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照顾者/受照顾者共同治疗在慢性脊髓损伤治疗性生活方式干预中的影响:一项比较病例系列研究

The Impact of Caregiver/Care-Receiver Co-Treatment in a Therapeutic Lifestyle Intervention for Chronic Spinal Cord Injury: A Comparative Case Series.

作者信息

Bigford G E, Lehmann D A, Mendez A J, Nash M S

机构信息

The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA.

出版信息

Ann Case Rep. 2024;9(2). doi: 10.29011/2574-7754.101755.

Abstract

INTRODUCTION

This study is a prospective comparative case series analysing the differential impacts of a therapeutic lifestyle intervention (TLI) on individuals with spinal cord injury (SCI) and their caregivers. The primary objective was to assess changes across several health metrics predictive of cardio metabolic disease (CMD), fitness, and quality of life, in dyadic partners and between 2 separate cases.

CASE PRESENTATION

SCI participants and their respective caregivers, forming 10 dyads, were included in the study. Dyads were randomly assigned to two distinct case scenarios: Case 1, where both dyadic partners received TLI; and Case 2, where only the SCI partner received the intervention. Each case series comprised five dyads. TLI constituted a rigorous 6-month program consisting of exercise, adherence to a Mediterranean diet, and behavioural support. Across cases, notable improvements were observed in body mass, and strength among SCI partners; and reductions in body mass and fasting glucose, and improved mental well-being was observed in caregiver partners. Dyadic interaction analysis found that insulin, HOMA, HDL, and mental health improvements in SCI were strongly linked to improvements in caregiver when both dyadic partners received TLI.

CONCLUSION

We conclude that TLI co-treatment for dyadic partners, including exercise, nutrition, and behaviour modification, improves health outcomes related to CMD risks and quality of life in both populations.

TRIAL REGISTRATION

ClinicalTrials.gov, ID: NCT02853149 Registered August 2, 2016.

摘要

引言

本研究是一项前瞻性比较病例系列研究,分析治疗性生活方式干预(TLI)对脊髓损伤(SCI)患者及其照顾者的不同影响。主要目的是评估在二元组伙伴以及两个独立病例之间,多个预测心血管代谢疾病(CMD)、健康状况和生活质量的健康指标的变化。

病例报告

该研究纳入了10个二元组的SCI参与者及其各自的照顾者。二元组被随机分配到两种不同的病例情景中:情景1,二元组双方伙伴均接受TLI;情景2,仅SCI伙伴接受干预。每个病例系列包含5个二元组。TLI是一个为期6个月的严格项目,包括运动、坚持地中海饮食和行为支持。在所有情景中,SCI伙伴的体重和力量有显著改善;照顾者伙伴的体重和空腹血糖降低,心理健康状况改善。二元组交互分析发现,当二元组双方伙伴均接受TLI时,SCI患者胰岛素、HOMA、高密度脂蛋白(HDL)和心理健康的改善与照顾者的改善密切相关。

结论

我们得出结论,对二元组伙伴进行TLI联合治疗,包括运动、营养和行为改变,可改善与CMD风险和生活质量相关的健康结局。

试验注册

ClinicalTrials.gov,标识符:NCT02853149,于2016年8月2日注册。

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