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研究方案:电刺激腓总神经对恢复期脑卒中偏瘫下肢运动功能的疗效(RALLY)研究的理论基础和设计:一项随机对照研究方案。

Rationale and design of the theRapeutic effects of peroneal nerve functionAl electrical stimuLation for Lower extremitY in patients with convalescent poststroke hemiplegia (RALLY) study: study protocol for a randomised controlled study.

机构信息

Department of Rehabilitation and Physical Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

出版信息

BMJ Open. 2019 Nov 25;9(11):e026214. doi: 10.1136/bmjopen-2018-026214.

Abstract

INTRODUCTION

Increasing evidence supports the utilisation of functional electrical stimulation (FES) to improve gait following stroke; however, few studies have focused exclusively on its use in the convalescent phase. In addition, its efficacy in patients with a non-Western life style has not been evaluated.

METHODS AND ANALYSIS

This is a randomised, controlled, open-label multicentre study, comparing rehabilitation with and without FES. The purpose of our study is to test the hypothesis that the FES system improves walking ability in Japanese patients with hemiplegia during the convalescent phase. Two hundred patients aged 20-85 years who had an initial stroke ≤6 months prior to the enrolment, are in a convalescent phase (after the end of acute phase treatment, within 6 months after the onset of stroke) with functional ambulation classification 3 or 4 and have a hemiplegic gait disorder (drop foot) due to stroke have been recruited from 21 institutions in Japan. The patients are randomised in 1:1 fashion to usual gait rehabilitation or rehabilitation using FES (Walkaide). The trial duration is 8 weeks, and the primary outcome measured will be the change in maximum distance from baseline to the end of the trial, as measured with the 6 min walk test (6-MWT). The 6-MWT is performed barefoot, and the two treatment groups are compared using the analysis of covariance.

ETHICS AND DISSEMINATION

This study is conducted in accordance with the principles of the Declaration of Helsinki and the Ethical Guidelines for Medical and Health Research Involving Human Subjects and is approved by the ethics committee of all participating institutions. The published results will be disseminated to all the participants by the study physicians.

TRIAL REGISTRATION NUMBER

The University Hospital Medical Information Network-Clinical Studies Registry (UMIN000020604).

摘要

简介

越来越多的证据支持使用功能性电刺激(FES)来改善中风后的步态;然而,很少有研究专门关注其在恢复期的应用。此外,其在非西方生活方式患者中的疗效尚未得到评估。

方法和分析

这是一项随机、对照、开放标签的多中心研究,比较了康复治疗加用和不加用 FES 的效果。我们的研究目的是检验 FES 系统是否能改善日本恢复期偏瘫患者的步行能力的假设。从日本 21 家机构招募了 200 名年龄在 20-85 岁之间、初次中风时间在 6 个月以内、处于恢复期(急性治疗期结束后,中风发作后 6 个月内)、功能步行分类 3 或 4 级、因中风导致偏瘫步态(足下垂)的患者。患者以 1:1 的比例随机分为常规步行康复组或使用 FES(Walkaide)康复组。试验持续 8 周,主要终点是 6 分钟步行试验(6-MWT)从基线到试验结束的最大距离变化。6-MWT 是赤脚进行的,使用协方差分析比较两组治疗的差异。

伦理和传播

本研究符合《赫尔辛基宣言》和《涉及人体医学研究伦理指导原则》的原则,并得到所有参与机构伦理委员会的批准。研究医生将向所有参与者公布研究结果。

试验注册号

日本大学医院医疗信息网络-临床研究注册(UMIN000020604)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b422/6886987/1969b81b9659/bmjopen-2018-026214f01.jpg

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