Long-term follow-up care for stroke survivors

A Multimodal Individualized Intervention to Prevent Functional Decline After Stroke. A Randomized Controlled Trial on Long-term Follow-up After Stroke (The LAST-long Trial)

Not applicable Interventional Norwegian University of Science and Technology · NCT03859063

This study tests whether personalized follow-up care from a stroke coordinator can help stroke survivors maintain their independence better than standard care over 18 months.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment301 (estimated)
Ages18 Years and up
SexAll
SponsorNorwegian University of Science and Technology Academic / other
Locations4 sites (Lørenskog and 3 other locations)
Trial IDNCT03859063 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the effectiveness of a personalized, multimodal intervention aimed at preventing long-term functional decline in stroke survivors. Participants will be randomly assigned to receive either individualized follow-up care from a stroke coordinator or standard care. The intervention includes monthly assessments of physical, cognitive, and social factors, with tailored treatment plans developed to address individual needs. Patients will be monitored over 18 months, with assessments at 6, 12, and 18 months to measure outcomes such as functional independence.

Who should consider this trial

Good fit: Ideal candidates are individuals who have experienced a first-ever or recurrent stroke and are living in specific municipalities in Norway.

Not a fit: Patients with a life expectancy of less than 12 months or those with serious comorbid conditions may not benefit from this study.

Why it matters

Potential benefit: If successful, this intervention could significantly improve long-term functional and cognitive outcomes for stroke survivors.

How similar studies have performed: Other studies have shown promise in using individualized interventions for stroke rehabilitation, suggesting potential success for this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Diagnosis of first ever or recurrent stroke (ischemic stroke or hemorrhage)
* mRS \< 5
* Living in Trondheim, Skedsmo or Lørenskog municipality
* Less than 10 points on Short Physical Performance Battery (SPPB) OR less than 26 points on Montreal Cognitive Assessment (MoCA) OR more than 27 points on the 7 item version of the Fatigue Severity Scale (FSS-7) OR more than 7 points on the depression or anxiety items on Hospital Anxiety and Depression Scale (HADS) OR reduced hand function (i.e. fails on Motor Assessment Scale - Advanced arm- and hand function, item 3)
* Able to understand Norwegian
* Able and willing to sign informed consent.

Exclusion Criteria:

* Life expectancy \< 12 months
* Other serious diseases, judged by the medical doctor to make it difficult to comply with the intervention (i.e. serious neurological diseases or drug abuse).

Where this trial is running

Lørenskog and 3 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions StrokeRehabilitationCognitionPhysical FitnessCase ManagersSecondary prevention
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.