Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.
VA Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, Colorado, USA.
Phys Ther. 2024 Jan 1;104(1). doi: 10.1093/ptj/pzad112.
This randomized controlled superiority trial will determine if an 18-month telehealth walking exercise self-management program produces clinically meaningful changes in walking exercise sustainability compared to attention-control education for veterans living with lower-limb amputation.
Seventy-eight participants with lower-limb amputation (traumatic or nontraumatic) aged 50 to 89 years will be enrolled. Two groups will complete 6 one-on-one intervention sessions, and 6 group sessions over an 18-month intervention period. The experimental arm will receive a self-management program focusing on increasing walking exercise and the control group will receive attention-control education specific to healthy aging. Daily walking step count (primary outcome) will be continuously monitored using an accelerometer over the 18-month study period. Secondary outcomes are designed to assess potential translation of the walking exercise intervention into conventional amputation care across the Veteran Affairs Amputation System of Care. These secondary outcomes include measures of intervention reach, efficacy, likelihood of clinical adoption, potential for clinical implementation, and ability of participants to maintain long-term exercise behavior.
The unique rehabilitation paradigm used in this study addresses the problem of chronic sedentary lifestyles following lower-limb amputation through a telehealth home-based walking exercise self-management model. The approach includes 18 months of exercise support from clinicians and peers. Trial results will provide rehabilitation knowledge necessary for implementing clinical translation of self-management interventions to sustain walking exercise for veterans living with lower-limb amputation, resulting in a healthier lifestyle.
本随机对照优势试验将确定，对于下肢截肢的退伍军人，与关注控制教育相比，18 个月的远程健康步行锻炼自我管理计划是否能在步行锻炼可持续性方面产生临床有意义的变化。
将招募 78 名年龄在 50 至 89 岁之间、有下肢截肢（创伤性或非创伤性）的参与者。两组将在 18 个月的干预期间完成 6 次一对一干预课程和 6 次小组课程。实验组将接受以增加步行锻炼为重点的自我管理计划，对照组将接受针对健康老龄化的关注控制教育。在 18 个月的研究期间，将使用加速度计连续监测日常步行步数（主要结果）。次要结果旨在评估步行锻炼干预在退伍军人事务部截肢系统护理中转化为常规截肢护理的潜在可能性。这些次要结果包括干预范围、疗效、临床采用的可能性、临床实施的潜力以及参与者长期维持锻炼行为的能力的测量。
本研究中使用的独特康复范式通过远程健康家庭步行锻炼自我管理模式解决了下肢截肢后慢性久坐生活方式的问题。该方法包括 18 个月的临床医生和同行的锻炼支持。试验结果将提供实施自我管理干预以维持下肢截肢退伍军人步行锻炼的临床转化所需的康复知识，从而形成更健康的生活方式。
