Barker Kathryn, Holland Anne E, Lee Annemarie L, Ritchie Kathryn, Boote Claire, Lowe Stephanie, Pazsa Fiona, Thomas Lee, Turczyniak Monica, Skinner Elizabeth H
Department of Physiotherapy and Community Services, Western Health, 176 Furlong Road, St Albans, Victoria, Australia.
Discipline of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia.
J Comorb. 2018 Jul 20;8(1):2235042X18783918. doi: 10.1177/2235042X18783918. eCollection 2018.
Multimorbidity, the coexistence of two or more chronic conditions, is common in clinical practice. Rehabilitation for people with multimorbidity may provide access to a rehabilitation programme that can address common symptoms and risk factors for multiple chronic diseases.
The aims of this study were to (1) evaluate the feasibility of a rehabilitation programme compared to usual medical care (UMC) in people with multimorbidity and (2) gather preliminary data regarding clinical effects and impact on functional exercise capacity, activities of daily living, health-related quality of life and resource utilization.
A pilot feasibility parallel randomized controlled trial was undertaken. Adults with multimorbidity were randomized to the rehabilitation programme (intervention) or UMC (control). The duration of the rehabilitation programme was 8 weeks and comprised exercise (1 h, twice weekly) and education (1 h, once weekly). The UMC group did not participate in a structured exercise programme.
One hundred people were screened to recruit 16 participants, with a 71% completion rate for the intervention group. The rehabilitation group achieved a mean (standard deviation) improvement in 6-minute walk distance of 44 (41) m and the UMC group of 23 (29) m.
This study suggests that it would be feasible to conduct a larger randomized control trial investigating a rehabilitation programme for people with multimorbidity. Low uptake of the study suggests that refinement of the inclusion criteria, recruitment sources and programme model will be needed to achieve the number of participants required.
多种慢性病共存的多病共存情况在临床实践中很常见。为患有多种慢性病的人提供康复治疗,可能会使他们获得一个能够解决多种慢性病常见症状和风险因素的康复项目。
本研究的目的是:(1)评估针对患有多种慢性病的人的康复项目与常规医疗护理(UMC)相比的可行性;(2)收集有关临床效果以及对功能运动能力、日常生活活动、健康相关生活质量和资源利用影响的初步数据。
进行了一项试点可行性平行随机对照试验。患有多种慢性病的成年人被随机分配到康复项目组(干预组)或常规医疗护理组(对照组)。康复项目为期8周,包括运动(每周两次,每次1小时)和教育(每周一次,每次1小时)。常规医疗护理组未参加结构化运动项目。
筛选了100人以招募16名参与者,干预组的完成率为71%。康复组6分钟步行距离的平均(标准差)改善为44(41)米,常规医疗护理组为23(29)米。
本研究表明,针对患有多种慢性病的人开展一项更大规模的关于康复项目的随机对照试验是可行的。该研究的低参与率表明,需要完善纳入标准、招募来源和项目模式,以达到所需的参与者数量。