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Published in: Trials 1/2014

Open Access 01-12-2014 | Study protocol

The DARS (Dopamine Augmented Rehabilitation in Stroke) trial: protocol for a randomised controlled trial of Co-careldopa treatment in addition to routine NHS occupational and physical therapy after stroke

Authors: Bipin B Bhakta, Suzanne Hartley, Ivana Holloway, J Alastair Couzens, Gary A Ford, David Meads, Catherine M Sackley, Marion F Walker, Sharon P Ruddock, Amanda J Farrin

Published in: Trials | Issue 1/2014

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Abstract

Background

Stroke has a huge impact, leaving more than a third of affected people with lasting disability and rehabilitation remains a cornerstone treatment in the National Health Service (NHS). Recovery of mobility and arm function post-stroke occurs through re-learning to use the affected body parts and/or learning to compensate with the lesser affected side. Promising evidence suggests that the addition of Co-careldopa to physical therapy and occupational therapy may improve the recovery of arm and leg movement and lead to improved function.

Methods/design

Dopamine Augmented Rehabilitation in Stroke (DARS) is a multi-centre double-blind, randomised, placebo, controlled clinical trial of Co-careldopa in addition to routine NHS occupational therapy and physical therapy as part of early stroke rehabilitation. Participants will be randomised on a 1:1 basis to either Co-careldopa or placebo. The primary objective of the trial is to determine whether the addition of six weeks of Co-careldopa treatment to rehabilitation therapy can improve the proportion of patients who can walk independently eight weeks post-randomisation.

Discussion

The DARS trial will provide evidence as to whether Co-careldopa, in addition to routine NHS occupational and physical therapy, leads to a greater recovery of motor function, a reduction in carer dependency and advance rehabilitation treatments for people with stroke.

Trial registration

ISRCTN99643613 assigned on 4 December 2009.
Appendix
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Literature
1.
go back to reference Pollock A, Baer G, Langhorne P, Pomeroy V: Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke: a systematic review. Clin Rehabil. 2007, 21: 395-410.CrossRefPubMed Pollock A, Baer G, Langhorne P, Pomeroy V: Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke: a systematic review. Clin Rehabil. 2007, 21: 395-410.CrossRefPubMed
2.
go back to reference Ward NS: Functional reorganization of the cerebral motor system after stroke. Curr Opin Neurol. 2004, 17: 725-730.CrossRefPubMed Ward NS: Functional reorganization of the cerebral motor system after stroke. Curr Opin Neurol. 2004, 17: 725-730.CrossRefPubMed
3.
go back to reference Wise RA: Dopamine, learning and motivation. Nat Rev Neurosci. 2004, 5: 1-12.CrossRef Wise RA: Dopamine, learning and motivation. Nat Rev Neurosci. 2004, 5: 1-12.CrossRef
4.
go back to reference Ziemann U, Meintzschel F, Korchounov A, Ilic TV: Pharmacological modulation of plasticity in the human motor cortex. Neurorehabil Neural Repair. 2006, 20: 243-CrossRefPubMed Ziemann U, Meintzschel F, Korchounov A, Ilic TV: Pharmacological modulation of plasticity in the human motor cortex. Neurorehabil Neural Repair. 2006, 20: 243-CrossRefPubMed
6.
go back to reference Feeney DM, Gonzalez A, Law WA: Amphetamine, haloperidol, and experience interact to affect rate of recovery after motor cortex injury. Science. 1982, 217: 855-885.CrossRefPubMed Feeney DM, Gonzalez A, Law WA: Amphetamine, haloperidol, and experience interact to affect rate of recovery after motor cortex injury. Science. 1982, 217: 855-885.CrossRefPubMed
7.
go back to reference Martinsson L, Hårdemark HG, Eksborg S: Amphetamines for improving recovery after stroke. Cochrane Database Syst Rev. 2007, (1): CD002090 Martinsson L, Hårdemark HG, Eksborg S: Amphetamines for improving recovery after stroke. Cochrane Database Syst Rev. 2007, (1): CD002090
8.
go back to reference Breitenstein C, Floel A, Korsukewitz C, Wailke S, Bushuven S, Knecht S: A shift of paradigm: from noradrenergic to dopaminergic modulation of learning?. J Neurol Sci. 2006, 248: 42-47.CrossRefPubMed Breitenstein C, Floel A, Korsukewitz C, Wailke S, Bushuven S, Knecht S: A shift of paradigm: from noradrenergic to dopaminergic modulation of learning?. J Neurol Sci. 2006, 248: 42-47.CrossRefPubMed
9.
go back to reference Scheidtmann K, Fries W, Müller F, Koenig E: Effect of L-dopa in combination with physiotherapy on functional motor recovery after stroke: a prospective, randomised, double blind study. Lancet. 2001, 358: 787-790.CrossRefPubMed Scheidtmann K, Fries W, Müller F, Koenig E: Effect of L-dopa in combination with physiotherapy on functional motor recovery after stroke: a prospective, randomised, double blind study. Lancet. 2001, 358: 787-790.CrossRefPubMed
10.
11.
go back to reference Rösser N, Heuschmann P, Wersching H, Breitenstein C, Knecht S, Flöel A: L-dopa improves procedural motor learning in chronic stroke patients. Arch Phys Med Rehabil. 2008, 89: 1633-1641.CrossRefPubMed Rösser N, Heuschmann P, Wersching H, Breitenstein C, Knecht S, Flöel A: L-dopa improves procedural motor learning in chronic stroke patients. Arch Phys Med Rehabil. 2008, 89: 1633-1641.CrossRefPubMed
12.
go back to reference Kobari M, Fukuuchi Y, Shinohara T, Obara K, Nogawa S: L-dopa-induced local cerebral blood flow changes in Parkinson’s disease and related disorders. J Neurol Sci. 1995, 128: 212-218.CrossRefPubMed Kobari M, Fukuuchi Y, Shinohara T, Obara K, Nogawa S: L-dopa-induced local cerebral blood flow changes in Parkinson’s disease and related disorders. J Neurol Sci. 1995, 128: 212-218.CrossRefPubMed
13.
go back to reference Salgado-Pineda P, Delaveau P, Falcon C, Blin O: Brain T1 intensity changes after L-dopa administration in healthy subjects: a voxel-based morphometry study. Br J Clin Pharmacol. 2006, 62: 5-546–551CrossRef Salgado-Pineda P, Delaveau P, Falcon C, Blin O: Brain T1 intensity changes after L-dopa administration in healthy subjects: a voxel-based morphometry study. Br J Clin Pharmacol. 2006, 62: 5-546–551CrossRef
14.
go back to reference Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X: Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008, (2): CD000011 Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X: Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008, (2): CD000011
15.
go back to reference Chisholm-Burns MA, Spivey CA: Pharmacoadherence: a new term for a significant problem. Am J Health Syst Pharm. 2008, 65: 661-667.CrossRefPubMed Chisholm-Burns MA, Spivey CA: Pharmacoadherence: a new term for a significant problem. Am J Health Syst Pharm. 2008, 65: 661-667.CrossRefPubMed
16.
go back to reference Leopold NA, Polansky M, Hurka MR: Drug adherence in Parkinson’s disease. Movement Disords. 2004, 19: 513-517.CrossRef Leopold NA, Polansky M, Hurka MR: Drug adherence in Parkinson’s disease. Movement Disords. 2004, 19: 513-517.CrossRef
17.
go back to reference Lee JK, Grace KA, Foster TG, Crawley MJ, Erowele GI, Sun HJ, Turner PT, Sullenberger LE, Taylor AJ: How should we measure medication adherence in clinical trials and practice?. Ther Clin Risk Manage. 2007, 3: 685-690. Lee JK, Grace KA, Foster TG, Crawley MJ, Erowele GI, Sun HJ, Turner PT, Sullenberger LE, Taylor AJ: How should we measure medication adherence in clinical trials and practice?. Ther Clin Risk Manage. 2007, 3: 685-690.
Metadata
Title
The DARS (Dopamine Augmented Rehabilitation in Stroke) trial: protocol for a randomised controlled trial of Co-careldopa treatment in addition to routine NHS occupational and physical therapy after stroke
Authors
Bipin B Bhakta
Suzanne Hartley
Ivana Holloway
J Alastair Couzens
Gary A Ford
David Meads
Catherine M Sackley
Marion F Walker
Sharon P Ruddock
Amanda J Farrin
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Trials / Issue 1/2014
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-15-316

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