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轻度或重度神经认知障碍远程康复的家庭核心方案:一项随机对照试验的研究方案

HomeCoRe for Telerehabilitation in Mild or Major Neurocognitive Disorders: A Study Protocol for a Randomized Controlled Trial.

作者信息

Bernini Sara, Panzarasa Silvia, Sinforiani Elena, Quaglini Silvana, Cappa Stefano F, Cerami Chiara, Tassorelli Cristina, Vecchi Tomaso, Bottiroli Sara

机构信息

Dementia Research Center, Scientific Institute for Research, Hospitalization, and Healthcare (IRCCS) Mondino Foundation, Pavia, Italy.

Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.

出版信息

Front Neurol. 2021 Dec 23;12:752830. doi: 10.3389/fneur.2021.752830. eCollection 2021.

Abstract

Given the limited effectiveness of pharmacological treatments for cognitive decline, non-pharmacological interventions have gained increasing attention. Evidence exists on the effectiveness of cognitive rehabilitation in preventing elderly subjects at risk of cognitive decline and in reducing the progression of functional disability in cognitively impaired individuals. In recent years, telerehabilitation has enabled a broader application of cognitive rehabilitation programs. The purpose of this study is to test a computer-based intervention administered according to two different modalities (at the hospital and at home) using the tools CoRe and HomeCoRe, respectively, in participants with Mild or Major Neurocognitive Disorders. Non-inferiority, single-blind randomized controlled trial where 40 participants with Mild or Major Neurocognitive Disorders will be assigned to the intervention group who will receive cognitive telerehabilitation through HomeCoRe or to the control group who will receive in-person cognitive intervention through CoRe, with the therapist administering the same computer-based exercises. The rehabilitative program will last 6 weeks, with 3 sessions/week, each lasting ~45 min. All the participants will be evaluated on an exhaustive neuropsychological battery before (T0) and after (T1) the intervention; follow-up visits will be scheduled after 6 (T2) and 12 months (T3). The results of this study will inform about the comparability (non-inferiority trial) of HomeCoRe with CoRe. Their equivalence would support the use of HomeCoRe for at distance treatment, favoring the continuity of care. This study has been approved by the Local Ethics Committee and registered in https://clinicaltrials.gov (NCT04889560). The dissemination plan includes the scientific community through publication in open-access peer-reviewed scientific journals and presentations at national and international conferences. Clinicaltrials.gov https://clinicaltrials.gov/ct2/show/NCT04889560 (registration date: May 17, 2021).

摘要

鉴于药物治疗对认知功能衰退的效果有限,非药物干预越来越受到关注。有证据表明认知康复在预防有认知功能衰退风险的老年受试者以及减少认知障碍个体的功能残疾进展方面是有效的。近年来,远程康复使得认知康复项目得到更广泛的应用。本研究的目的是在轻度或重度神经认知障碍参与者中,分别使用CoRe和HomeCoRe工具,测试根据两种不同模式(在医院和在家中)实施的基于计算机的干预。非劣效性单盲随机对照试验,40名轻度或重度神经认知障碍参与者将被分配到干预组,通过HomeCoRe接受认知远程康复,或分配到对照组,通过CoRe接受面对面认知干预,治疗师实施相同的基于计算机的练习。康复项目将持续6周,每周3次,每次约45分钟。所有参与者将在干预前(T0)和干预后(T1)接受全面的神经心理测试;随访将安排在6个月(T2)和12个月(T3)后进行。本研究结果将说明HomeCoRe与CoRe的可比性(非劣效性试验)。它们的等效性将支持使用HomeCoRe进行远程治疗,有利于护理的连续性。本研究已获得当地伦理委员会批准,并在https://clinicaltrials.gov(NCT04889560)注册。传播计划包括通过在开放获取的同行评审科学期刊上发表以及在国内和国际会议上进行展示,向科学界传播。Clinicaltrials.gov https://clinicaltrials.gov/ct2/show/NCT04889560(注册日期:202年5月17日)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/731d/8733654/d13d9ae95e4e/fneur-12-752830-g0001.jpg

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