[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100610816":3},{"organization":4,"outcomesModule":7,"designInfo":78,"detailedDescription":87,"studyPopulation":77,"armGroups":88,"interventions":99,"overallOfficials":104,"centralContacts":111,"locations":120,"responsibleParty":173,"collaborators":176,"id":191,"slug":192,"hasResults":193,"nctId":194,"briefTitle":195,"officialTitle":196,"acronym":197,"eligibilityCriteria":198,"healthyVolunteers":193,"sex":199,"minAge":200,"maxAge":77,"enrollmentInfo":201,"targetDuration":77,"studyType":204,"phases":205,"briefSummary":207,"conditions":208,"keywords":210,"overallStatus":122,"whyStopped":77,"lastUpdateSubmitDate":216,"lastUpdatePostDateStruct":217,"startDateStruct":220,"completionDateStruct":222,"leadSponsor":224,"locationsCount":225},{"fullName":5,"class":6},"Unidade Local de Saúde de Coimbra, EPE","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":13,"otherOutcomes":77},[9],{"measure":10,"description":11,"timeFrame":12},"Functional status at 3 months after ischemic stroke","Functional status assessment at 3 months after ischemic stroke, using the modified Rankin Scale (mRS), analyzed on an ordinal scale (0-6), to measure the degree of dependence\u002Ffunctional impairment.\n\nScore ranges:\n\n0-no residual symptoms (better outcome);\n\n1. no significant disability;\n2. slight disability;\n3. moderate disability;\n4. moderately severe disability;\n5. severe disability;\n6. death (worse outcome).","3 months post-stroke",[14,18,22,26,29,32,36,39,42,46,49,53,57,60,63,67,71,74],{"measure":15,"description":16,"timeFrame":17},"Neurological Assessment (NIHSS Scale)","Neurological assessment on the 7th day after ischemic stroke, measured using the National Institutes of Health Stroke Scale score (NIHSS, from 0-42) to evaluate the severity of neurological deficits.\n\nScore ranges:\n\n0-4: Minor Stroke (better outcome); 5-15: Moderate Stroke; 16-20: Moderate to Severe Stroke; 21-42: Severe Stroke (worse outcome).","Day 0, 48 hours, Day 7 and Month 3",{"measure":19,"description":20,"timeFrame":21},"Development of hospital-acquired infections","Incidence of infections acquired during hospitalization","Up to 7 days",{"measure":23,"description":24,"timeFrame":25},"Vital signs - Body temperature","Measurement of body temperature in degrees Celsius at the time of the visit","Day 0, 48 hours, Day 7",{"measure":27,"description":28,"timeFrame":25},"Vital signs - Systolic and diastolic blood pressure","Measurement of blood pressure in mmHg at the time of the visit",{"measure":30,"description":31,"timeFrame":25},"Vital signs - Heart rate","Measurement of heart rate in beats per minute (bpm) at the time of the visit",{"measure":33,"description":34,"timeFrame":35},"Mortality","Mortality rate (%)","3 months",{"measure":37,"description":38,"timeFrame":35},"EQ-5D-5L","An instrument to describe and value health across a wide range of disease areas.\n\n5-level EQ-5D (EuroQol instrument with 5 dimensions and 5 levels) version with five dimensions (five levels, categorical options): mobility, self-care, usual activities, pain\u002Fdiscomfort, and anxiety\u002Fdepression.\n\nScore ranges:\n\n1. I have no problems ...walking\u002Fdressing, etc (better outcome);\n2. I have some problems ...walking\u002Fdressing, etc;\n3. I have moderate problems ...walking\u002Fdressing, etc;\n4. I have severe problems ...walking\u002Fdressing, etc;\n5. I have extreme problems ...walking\u002Fdressing, etc (worse outcome).",{"measure":40,"description":41,"timeFrame":25},"Recurrent stroke assessment","Assessment of stroke recurrence after the first event, specifying the type into categories (no recurrence, new transient ischemic attack, new ischemic stroke, hemorrhagic stroke) and the time interval between events.",{"measure":43,"description":44,"timeFrame":45},"MONTREAL COGNITIVE ASSESSMENT (MoCA)","A brief cognitive screening tool used to assess mild cognitive impairment, score from 0-30.\n\nScore ranges:\n\n\\\u003C 19: moderate to severe cognitive impairment (worse outcome); 19-25: mild cognitive impairment; \\> 26: normal (better outcome).","Month 3",{"measure":47,"description":48,"timeFrame":35},"Hospital Anxiety and Depression Scale (HADS)","Final score of the scale that assesses anxiety and depression in patients, especially those with physical illnesses (score from 0-21, wiht 14 items and each item with four-point scale, 0-3).\n\nScore ranges:\n\n0-7: Normal - No significant symptoms of anxiety or depression (better outcome); 8-10: Borderline\u002FMild - Presence of symptoms that may require attention; 11 or higher: Probable Case\u002FSevere - Clinically significan psychological disorder or \"probable case\" (worse outcome).",{"measure":50,"description":51,"timeFrame":52},"Mobility assessment","Assessment of participant mobility according to categories (not yet mobilized, transfers to chair, ambulating)","48 hours, Day 7, Month 3.",{"measure":54,"description":55,"timeFrame":56},"Breath Holding Index (BHI) - measure 1","Non-invasive method used to assess cerebrovascular reactivity, specifically the ability of the brain's blood vessels to adjust to changes in carbon dioxide levels.\n\nThree attempts will be performed for each participant with measurements of:\n\n* (a) baseline mean flow velocity before the apnea test (cm\u002Fsec)","Before 48 hours or Day 7 (if not performed previously)",{"measure":58,"description":59,"timeFrame":56},"Breath Holding Index (BHI) - measure 2","Non-invasive method used to assess cerebrovascular reactivity, specifically the ability of the brain's blood vessels to adjust to changes in carbon dioxide levels.\n\nThree attempts will be performed for each participant with measurements of:\n\n* (b) mean flow velocity at the end of the apnea test (cm\u002Fsec).",{"measure":61,"description":62,"timeFrame":56},"Breath Holding Index (BHI) - measure 3","Non-invasive method used to assess cerebrovascular reactivity, specifically the ability of the brain's blood vessels to adjust to changes in carbon dioxide levels.\n\nThree attempts will be performed for each participant with measurements of:\n\n* (c) apnea duration (sec).",{"measure":64,"description":65,"timeFrame":66},"Hemorrhagic transformation","Type of ischemic stroke complication according to hemorrhage infarction (HI) \u002Fparenchymal hemorrhage (PH) levels in brain tissue.\n\nScore:\n\n0- No complication HI1- Hemorrhage infarction 1; HI2- Hemorrhage infarction 2; PH1- Parenchymal hemorrhage 1; PH2- Parenchymal hemorrhage 2; No follow-up CT\u002FMRI performed.","48 hours, Day 7",{"measure":68,"description":69,"timeFrame":70},"Early Mobilization Decision (\u003C48h)","Ultrasound-guided (US) mobilization: early mobilization (\\\u003C48h) if no cerebral hemodynamic impairment in US; Decision - yes or no? (only for interventional group)","Day 0",{"measure":72,"description":73,"timeFrame":45},"Hospitalization duration","Number of days of hospitalization",{"measure":75,"description":76,"timeFrame":70},"White matter lesions in neuroimaging","White matter legions in neuroimaging - ARWMC scale: 0-no lesions (better outcome); 1-focal lesions; 2-beginning confluence of lesions; 3-diffuse involvement of the entire region, with or without involvement of U fibers (worse outcome).",null,{"allocation":79,"interventionModel":80,"interventionModelDescription":77,"primaryPurpose":81,"observationalModel":77,"timePerspective":77,"maskingInfo":82},"RANDOMIZED","PARALLEL","PREVENTION",{"masking":83,"maskingDescription":77,"whoMasked":84},"DOUBLE",[85,86],"PARTICIPANT","OUTCOMES_ASSESSOR","Cerebrovascular diseases are the leading cause of death in Portugal and one of the most significant contributors to morbidity and disability.\n\nEarly mobilization after stroke is debated due to its potential benefits-such as fewer systemic complications and faster rehabilitation-and risks, particularly in patients with hemodynamic instability.\n\nInternational guidelines support for early mobilization tailored to the patient's neurological status; however, the scientific evidence remains limited, resulting in heterogeneous practices across institutions.\n\nPrevious studies have highlighted the insufficient consideration of hemodynamic status when determining the timing of initial mobilization.\n\nThis study is a phase 3, pragmatic, prospective, multicenter randomized controlled trial with blinded outcome assessment (PROBE design: Prospective, Randomized, Open-label, Blinded Outcome Assessment), with an anticipated total duration of 36 months.\n\nThe study will be conducted in the Neurology Departments of the participating hospital centers and aims to: (1) evaluate the superiority of early mobilization guided by hemodynamic assessment following acute ischemic stroke, compared to standard clinical practice; (2) assess neurological deficits, quality of life, and cognitive function at three months, as well as hospital length of stay, blood pressure profile evolution, patient-reported outcome measures (PROMs), and employability; (3) compare adverse events between patients undergoing Doppler-guided early mobilization and those in the control group, including hospital-acquired infections, neurological deterioration, hemorrhagic transformation, and mortality.\n\nPatients randomized to the intervention group will be mobilized according to carotid and transcranial Doppler ultrasound findings. In the presence of hemodynamic impairment, patients will undergo progressive mobilization, aiming to be out of bed by days 5 to 7 post-stroke, with gait training as neurologically feasible. In the absence of such findings, patients will begin mobilization immediately after the examination, with the goal of being out of bed and seated within 48 hours, including gait training when possible. Functional status at three months will be assessed using the modified Rankin Scale (mRS), which constitutes the study's primary endpoint.\n\nAll data collection procedures will follow formal and ethical research standards, ensuring that all informed participants voluntarily, anonymously, consent to take part in the study, with confidentiality maintained and no costs or harm to participants.",[89,95],{"label":90,"type":91,"description":92,"interventionNames":93},"Doppler-guided early mobilization","EXPERIMENTAL","Patients with ischemic stroke will be mobilized based on the results of carotid and transcranial Doppler ultrasound examinations. If significant hemodynamic alterations are identified, such as stenosis ≥70% or intracranial occlusions, mobilization will be gradually introduced up to the 5th-7th day post-event. In the absence of such alterations, mobilization will begin immediately, with out-of-bed transfer to a chair within 48 hours and gait training, if clinically feasible.",[94],"Procedure: Doppler-guided early mobilization",{"label":96,"type":97,"description":98,"interventionNames":77},"Standard Care Mobilization - Control Group","NO_INTERVENTION","Patients with ischemic stroke are mobilized according to standard clinical practice, without considering hemodynamic assessment results from Doppler ultrasound. Mobilization is introduced gradually, guided by the patient's clinical tolerance.",[100],{"type":101,"name":90,"description":102,"armGroupLabels":103,"otherNames":77},"PROCEDURE","Individualized early mobilization after ischemic stroke, guided by hemodynamic assessment using carotid and transcranial Doppler ultrasound. The type and timing of mobilization are adjusted according to the presence of significant hemodynamic alterations.",[90],[105,109],{"name":106,"affiliation":107,"role":108},"Joao Sargento Freitas, MD, PhD","Unidade Local de Saude de Coimbra","PRINCIPAL_INVESTIGATOR",{"name":106,"affiliation":107,"role":110},"STUDY_DIRECTOR",[112,116],{"name":106,"role":113,"phone":114,"phoneExt":77,"email":115},"CONTACT","+351 239 400 400","joaosargentofreitas@ulscoimbra.min-saude.pt",{"name":117,"role":113,"phone":114,"phoneExt":118,"email":119},"Clinical Trials Unit - Coimbra Academic Clinical Center CTU-CACC Unidade Local de Saude de Coimbra","8408","ctu-cacc@ulscoimbra.min-saude.pt",[121,137,156],{"facility":107,"status":122,"city":123,"state":124,"zip":125,"country":126,"countryCode":127,"cosmosGeoPoint":128,"geoPoint":133,"contacts":134},"RECRUITING","Coimbra","Coimbra District","3004-561","Portugal","PT",{"type":129,"coordinates":130},"Point",[131,132],-8.41996,40.20686,{"lat":132,"lon":131},[135,136],{"name":117,"role":113,"phone":114,"phoneExt":118,"email":119},{"name":106,"role":108,"phone":77,"phoneExt":77,"email":77},{"facility":138,"status":139,"city":140,"state":141,"zip":142,"country":126,"countryCode":127,"cosmosGeoPoint":143,"geoPoint":147,"contacts":148},"Unidade Local de Saúde de Santa Maria","NOT_YET_RECRUITING","Lisbon","Lisbon District","1649-028",{"type":129,"coordinates":144},[145,146],-9.1498,38.72509,{"lat":146,"lon":145},[149,153,155],{"name":150,"role":113,"phone":151,"phoneExt":77,"email":152},"Ana Catarina Fonseca, MD","+351 21 780 5000","contactcenter@ulssm.min-saude.pt",{"name":154,"role":113,"phone":77,"phoneExt":77,"email":77},"Clinical Trials Unit - Coimbra Academic Clinical Center CTU-CACC",{"name":150,"role":108,"phone":77,"phoneExt":77,"email":77},{"facility":157,"status":139,"city":158,"state":159,"zip":160,"country":126,"countryCode":127,"cosmosGeoPoint":161,"geoPoint":165,"contacts":166},"Unidade Local de Saúde de São João","Porto","Porto District","4200-319",{"type":129,"coordinates":162},[163,164],-8.61097,41.1485,{"lat":164,"lon":163},[167,171,172],{"name":168,"role":113,"phone":169,"phoneExt":77,"email":170},"Pedro Miguel Castro, MD","+351 225 512 100","pedromacc@gmail.com",{"name":154,"role":113,"phone":77,"phoneExt":77,"email":77},{"name":168,"role":108,"phone":77,"phoneExt":77,"email":77},{"type":108,"investigatorFullName":174,"investigatorTitle":175,"investigatorAffiliation":5,"oldNameTitle":77,"oldOrganization":77},"João Sargento Freitas","Principal Investigator, MD, PhD, Stroke Unit Coordinator",[177,180,182,184,186,189],{"name":178,"class":179},"Unidade Local de Saúde São João","OTHER_GOV",{"name":181,"class":179},"Unidade Local de Saúde Santa Maria",{"name":183,"class":6},"Unidade Local de Saúde de Matosinhos, EPE",{"name":185,"class":6},"University Hospital Rijeka",{"name":187,"class":188},"Unidade Local de Saúde de São José","INDIV",{"name":190,"class":6},"Klinički Bolnički Centar Zagreb","100610816","early-doppler-assisted-mobilization-in-adults-after-acute-ischemic-stroke-100610816",false,"NCT07232498","Early Doppler-Assisted Mobilization in Adults After Acute Ischemic Stroke","Early Doppler-Assisted Mobilization in Adults After Acute Ischemic Stroke - a Randomized Clinical Trial","DOP-MOBILIZE","Inclusion Criteria:\n\n* Patients diagnosed with ischemic stroke aged 18 years or older;\n* Ability to undergo carotid and transcranial Doppler ultrasound, as well as to mobilize within 48 hours;\n* Informed consent obtained from the patient or legal representative.\n\nExclusion Criteria:\n\n* Pre-existing disability with a modified Rankin Scale (mRS) score ≥ 4;\n* Diagnosis of Transient Ischemic Attack (TIA);\n* Severe hemodynamic instability, defined as:\n* Systolic blood pressure \\\u003C 100 mmHg or \\> 220 mmHg;\n* Peripheral oxygen saturation \\\u003C 92%;\n* Heart rate \\\u003C 40 or \\> 112 beats per minute;\n* Body temperature \\> 38.5°C;\n* Neurological deterioration with altered level of consciousness (defined as Glasgow Coma Scale \\\u003C 10);\n* Patients who underwent neurosurgical intervention within the past 30 days;\n* Concomitant diagnosis of a rapidly progressive fatal disease (e.g., terminal-stage cancer);\n* Requirement for continuous monitoring or continuous intravenous drug infusion;\n* Acute deep vein thrombosis\u002Fpulmonary embolism.","ALL","18 Years",{"count":202,"type":203},1300,"ESTIMATED","INTERVENTIONAL",[206],"NA","Post-stroke mobilization remains a subject of ongoing debate. While early mobilization-particularly the first out-of-bed mobilization-has been associated with reduced systemic complications and earlier rehabilitation, it also carries potential risks, such as neurological deterioration in the presence of hemodynamic instability.\n\nIn this study, the primary aim is to investigate whether early mobilization, guided by hemodynamic evaluation after acute ischemic stroke offers superior outcomes compared to standard clinical care.",[209],"Arterial Ischemic Stroke",[209,211,212,213,214,215],"Early mobilization","mRS","Transcranial doppler ultrasound","Neurology","Hemodynamics","2026-08-23",{"date":218,"type":219},"2026-08-25","ACTUAL",{"date":221,"type":219},"2025-06-04",{"date":223,"type":203},"2027-12",{"name":5,"class":6},3]