挪威再康复的多中心调查：一项临床对照试验。
A multicenter investigation of reablement in Norway: a clinical controlled trial.
机构信息
Centre for Care Research Western Norway, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway.
Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, P.O Box 7030, 5020, Bergen, Norway.
出版信息
BMC Geriatr. 2019 Jan 30;19(1):29. doi: 10.1186/s12877-019-1038-x.
BACKGROUND
Reablement is an emerging approach in rehabilitation services, but evidence for its efficacy is rather weak and inconsistent. The purpose of the present study is therefore to investigate the health effects of reablement in home-dwelling adults.
METHODS
A multicenter, clinical controlled trial involving 47 municipalities in Norway, with assessments at baseline, and after 10 weeks and at 6 and 12 months. The sample consisted of 707 persons that received a 4-10 week reablement program and 121 underwent treatment as usual. Primary outcomes were activity performance and satisfaction with performance measured by the Canadian Occupational Performance Measure (COPM, 1-10). Secondary outcomes included the Short Physical Performance Measure Battery (SPPB), the European Quality of Life Scale (EQ-5D-5 L), and the Sense of Coherence Questionnaire (SOC). Overall treatment effects were estimated with mixed-model repeated measures analyses.
RESULTS
Significant treatment effects in the rehabilitation group compared with the control group were found in COPM-Performance and COPM-Satisfaction scores at 10 weeks (mean differences between groups (MD), 1.61, 95% confidence interval (CI), 1.13, 2.10 and MD 1.47, CI 0.98, 1.97, respectively), and at 6 months (MD 1.42; CI 0.82,2.02 and MD 1.37; CI 0.77,1.98, respectively). There were also significant treatment effects in the SPPB-subscales for balance and walking after 6 months, in the total SPPB score and in the subscale for sit-to-stand after 12 months. In the EQ-5D-5 L assessment, significant treatment effects were found in the subscales for mobility, and for usual activities and health after 6 months. There was a significant difference in the SOC after six months.
CONCLUSION
Reablement seems to be a more effective rehabilitation service for persons with functional decline than traditional home-based services after six months. After 12 months, the differences between the groups decreased.
TRIAL REGISTRATION
The trial was registered at ClinicalTrials.gov on October 24, 2014, (retrospectively registered) identifier: NCT02273934 .
背景
再能力化是康复服务中一种新兴的方法，但它的疗效证据相当薄弱且不一致。因此，本研究的目的是调查再能力化对居家成年人的健康影响。
方法
这是一项多中心、临床对照试验，涉及挪威的 47 个市，在基线、10 周后以及 6 个月和 12 个月时进行评估。样本包括 707 名接受 4-10 周再能力化计划的患者和 121 名接受常规治疗的患者。主要结局是通过加拿大职业表现测量（COPM，1-10）测量的活动表现和对表现的满意度。次要结局包括简短身体表现测量组合（SPPB）、欧洲生活质量量表（EQ-5D-5L）和心理韧性量表（SOC）。使用混合模型重复测量分析估计总体治疗效果。
结果
与对照组相比，康复组在 COPM 表现和 COPM 满意度评分方面在 10 周时（组间平均差异（MD），1.61，95%置信区间（CI），1.13，2.10 和 MD 1.47，CI 0.98，1.97）和 6 个月时（MD 1.42；CI 0.82，2.02 和 MD 1.37；CI 0.77，1.98）均存在显著的治疗效果。在 6 个月时的 SPPB 平衡和行走子量表、总 SPPB 评分和坐立站起子量表以及 12 个月时的 EQ-5D-5L 评估中，移动能力和日常活动和健康子量表也存在显著的治疗效果。SOC 在 6 个月时存在显著差异。
结论
与传统的居家服务相比，再能力化似乎是一种更有效的康复服务，可改善功能下降的患者的健康状况，6 个月后效果更显著。12 个月后，两组之间的差异减小。
试验注册
该试验于 2014 年 10 月 24 日在 ClinicalTrials.gov 注册（回顾性注册），标识符：NCT02273934。
Zotero 插件