CanStroke Recovery Trials is an eight-site national clinical trials platform in stroke recovery, funded by Brain Canada and CPSR. It brings together the leading clinicians and researchers across Canada to test new approaches, therapies, therapeutics and technologies to improve recovery from stroke.
Dr. Mark Bayley, Toronto Rehabilitation Institute (Mark.Bayley@uhn.ca)
Dr. Janice Eng, University of British Columbia (firstname.lastname@example.org)
Farrell Leibovitch, CPSR (email@example.com)
Dr. Sean Dukelow, University of Calgary, Hotchkiss Brain Institute (firstname.lastname@example.org)
Dr. Marilyn Mackay-Lyons, Dalhousie University (email@example.com)
Dr. Robert Teasell, Western University (firstname.lastname@example.org)
Dr. Michelle Ploughman, Memorial University of Newfoundland (Michelle.Ploughman@med.mun.ca)
Dr. Sandra Black, Sunnybrook Health Sciences, (email@example.com)
Dr. Bradley MacIntosh, Sunnybrook Health Sciences (firstname.lastname@example.org)
Dr. Courtney Pollock, University of British Columbia (email@example.com)
Dr. Sepideh Pooyania, Riverview Health Centre, Manitoba (firstname.lastname@example.org)
While enrolment in some clinical trials is temporarily on hold during the Covid-19 pandemic, all CanStroke Recovery Trials sites are still actively looking for potential participants. Two studies, ABC and TRAIL (see details below), have been converted to completely remote trials so they can run during the pandemic.
The hope is, once restrictions put in place during the pandemic are lifted, identified potential participants can be screened for all CanStroke trials.
These include the first CanStroke trial, called FLOW, which involves a 'combination approach' -- the anti-depressant drug fluoxetine and exercise -- aimed at reopening the window of recovery for people with chronic stroke.
Since initiating recruitment in January 2019, 346 people were identified for participation in the FLOW trial, 76 made it to the consent phase and 47 made it to the drug ramp-up phase and were moving into the 12-week exercise intervention phase, and five have made it to the six-month assessment phase.
Four more studies have been identified for the CanStroke Recovery Platform and will continue when research efforts begin to ramp up again.
- Arm Boot Camp (ABC), led by Dr. Janice Eng at UBC, at seven platform sites. ABC will determine the feasibility of a treatment program that involves feedback from a wearable device in combination with an exercise program. It will determine the effect it has on the amount of stroke-affected upper limb use.
- Dr. Sean Dukelow's RESTORE trial compares two intensities of robotic therapy for rehabilitation. It will be rolled out at the Calgary and UHN sites.
- Five of the 8 platform sites will participate in the TRAIL trial. TRAIL (TeleRehabilitation with Aims to Improve Lower Extremity Recovery Post-Stroke) is led by Dr. Brodie Sakakibara at UBC and Dr. Ada Tang at McMaster and will examine the feasibility of a lower extremity telerehabilitation protocol among community-living stroke survivors, and the effectiveness of a telerehab protocol on functional mobility and lower-extremity impairment.
- And, finally, a TMS add-on study will become part of the FLOW trial, looking at the added value of brain stimulation in the combination-therapy approach.
Once things return to normal, CanStroke Recovery Trials project manager Josie Chundamala said new trials will be able to move along much more quickly because the platform is in place, training has been done, site agreements and data transfer agreements are in place, and the CanStroke Recovery Platform has made it easier and faster to get things up and running. "There is an efficient process," she said. "We know the steps involved."
Full details about who is involved in CanStroke and contact information for each project can be found HERE.
Meet a Trial Participant
Debbie Tompkins, Halifax
A camping trip to New Brunswick with her six grandchildren seemed like the perfect way to mark a new phase of life last summer for recently retired nurse Debbie Tompkins.
Until, days before the planned departure, a stroke changed everything.
Signs of stroke began slowly. Her right leg felt unhinged. The 63-year-old Halifax woman went to the hospital and, although she felt no pain, received a diagnosis of sciatica, or nerve pain.
The next day, a Monday, she could barely walk. By Tuesday, she was back at the emergency department. Again, she returned home – no CT scan, no MRI, but with a plan to consult a neurologist.
The week dragged on. Sometimes she could put weight on her leg and sometimes she couldn’t. When she awoke on Sunday morning – a week to the day after her first hospital visit – she was nauseated and perspiring. She called 9-1-1.
“It was too late to get a clot-busting drug” to reverse the stroke symptoms at the hospital, but she was put on blood thinners. “Women are underdiagnosed, not listened to, and present differently,” she says.
Debbie moved from acute care to an inpatient stroke rehabilitation unit and stayed there until the end of October.
While in the inpatient rehab unit, Debbie was recruited to participate in CPSR’s FLOW trial -- the first national trial on the CanStroke Recovery Trials platform. It combines intensive rehabilitation therapy with the drug fluoxetine in an effort to enhance post-stroke recovery.
For Debbie, her participation meant an additional 12 weeks of therapy she would not have had otherwise.
“I’ve really enjoyed the FLOW,” Debbie says. “It’s hard and I’m exhausted when I’m done, but it’s good.”
For her, there is no question that extra therapy provided from her involvement in CanStroke Recovery Trials put her back on the road to recovery – and rekindling her camping plans.