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血友病男孩物理治疗研究方案中选定结局指标的可行性、安全性和可接受性。

Feasibility, safety and acceptability of select outcome measures in a physiotherapy study protocol for boys with haemophilia.

作者信息

Thorpe Nicola, Harniess Phillip, Main Eleanor, Hubert Nicola, Rand Sarah, Stephensen David, Liesner Ri, Bladen Melanie

机构信息

Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.

UCL Great Ormond Street Institute of Child Health, London, UK.

出版信息

Pilot Feasibility Stud. 2021 May 6;7(1):105. doi: 10.1186/s40814-021-00831-1.

Abstract

BACKGROUND

There is a lack of functional performance measures for children and young people with haemophilia (CYPwH) with associated control data from typically developing boys (TDB). The literature advocates development of a core set of outcome measures for different chronic conditions. As medical treatment improves, CYPwH are experiencing better outcomes; therefore, more challenging measures are required to monitor physical performance. Such testing is not performed routinely, due to practical and safety concerns.

AIM

Evaluate the feasibility, safety and acceptability of select outcome measures as part of a study protocol testing CYPwH; including myometry, 10 metre incremental shuttle walk test (10-m ISWT), iSTEP (an incremental step test, with data from TDB), and 1 week of accelerometry-wear at home.

METHODS

Sixty-six boys aged 6-15 years with mild, moderate or severe haemophilia A or B (including inhibitors) attending routine clinics at Great Ormond Street Hospital were approached to participate. Descriptive statistics and content analysis were used to assess outcomes of feasibility, safety and acceptability, which included recruitment/retention rates, protocol completion within routine appointment timeframes, performance testing without serious adverse events/reactions (SAE/SARs), and acceptability to CYPwH of high-level performance measures.

RESULTS

Outcomes were met: 43 boys completed testing at clinic review (Jan-Nov 2018) within a 10-month timeframe, retention was 95% at completion of protocol and no SAE/SARs were reported throughout testing.

CONCLUSION

Feasibility, safety and acceptability of the study protocol have been established in this population. Both high-level performance tests, iSTEP and 10-m ISWT, were an acceptable addition to boys' routine clinic appointments and could be safe, acceptable choices of outcome measure as part of a core set of tests for CYPwH. Further investigation of the psychometric properties for the iSTEP is now justified, in order for it to be used as a standardised, validated, reliable outcome measure in clinical or research settings.

TRIAL REGISTRATION

Retrospectively registered on September 3, 2019, on ClinicalTrials.gov (ID: NCT04076306 ).

摘要

背景

血友病儿童和青少年(CYPwH)缺乏功能表现测量指标,且缺乏来自正常发育男孩(TDB)的相关对照数据。文献提倡为不同慢性病制定一套核心结局指标。随着医疗治疗的改善,CYPwH的预后越来越好;因此,需要更具挑战性的指标来监测身体表现。由于实际和安全方面的考虑,此类测试并非常规进行。

目的

评估选定结局指标作为测试CYPwH的研究方案一部分的可行性、安全性和可接受性;包括肌测量法、10米递增往返跑测试(10-m ISWT)、iSTEP(一种递增台阶测试,有来自TDB的数据)以及在家进行1周的加速度计佩戴测试。

方法

邀请了66名年龄在6至15岁、患有轻度、中度或重度甲型或乙型血友病(包括有抑制剂的情况)的男孩参与,他们在大奥蒙德街医院的常规诊所就诊。使用描述性统计和内容分析来评估可行性、安全性和可接受性的结果,包括招募/保留率、在常规预约时间范围内完成方案、进行性能测试时无严重不良事件/反应(SAE/SARs)以及CYPwH对高水平性能指标的可接受性。

结果

达到了各项结果:43名男孩在10个月的时间范围内(2018年1月至11月)在诊所复诊时完成了测试,方案完成时保留率为95%,且在整个测试过程中未报告SAE/SARs。

结论

已在该人群中确立了研究方案的可行性、安全性和可接受性。高水平性能测试iSTEP和10-m ISWT均可作为男孩常规诊所预约的可接受补充内容,并且作为CYPwH核心测试集的一部分,可能是安全、可接受的结局指标选择。现在有必要进一步研究iSTEP的心理测量特性,以便将其用作临床或研究环境中标准化、经过验证且可靠的结局指标。

试验注册

于2019年9月3日在ClinicalTrials.gov上进行回顾性注册(ID:NCT04076306)。

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