Dunphy Emma, Button Kate, Hamilton Fiona, Williams Jodie, Spasic Irena, Murray Elizabeth
Research Department of Primary Care and Population Health, University College London, London, UK.
Physiotherapy Department, Homerton University Hospital NHS Foundation Trust, London, UK.
BMJ Open Sport Exerc Med. 2021 May 5;7(2):e001002. doi: 10.1136/bmjsem-2020-001002. eCollection 2021.
To evaluate the feasibility of trialling taxonomy for the rehabilitation of knee conditions-ACL (TRAK-ACL), a digital health intervention that provides health information, personalised exercise plans and remote clinical support combined with treatment as usual (TAU), for people following ACL reconstruction.
The study design was a two-arm parallel randomised controlled trial (RCT). Eligible participants were English-speaking adults who had undergone ACL reconstruction within the last 12 weeks, had access to the internet and could provide informed consent. Recruitment took place at three sites in the UK. TRAK-ACL intervention was an interactive website informed by behaviour change technique combined with TAU. The comparator was TAU. Outcomes were: recruitment and retention; completeness of outcome measures at follow-up; fidelity of intervention delivery and engagement with the intervention. Individuals were randomised using a computer-generated random number sequence. Blinded assessors allocated groups and collected outcome measures.
Fifty-nine people were assessed for eligibility at two of the participating sites, and 51 were randomised; 26 were allocated to TRAK-ACL and 25 to TAU. Follow-up data were collected on 44 and 40 participants at 3 and 6 months, respectively. All outcome measures were completed fully at 6 months except the Client Service Receipt Inventory. Two patients in each arm did not receive the treatment they were randomised to. Engagement with TRAK-ACL intervention was a median of 5 logins (IQR 3-13 logins), over 18 weeks (SD 12.2 weeks).
TRAK-ACL would be suitable for evaluation of effectiveness in a fully powered RCT.
评估膝关节疾病康复分类法(TRAK-ACL)的可行性,这是一种数字健康干预措施,为前交叉韧带(ACL)重建后的患者提供健康信息、个性化运动计划和远程临床支持,并结合常规治疗(TAU)。
研究设计为双臂平行随机对照试验(RCT)。符合条件的参与者为在过去12周内接受过ACL重建、会说英语、能上网且能提供知情同意书的成年人。招募在英国的三个地点进行。TRAK-ACL干预是一个结合行为改变技术和TAU的交互式网站。对照为TAU。结局指标包括:招募与保留;随访时结局测量的完整性;干预实施的保真度以及对干预的参与度。使用计算机生成的随机数字序列对个体进行随机分组。采用盲法评估人员分配组别并收集结局测量数据。
在两个参与地点对59人进行了资格评估,51人被随机分组;26人被分配到TRAK-ACL组,25人被分配到TAU组。分别在3个月和6个月时收集了44名和40名参与者的随访数据。除客户服务收据清单外,所有结局测量在6个月时均已完全完成。每组有两名患者未接受其随机分配的治疗。参与TRAK-ACL干预的中位数为5次登录(四分位间距为3 - 13次登录),持续18周(标准差为12.2周)。
TRAK-ACL适合在充分有力的RCT中评估有效性。