AVERT

1. AVERT

AVERT is an acronym that stands for "A Very Early Rehabilitation Trial". It is a significant clinical trial in the field of stroke rehabilitation, focusing on the timing and intensity of physical therapy interventions following a stroke. The trial investigates whether very early mobilization (VEM) after a stroke can improve patient outcomes compared to standard care.

Background

Stroke is a leading cause of disability worldwide, and early rehabilitation is crucial for recovery. Traditional rehabilitation practices often delay mobilization due to concerns about patient safety and the potential for adverse effects. However, emerging evidence suggests that early intervention may enhance recovery by promoting neuroplasticity and preventing complications associated with immobility.

The AVERT Trial

The AVERT trial was a large, multicenter, randomized controlled trial designed to assess the efficacy and safety of very early mobilization after stroke. The trial included patients who had experienced an acute stroke and were admitted to participating hospitals.

Objectives

The primary objective of the AVERT trial was to determine whether very early mobilization (within 24 hours of stroke onset) could improve functional outcomes at 3 months post-stroke, as measured by the modified Rankin Scale (mRS).

Methodology

Participants in the AVERT trial were randomly assigned to either the intervention group, which received very early mobilization, or the control group, which received standard care. The intervention involved frequent, short-duration mobilization sessions, including sitting, standing, and walking, initiated within 24 hours of stroke onset.

Results

The results of the AVERT trial were published in 2015. The trial found that very early mobilization did not significantly improve functional outcomes compared to standard care. In fact, patients in the very early mobilization group had a slightly higher risk of adverse events, suggesting that the timing and intensity of rehabilitation need to be carefully considered.

Implications

The findings of the AVERT trial have important implications for stroke rehabilitation practices. While early mobilization remains a key component of stroke recovery, the trial highlights the need for a balanced approach that considers patient safety and individual variability in recovery trajectories.

Also see

• Stroke rehabilitation
• Neuroplasticity
• Modified Rankin Scale
• Randomized controlled trial