Højskov Ida Elisabeth, Moons Philip, Hansen Niels Viggo, La Cour Søren, Olsen Peter Skov, Gluud Christian, Winkel Per, Lindschou Jane, Thygesen Lau Caspar, Egerod Ingrid, Berg Selina Kikkenborg
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
KU Leuven Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
BMJ Open. 2017 Jan 17;7(1):e013038. doi: 10.1136/bmjopen-2016-013038.
Patients undergoing coronary artery bypass graft surgery often experience a range of symptoms. Studies indicate that non-pharmacological interventions such as exercise training and psychoeducation have a positive physiological and psychological effect in early outpatient rehabilitation. The SheppHeartCABG trial will investigate the effect of early comprehensive rehabilitation in early phase rehabilitation versus usual care. The aim of this paper is to present the protocol for the SheppHeartCABG trial.
METHODS/ANALYSIS: SheppHeartCABG is an investigator-initiated randomised clinical superiority trial with blinded outcome assessment, employing 1:1 central randomisation to rehabilitation plus usual care versus usual care alone. On the basis of a sample size calculation, 326 patients undergoing coronary artery bypass grafting will be included from two clinical sites. All patients receive usual care and patients allocated to the experimental intervention follow 4 weeks rehabilitation consisting of an exercise programme, psycho-educative consultations and a compact mindfulness programme. The primary outcome is physical function measured by the 6-min walk test. The secondary outcomes are mental health and physical activity measured by the Medical Outcome Study Short Form (SF-12), anxiety and depression measured by the Hospital Anxiety and Depression Scale questionnaire, physical, emotional and global scores by the HeartQoL questionnaire, sleep measured by the Pittsburgh Sleep Quality Index, pain measured by the Örebro Musculoskeletal Screening Questionnaire and muscle endurance measured by the sit-to-stand test. A number of explorative analyses will also be conducted.
SheppHeartCABG is approved by the regional ethics committee (no. H-4-2014-109) and the Danish Data Protection Agency (no. 30-1309) and is performed in accordance with good clinical practice and the Declaration of Helsinki in its latest form. Positive, neutral and negative results of the trial will be submitted to international peer-reviewed journals. Furthermore, results will be presented at national and international conferences relevant to the subject fields.
NCT02290262; pre-results.
接受冠状动脉搭桥手术的患者常常会出现一系列症状。研究表明,运动训练和心理教育等非药物干预措施在早期门诊康复中对生理和心理具有积极影响。SheppHeartCABG试验将研究早期综合康复与常规护理相比在早期康复阶段的效果。本文旨在介绍SheppHeartCABG试验的方案。
方法/分析:SheppHeartCABG是一项由研究者发起的随机临床优势试验,采用盲法结局评估,通过1:1的中心随机分组,将患者分为康复加常规护理组和单纯常规护理组。根据样本量计算,将从两个临床地点纳入326例接受冠状动脉搭桥手术的患者。所有患者均接受常规护理,分配到试验性干预组的患者接受为期4周的康复治疗,包括运动计划、心理教育咨询和紧凑的正念训练计划。主要结局指标是通过6分钟步行试验测量的身体功能。次要结局指标包括通过医学结局研究简表(SF-12)测量的心理健康和身体活动、通过医院焦虑抑郁量表问卷测量的焦虑和抑郁、通过HeartQoL问卷测量的身体、情感和总体评分、通过匹兹堡睡眠质量指数测量的睡眠、通过厄勒布鲁肌肉骨骼筛查问卷测量的疼痛以及通过坐立试验测量的肌肉耐力。还将进行一些探索性分析。
SheppHeartCABG试验已获得地区伦理委员会(编号H-4-2014-109)和丹麦数据保护局(编号30-1309)的批准,并按照良好临床实践和最新版《赫尔辛基宣言》进行。试验的阳性、中性和阴性结果将提交给国际同行评审期刊。此外,研究结果将在与该主题领域相关的国内和国际会议上公布。
NCT02290262;预结果。