To find out more about current Stroke studies you can view a list of studies on the NIHR Clinical Research Network Portfolio Database.
The NIHR Clinical Research Network Stroke has been enormously successful in integrating clinical research into NHS clinical service provision, and both developing and delivering a large practice changing portfolio of clinical trials.
Read our Stroke Specialty Profile to find out more.
As the most integrated clinical research system in the world, the NIHR supports research studies through our funding programmes, training and supporting health researchers, and providing world-class research facilities. We also support dialogue between the life sciences industry and charities to benefit all, and facilitate the involvement of patients and the public to make research more effective.
Last year (2016/2017) the NIHR supported 145 studies on stroke. The NIHR supported these studies through our funding programmes and our research schools and units. We also support stroke research through our research infrastructure and our training and career development awards for researchers.
The Stroke specialty covers the entire stroke pathway, from the first few hours after stroke, until months and years later. Patients with stroke present to all healthcare settings and we can seamlessly access them all, from primary care to specialist hospitals. Research areas of focus in stroke have included hyperacute, recovery, rehabilitation and prevention. We are currently delivering trials testing novel clot retrieval devices, drugs for the treatment of stroke, stem cell therapies and robotics to help recovery after stroke.
The aim of the study was to determine the safety and effectiveness of early intensive lowering of blood pressure in patients with intracerebral haemorrhage, and whether it would improve patient outcomes.
INTERACT2 was an international, multicentre, prospective, randomized, open-treatment, blinded end-point trial.
The study compared the effect of an intensive (<140mmHg systolic blood pressure) versus the current guideline (<180) strategy of lowering blood pressure within six hours of spontaneous intracerebral haemorrhage onset in patients with baseline systolic blood pressure between 150 and 220mmHg.
From October 2008 to August 2012, a total of 2839 participants were enrolled at 144 hospitals in 21 countries; 1403 participants were randomly assigned to receive early intensive treatment to lower their blood pressure, and 1436 were assigned to receive guideline-recommended treatment.
The study found that early intensive lowering of blood pressure, compared with the recommended guidelines, did not result in a significant reduction in the rate of the primary outcome of death or major disability. However, the study did find there were significantly better functional outcomes among patients assigned to intensive treatment to
lower their blood pressure than among patients assigned to guideline-recommended treatment.
The study was on the NIHR Clinical Research Network’s Portfolio and received NIHR infrastructure support, including research nurses, to deliver the study.
Whilst wider use of mechanical thrombectomy will have a significant impact on quality of life, research into use of the treatment doesn’t end here. Studies like STABILISE are looking into the efficacy and safety of a new device for thrombectomy, so that clinicians can maximise its use and patient benefits can continue to be realised.
A biosensor, called SMARTchip, has been designed to detect whether a person has had a stroke or not. The biosensor identifies an increase in the level of purines in the blood, believed to be an indicator of a stroke.
The SMARTchip has the potential to speed up diagnosis and reduce doubt, by supporting our clinical diagnostic skills and other tests. It is vital to act fast. Any indecision can increase the time it takes to assess the best course of action.
In 2013, the project received a £471,000 grant from the NIHR Invention for Innovation Programme.
The support provided by the CRN was important to this study, as Dr Roffe explains: “You can’t run a study like this without the infrastructure and research nurses support the Network provides. This enabled us to deliver the study over three different sites across England.
The aim of the GORE study was to investigate a percutaneous cardiac closure device for the secondary prevention of stroke in younger people. The NIHR Clinical Research Network supported recruitment of patients with ischaemic stroke secondary to an underlying cardiac defect from four stroke units across the UK.
Following identification and specialist stroke work up, eligible participants were randomised to either percutaneous closure device (or standard care) by the cardiologist. This trial was complex as it required collaboration between acute stroke services and cardiology, NIHR support for identification, enrolment and follow-up across both specialties was key in this study exceeding its target recruitment by 200 per cent.
Swallowing problems are common after stroke and a proportion of survivors are left dependent on feeding tubes. The STEPS study investigated electrical stimulation, applied to the pharynx by a device similar to a feeding tube. Assessment and treatment of swallowing is dependent on multi-disciplinary skills, including doctors nurses and speech and language therapists
The NIHR supported research staff from these multi-disciplinary teams to deliver the STEPS study in 11 stroke units across the UK, with 102 participants recruited over 26 months, making this the largest trial of its kind worldwide.
Immobile patients face a 10-20% risk of deep vein thrombosis (DVT) during the first month after stroke. The CLOTS – or ‘Clots in Legs Or sTockings after Stroke’ studies are testing graduated compression stockings for DVT prevention in acute stroke patients.
The study found that 200 patients would need to be fitted with thigh-length GCS to prevent one proximal DVT. Patients in the interventional group had significantly more problems with skin ulcers, blisters and ulceration.
As a result, NICE revised its stroke guidelines in early 2010, and no longer recommend thigh-length GCS for stroke patients.
You can find out more about Stroke studies in your area through the UK Clinical Trials Gateway.
The NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester created a tailored assessment tool to help determine the specific care needs for individual stroke patients, six months after their stroke.
The Greater Manchester Stroke Assessment Tool (GM-SAT) is a free, evidence-based assessment tool designed specifically for a six month post-stroke review. GM-SAT identifies a wide range of potential post-stroke care needs, from medication management and secondary prevention, through to mood and fatigue problems.
GM-SAT is now used across the country and is the only tool used for post-stroke assessment by the Stroke Association. They have carried out more than 12,500 assessments to date in areas where they are commissioned to do so, with the number of assessments having grown year on year since its introduction as shown in the table across.
Better prescribing might prevent thousands of strokes in the UK