience and Mental Health .
The AVERT DOSE trial aims to identify best practices in reducing disability after a stroke . Dr Katijjahbe and Dr Wan are the lead investigators for the trial in Malaysia .
Both Dr Wan and Dr Katijjahbe noted that lack of awareness was a key challenge when it came to care following a stroke .
Dr Katijjahbe noted it was essential to explain and inform the patients on the best practices and treatments available for them to make an informed decision .
Dr Wan said : “ We need to strive for the empowerment of the patient . We need to create better awareness on the stroke risk factors . Like how to prevent a stroke and what should be done once a stroke has happened .
“ The awareness is also important for all general practitioners and doctors in Malaysia as well . Sometimes they are not aware that they need to consult with the stroke team first .” — The Health
Determining effective and safe treatment
“ We know that exercise and rehabilitation interventions post-stroke can make a big difference to a person ’ s outcome . This trial will help us to determine the most effective and safe regimen in patients with both mild and moderate stroke severity in the early stages after their stroke ,” said Professor Bernhardt .
When asked about the significance of the study , Dr Katijjahbe said : “ Well , there is no high-quality study , research or evidence that informs us of what kind of therapy is best for stroke patients , particularly for stroke survivors .
“ So , this study will provide information to help to determine the best practice and care for our stroke survivors .”
Shared HCTM Stroke Neurologist , Dr Wan Asyraf , who is also the AVERT DOSE Co-Lead Principle Investigator : “ With AVERT DOSE , we want to increase the success rate of recovery as early as in the ward or admission itself . This is an intervention treatment which will benefit the patient .
“ This is an excellent study coming from Prof Julie . As a stroke neurologist , I was happy when Dr Katijjahbe invited us to be part of this initiative .
“ We believe such clinical trials change the environment to be more evidence-based and create more access toward better care for the patient .”
HCTM has started recruitment of participants to AVERT DOSE .
Dr Katijjahbe shared : “ The minimum target sample size for Malaysia is 100 cases . Currently , we have recruited 10 patients and are working on bringing in more patients .”