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Move-PCD:一项为期 6 个月的个体化支持性体力活动(PA)方案对原发性纤毛运动障碍患儿、青少年和成人生活质量(QoL)影响的多中心纵向随机对照优效性研究。

Move-PCD-a multi-center longitudinal randomized controlled superiority trial on the effect of a 6-month individualized supported physical activity (PA) program on quality of life (QoL) in children, adolescents, and adults with primary ciliary dyskinesia.

机构信息

University Clinic for Pediatrics and Adolescent Medicine, Ruhr University Bochum, Alexandrinenstr. 5, 44791, Bochum, Germany.

Medical Informatics, Biometry and Epidemiology (AMIB), Ruhr University Bochum, 44780, Bochum, Germany.

出版信息

Trials. 2024 Aug 15;25(1):539. doi: 10.1186/s13063-024-08379-0.

Abstract

BACKGROUND

Primary ciliary dyskinesia (PCD) is a rare genetical disease with malfunction of the motile cilia leading to impaired muco-ciliary clearance in the respiratory tract. There is no cure for PCD, only supportive therapy aimed at minimizing the progression of the disease and improving the patient's quality of life (QoL). Physical activity (PA) is one of these recommended supportive therapies for people with PCD (pwPCD). However, there is no scientific evidence to support this recommendation. In addition, regular medical advice to increase PA remains largely ineffective in pwPCD.

METHODS

To test the main hypothesis, that an individualized and supported PA program leads to a better QoL 6 months after randomization (QoL-PCD questionnaire) compared to usual recommendation in pwPCD, 158 pwPCD aged 7 to 55 years are to be included in this multi-center randomized controlled trial (RCT). After the screening visit, a 1:1 randomization stratified by age group and FEV1 will be performed. A QoL-PCD questionnaire, motor test, and lung function will be carried out at regular intervals in both groups. PA is recorded in both groups using activity trackers during the study period. The main aim of the trial is to estimate the difference in the change of QoL between the groups after 6 months. Therefore, our full analysis set consists of all randomized patients and analysis is performed using the intention-to-treat principle. Statistical software R ( http://www.r-project.org ) is used. Ethical approvement without any reservations: RUB Bochum Ethics Committee (No. 23-7938; December 4, 2023). Recruitment start: March 2024.

DISCUSSION

Limitations result from the rarity of PCD with its broad disease spectrum and the large age range. These are reduced by stratified randomization and the measurement of the individual change in QoL as primary endpoint. In our view, only a PA program tailored to individual needs with close contact to trainers offers the chance to meet personal needs of pwPCD and to establish PA as a pillar of therapy in the long term. The study protocol explains all procedures and methods of recruitment, implementation of the study visits and intervention, measures for patient and data safety, and for minimizing risks and bias.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS) 00033030. Registered on December 7, 2023. Update 10 July 2024. STUDY PROTOCOL VERSION 10: Version 1.2; 12 June 2024.

摘要

背景

原发性纤毛运动障碍(PCD)是一种罕见的遗传性疾病,其特征为运动纤毛功能障碍,导致呼吸道黏液纤毛清除功能受损。目前尚无针对 PCD 的治愈方法,仅能采取支持性疗法以减缓疾病进展并改善患者的生活质量(QoL)。身体活动(PA)是推荐给 PCD 患者(pwPCD)的支持性疗法之一。然而,目前尚无科学证据支持这一建议。此外,定期向 pwPCD 患者提供增加 PA 的常规医疗建议在很大程度上效果不佳。

方法

为了检验主要假设,即个体化和支持性的 PA 方案在随机分组后 6 个月(PCD 生活质量问卷)能比 pwPCD 的常规建议更好地改善 QoL,将有 158 名年龄在 7 至 55 岁之间的 pwPCD 纳入这项多中心随机对照试验(RCT)。在筛选访视后,将按照年龄组和 FEV1 进行 1:1 随机分组。两组将定期进行 PCD 生活质量问卷、运动测试和肺功能检查。在研究期间,两组均使用活动追踪器记录 PA。该试验的主要目的是估计两组在 6 个月后的 QoL 变化差异。因此,我们的全分析集包含所有随机分组的患者,分析采用意向治疗原则。使用统计软件 R(http://www.r-project.org)进行分析。鲁尔波鸿大学伦理委员会无保留地批准(2023 年 12 月 4 日,第 23-7938 号)。招募开始时间:2024 年 3 月。

讨论

PCD 的罕见性及其广泛的疾病谱和年龄范围限制了研究结果。通过分层随机化和以个体 QoL 变化作为主要终点来测量,可以降低这些限制。在我们看来,只有量身定制、密切联系教练的 PA 方案才能满足 pwPCD 的个人需求,并将 PA 作为长期治疗的支柱。研究方案详细说明了招募、实施研究访视和干预、患者和数据安全措施以及最小化风险和偏倚的所有程序和方法。

试验注册

德国临床试验注册处(DRKS)00033030。注册于 2023 年 12 月 7 日。2024 年 7 月 10 日更新。试验方案版本 10:版本 1.2;2024 年 6 月 12 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6574/11328395/fedf8c75ef5f/13063_2024_8379_Fig1_HTML.jpg

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