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改善纤维肌痛女性的日常生活活动能力:一项探索性、半随机、二期研究,即IMPROvE试验。

Improving activities of daily living ability in women with fibromyalgia: An exploratory, quasi-randomized, phase-two study, IMPROvE trial.

作者信息

von Bülow Cecilie, Amris Kirstine, Bandak Elisabeth, Danneskiold-Samsøe Bente, Wæhrens Eva Elisabet Ejlersen

机构信息

Department of Rheumatology, The Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, DK-2000 Frederiksberg, Denmark.

出版信息

J Rehabil Med. 2017 Mar 6;49(3):241-250. doi: 10.2340/16501977-2198.

Abstract

OBJECTIVE

To explore and compare the outcomes of adaptation and physical activity programmes regarding activities of daily living (ADL) ability following interdisciplinary rehabilitation in women with fibromyalgia.

METHODS

Participants (n = 85) were quasi-randomized to 16-week adaptation (ADAPT) or physical activity (ACTIVE) programmes following 2-week interdisciplinary rehabilitation. Primary outcomes were ADL motor and ADL process ability, measured with the Assessment of Motor and Process Skills (AMPS) at 4-week follow-up. Data were analysed per protocol.

RESULTS

Participants (ADAPT, n = 21; ACTIVE, n = 27) did not differ from withdrawers (n = 37). Improvements in ADL ability in the ADAPT (ADL motor mean change = 0.43 logits (95% confidence interval (95% CI) = 0.31-0.56); ADL process mean change = 0.34 logits (95% CI = 0.17-0.52)) and ACTIVE (ADL motor mean change = 0.33 logits (95% CI = 0.22-0.43); ADL process mean change = 0.25 logits (95% CI = 0.12-0.38)) groups were statistically significant, with no differences between groups. Responder analyses revealed that 63% of all participants obtained clinically relevant improvements in ADL motor ability and 48% in ADL process ability.

CONCLUSION

Although limited by a large drop-out, this exploratory study showed that both adaptation and physical activity programmes following interdisciplinary rehabilitation improved ADL ability in the majority of participants. ADL ability outcomes were independent of group allocation (ADAPT vs ACTIVE), suggesting efficacy of both programmes.

摘要

目的

探讨并比较纤维肌痛女性患者在跨学科康复后,适应性训练和体育活动计划对日常生活活动(ADL)能力的影响。

方法

85名参与者在接受为期2周的跨学科康复后,被准随机分配至为期16周的适应性训练(ADAPT)或体育活动(ACTIVE)计划。主要结局指标为ADL运动能力和ADL流程能力,在4周随访时通过运动与流程技能评估(AMPS)进行测量。数据按方案进行分析。

结果

参与者(ADAPT组,n = 21;ACTIVE组,n = 27)与退出者(n = 37)无差异。ADAPT组(ADL运动平均变化 = 0.43对数单位(95%置信区间(95%CI)= 0.31 - 0.56);ADL流程平均变化 = 0.34对数单位(95%CI = 0.17 - 0.52))和ACTIVE组(ADL运动平均变化 = 0.33对数单位(95%CI = 0.22 - 0.43);ADL流程平均变化 = 0.25对数单位(95%CI = 0.12 - 0.38))的ADL能力改善具有统计学意义,两组间无差异。反应者分析显示,所有参与者中63%在ADL运动能力方面获得了临床相关改善,48%在ADL流程能力方面获得了临床相关改善。

结论

尽管受到大量退出的限制,但这项探索性研究表明,跨学科康复后的适应性训练和体育活动计划在大多数参与者中均改善了ADL能力。ADL能力结局与分组(ADAPT组与ACTIVE组)无关,表明两种计划均有效。

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