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确定一种新型手部治疗设备(FEPSim设备)的有效性:一项随机对照试验研究的可行性方案

Determining the Effectiveness of a New Device for Hand Therapy (The FEPSim Device): Feasibility Protocol for a Randomized Controlled Trial Study.

作者信息

Miguel-Cruz Antonio, Guptill Christine, Gregson Geoffrey, Ladurner Anna-Maria, Holmes Cindy, Yeung Daniel, Siebert Justine, Dziwenko Gwen, Ríos Rincón Adriana

机构信息

Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.

Glenrose Rehabilitation Research Innovation and Technology, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.

出版信息

JMIR Res Protoc. 2021 May 27;10(5):e22145. doi: 10.2196/22145.

Abstract

BACKGROUND

Impairments of the forearm, wrist, and hand affect a sizable proportion of individuals and impose a significant economic burden on health care systems. FEPSim is a medical device for hand and wrist rehabilitation. The FEPSim device could be part of the standard of care for upper extremity rehabilitation during therapeutic activities to increase range of motion, dexterity, and strength. FEPSim has not yet been tested in a health care setting; therefore, a trial of the effectiveness of FEPSim in upper extremity rehabilitation is warranted.

OBJECTIVE

This study aims to assess the feasibility of conducting a definitive trial in terms of recruitment, eligibility criteria, the type and number of diagnoses included, the length and dosage of the intervention, and data collection methods. This study also aims to gather clinical and statistical information as well as information related to the cost and usability, which allows for an economic evaluation of the device.

METHODS

The trial will use a randomized controlled design comprising 47 intervention participants and 47 control group participants. Participants will be adults (age≥18 years) attending outpatient rehabilitation with limitations in their forearm, wrist, or hand function due to distal radial or ulnar fractures, stroke, or osteoarthritis. This study's primary outcome variables are related to patients' range of motion and strength, specifically active and passive wrist flexion and extension range of motion; active and passive forearm pronation and supination range of motion; grip strength; and pinch strength. The secondary outcome variables are related to patients' perceived wrist pain and disability in activities of daily living. The patients' perceived wrist pain and disability in activities of daily living will be measured using the patient-rated wrist evaluation questionnaire. The control group will receive the standard of care at each of the 2 hospital facilities (Glenrose Rehabilitation and Royal Alexandra Hospitals). The intervention group will receive the same standard of care as the control group at each facility and will use the FEPSim device for therapeutic activities to increase strength, range of motion, resistance, and dexterity. All the participants will be assessed at baseline (week 0); weeks 2, 4, and 8; and postintervention (week 10).

RESULTS

The FEPSim study was launched in April 2020. This study is currently on hold because of the global COVID-19 pandemic. The recruitment process is expected to resume by September 2020, and the primary impact analysis is expected to be conducted by December 2020.

CONCLUSIONS

This study will provide valuable information on the measurement of comparative intervention effects, technology acceptance by hand therapists, and how associated treatment and product costs will contribute to the evidence planning process, which will be crucial for the future adoption of FEPSim.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number Registry ISRCTN13656014; https://www.isrctn.com/ISRCTN13656014.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/22145.

摘要

背景

前臂、手腕和手部功能障碍影响着相当一部分人,并给医疗保健系统带来巨大经济负担。FEPSim是一种用于手部和手腕康复的医疗设备。在治疗活动中,FEPSim设备可以成为上肢康复护理标准的一部分,以增加活动范围、灵活性和力量。FEPSim尚未在医疗环境中进行测试;因此,有必要对FEPSim在上肢康复中的有效性进行试验。

目的

本研究旨在评估在招募、纳入标准、所包括诊断的类型和数量、干预的时长和剂量以及数据收集方法等方面进行确定性试验的可行性。本研究还旨在收集临床和统计信息以及与成本和可用性相关的信息,以便对该设备进行经济评估。

方法

该试验将采用随机对照设计,包括47名干预参与者和47名对照组参与者。参与者将为成年人(年龄≥18岁),因桡骨或尺骨远端骨折、中风或骨关节炎导致前臂、手腕或手部功能受限而接受门诊康复治疗。本研究的主要结局变量与患者的活动范围和力量有关,具体为主动和被动腕关节屈伸活动范围;主动和被动前臂旋前和旋后活动范围;握力;以及捏力。次要结局变量与患者感知的手腕疼痛和日常生活活动能力障碍有关。将使用患者自评手腕评估问卷来测量患者感知的手腕疼痛和日常生活活动能力障碍。对照组将在两家医院设施(格伦罗斯康复医院和皇家亚历山德拉医院)接受标准护理。干预组在每家设施将接受与对照组相同的标准护理,并将使用FEPSim设备进行治疗活动,以增加力量、活动范围、阻力和灵活性。所有参与者将在基线(第0周)、第2、4和8周以及干预后(第10周)进行评估。

结果

FEPSim研究于2020年4月启动。由于全球新冠疫情,本研究目前暂停。预计招募过程将于2020年9月恢复,主要影响分析预计将于2020年12月进行。

结论

本研究将提供关于比较干预效果测量、手部治疗师对技术的接受程度以及相关治疗和产品成本如何有助于证据规划过程的宝贵信息,这对于FEPSim未来的应用至关重要。

试验注册

国际标准随机对照试验编号注册库ISRCTN13656014;https://www.isrctn.com/ISRCTN13656014。

国际注册报告识别码(IRRID):PRR1-10.2196/22145。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c19/8193477/f6222882845f/resprot_v10i5e22145_fig1.jpg

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