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髌骨脱位后物理治疗康复(PRePPeD)试点随机对照试验中急性髌骨脱位患者康复干预措施的制定。

Development of the rehabilitation interventions for people with an acute patellar dislocation in the Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD) pilot randomized controlled trial.

作者信息

Forde Colin P, Costa Matthew L, Tutton Elizabeth, Cook Jonathan A, Keene David J

机构信息

Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

出版信息

Bone Jt Open. 2025 Apr 22;6(4):469-479. doi: 10.1302/2633-1462.64.BJO-2024-0174.

Abstract

AIMS

To develop the rehabilitation interventions for people with an acute patellar dislocation in the Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD) pilot randomized controlled trial (RCT), and to describe how these interventions are delivered.

METHODS

We developed the interventions drawing on a range of established intervention development approaches and frameworks. We selected intervention components after reviewing the existing evidence, clinical guidelines, UK NHS practice, and relevant scientific theory. We then created early versions of the interventions, and discussed these with clinical experts and patient and public partners. We finalized the interventions considering their feedback, findings from our preliminary study, and what would be acceptable and deliverable in the UK NHS.

RESULTS

Upon randomization, all participants receive a workbook containing advice and initial exercises to implement before their first physiotherapy session. Self-managed rehabilitation then involves a single one-to-one session with a physiotherapist who provides advice, introduces a structured home exercise programme, and uses strategies to support exercise adherence. Participants then continue their recovery independently. Supervised rehabilitation involves four to six one-to-one physiotherapy sessions over a maximum of six months. Physiotherapists also provide advice, prescribe home exercise, and use exercise adherence strategies. Routine follow-up sessions enable physiotherapists to reassess participants and tailor the advice and exercises accordingly.

CONCLUSION

The interventions were developed and are currently being assessed in the PRePPeD pilot RCT. This will determine whether a full-scale RCT comparing these interventions is feasible. Results are anticipated in Summer 2025.

摘要

目的

在髌骨脱位后物理治疗康复(PRePPeD)试点随机对照试验(RCT)中,为急性髌骨脱位患者制定康复干预措施,并描述这些干预措施的实施方式。

方法

我们借鉴一系列既定的干预措施开发方法和框架来制定干预措施。在回顾现有证据、临床指南、英国国民健康服务体系(NHS)实践及相关科学理论后,我们选择了干预措施的组成部分。然后我们创建了干预措施的早期版本,并与临床专家以及患者和公众合作伙伴进行了讨论。我们根据他们的反馈、初步研究结果以及英国NHS中可接受和可实施的内容,最终确定了干预措施。

结果

随机分组后,所有参与者都会收到一本工作手册,其中包含在首次物理治疗课程之前实施的建议和初始练习。自我管理的康复包括与物理治疗师进行一次一对一的课程,物理治疗师会提供建议、介绍结构化的家庭锻炼计划,并使用策略来支持锻炼的依从性。然后参与者独立继续康复。监督康复包括在最多六个月内进行四到六次一对一的物理治疗课程。物理治疗师还会提供建议、开家庭锻炼处方,并使用锻炼依从性策略。常规随访课程使物理治疗师能够重新评估参与者,并相应地调整建议和锻炼计划。

结论

这些干预措施已制定完成,目前正在PRePPeD试点RCT中进行评估。这将确定比较这些干预措施的大规模RCT是否可行。预计2025年夏季得出结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e805/12011453/5c2297981a96/BJO-2024-0174-galleyfig1.jpg

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