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基于远程咨询的康复在儿童急性迟缓性麻痹中的疗效:一项开放标签随机对照试验(Tele Rehab-LGBS 试验)。

Efficacy of Teleconsultation-Based Rehabilitation in Children with Landry-Guillain-Barré Syndrome: An Open Label Randomized Controlled Trial (Tele Rehab-LGBS Trial).

机构信息

Department of Pediatrics, PGIMER, Chandigarh, India.

Department of Pharmacology, PGIMER, Chandigarh, India.

出版信息

Indian J Pediatr. 2024 May;91(5):455-462. doi: 10.1007/s12098-023-04882-5. Epub 2023 Oct 27.

Abstract

OBJECTIVES

To evaluate the feasibility and efficacy of teleconsultation-based rehabilitation in children with Landry-Guillain-Barré syndrome (LGBS), measured with Medical Research Council (MRC) sum score and Hughes score.

METHODS

A pragmatic, prospective, parallel open label randomized controlled trial was conducted among a total of 50 children with LGBS. The children were randomized using computer generated block randomization into 2 groups (25 in each group): Standard of care (Group A) and teleconsultation-based rehabilitation (Group B). Primary and secondary outcomes were measured with MRC sum score and Hughes score at 12- and 24-wk follow-up.

RESULTS

The mean age was 6.4 ± 3.3 y; 29 (58%) were boys. Baseline MRC sum score (median, IQR), and Hughes score (median, IQR) in group A was 24 (7-31) and 5 (4-5) respectively; and in group B was 18 (9-24) and 4 (4-5) respectively. At discharge, median (IQR) MRC sum score in group A and B was 34 (28-41), and 30 (25-43) (p value = 0.31) respectively. Tele-rehabilitation was provided to group B for 24 wk with 96% compliance. At 12 wk, median MRC sum score in group A and group B were similar [48 (IQR 44-54) vs. 52 (IQR 46-60), p value = 0.08]. At 12 wk and 24 wk, median Hughes score in group A and B were similar. At 24 wk, 15 out of 23 subjects of group A and 18 out of 25 subjects of group B were ambulatory (p value = 0.61).

CONCLUSIONS

Teleconsultation-based rehabilitation was feasible with a high compliance rate. The functional outcomes measured with MRC sum score and Hughes score were similar in both the groups at 12 and 24 wk follow-up. Teleconsultation-based rehabilitation has similar efficacy as physical rehabilitation.

摘要

目的

通过测量医学研究理事会(MRC)总评分和 Hughes 评分,评估基于远程咨询的康复对兰德里-吉耶尔曼-巴雷综合征(LGBS)患儿的可行性和疗效。

方法

这是一项实用的、前瞻性的、平行的、开放标签的随机对照试验,共纳入 50 例 LGBS 患儿。使用计算机生成的区组随机化方法将患儿随机分为两组(每组 25 例):常规护理组(A 组)和基于远程咨询的康复组(B 组)。主要和次要结局指标在 12 周和 24 周随访时采用 MRC 总评分和 Hughes 评分进行评估。

结果

患儿的平均年龄为 6.4±3.3 岁;29 例(58%)为男性。A 组患儿基线 MRC 总评分(中位数,IQR)和 Hughes 评分(中位数,IQR)分别为 24(7-31)和 5(4-5),B 组分别为 18(9-24)和 4(4-5)。出院时,A 组和 B 组的 MRC 总评分中位数(IQR)分别为 34(28-41)和 30(25-43)(p 值=0.31)。B 组接受了 24 周的远程康复治疗,依从性为 96%。12 周时,A 组和 B 组的 MRC 总评分中位数分别为 48(IQR 44-54)和 52(IQR 46-60)(p 值=0.08)。12 周和 24 周时,A 组和 B 组的 Hughes 评分中位数相似。24 周时,A 组 23 例中有 15 例和 B 组 25 例中有 18 例可独立行走(p 值=0.61)。

结论

基于远程咨询的康复是可行的,且依从性很高。在 12 周和 24 周的随访中,两组患儿的 MRC 总评分和 Hughes 评分的功能结局相似。基于远程咨询的康复与物理康复具有相似的疗效。

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