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振动疗法对危重症成人身体功能影响的研究(VTICIA 试验):一项单盲随机对照试验方案。

Effect of vibration therapy on physical function in critically ill adults (VTICIA trial): protocol for a single-blinded randomised controlled trial.

机构信息

Department of Emergency and Critical Care Medicine, Tokushima University Hospital, Tokushima, Japan

Department of Nursing, Tokushima University Hospital, Tokushima, Japan.

出版信息

BMJ Open. 2021 Mar 2;11(3):e043348. doi: 10.1136/bmjopen-2020-043348.

Abstract

INTRODUCTION

Vibration therapy has been used as an additional approach in passive rehabilitation. Recently, it has been demonstrated to be feasible and safe for critically ill patients, whose muscle weakness and intensive care unit (ICU)-acquired weakness are serious problems. However, the effectiveness of vibration therapy in this population is unclear.

METHODS AND ANALYSIS

This study will enrol 188 adult critically ill patients who require further ICU stay after they can achieve sitting at the edge of the bed or wheelchair. The sample size calculation is based on a 15% improvement of Functional Status Score for the ICU. They will be randomised to vibration therapy coupled with protocolised mobilisation or to protocolised mobilisation alone; outcomes will be compared between the two groups. Therapy will be administered using a low-frequency vibration device (5.6-13 Hz) for 15 min/day from when the patient first achieves a sitting position and onward until discharge from the ICU. Outcome assessments will be blinded to the intervention. Primary outcome will be measured using the Functional Status Score for the ICU during discharge. Secondary outcomes will be identified as follows: delirium, Medical Research Council Score, ICU-acquired weakness, the change of biceps brachii and rectus femoris muscle mass measured by ultrasound, ICU mobility scale and ventilator-free and ICU-free days (number of free days during 28 days after admission). For safety assessment, vital signs will be monitored during the intervention.

ETHICS AND DISSEMINATION

This study has been approved by the Clinical Research Ethics Committee of Tokushima University Hospital. Results will be disseminated through publication in a peer-reviewed journal and presented at conferences.

TRIAL REGISTRATION NUMBER

UMIN000039616.

摘要

简介

振动疗法已被用作被动康复的一种辅助方法。最近,它已被证明对重症患者是可行且安全的,这些患者的肌肉无力和重症监护病房(ICU)获得性肌无力是严重的问题。然而,振动疗法在这一人群中的疗效尚不清楚。

方法与分析

这项研究将纳入 188 名需要在能够坐于床边或轮椅上后继续在 ICU 中接受治疗的成年重症患者。样本量的计算基于 ICU 功能状态评分提高 15%。他们将被随机分配到振动治疗联合方案性活动或仅方案性活动;将比较两组之间的结果。治疗将使用低频振动设备(5.6-13Hz)进行,每天 15 分钟,从患者首次达到坐姿开始,直至从 ICU 出院。结果评估将对干预措施进行盲法。主要结果将在出院时使用 ICU 功能状态评分进行测量。次要结果将如下确定:谵妄、医学研究理事会评分、ICU 获得性肌无力、超声测量肱二头肌和股四头肌肌肉质量的变化、ICU 活动量表和无呼吸机天数和无 ICU 天数(入住后 28 天内的自由天数)。为了进行安全性评估,将在干预期间监测生命体征。

伦理与传播

这项研究已获得德岛大学医院临床研究伦理委员会的批准。结果将通过在同行评议期刊上发表和在会议上展示来传播。

注册号

UMIN000039616。

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