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术前手术康复与教育计划(PREPS):一项试点随机对照试验方案。

Preoperative rehabilitation and education program for surgery (PREPS): A pilot randomized control trial protocol.

作者信息

Furtado Rochelle, MacDermid Joy C, Bryant Dianne, Faber Kenneth J

机构信息

Department of Rehabilitation Sciences, Faculty of Health Science, Western University, London, ON, Canada.

School of Physical Therapy, Faculty of Health Science, Western University, London, ON, Canada.

出版信息

Hand Ther. 2025 Jun 20:17589983251345393. doi: 10.1177/17589983251345393.

Abstract

BACKGROUND

We designed a program for prehabilitation and education before a shoulder replacement (PREPS) that is based on reviews of relevant literature, and is co-designed with preferences of patients recruited from the wait list for a shoulder replacement, and a transdisciplinary healthcare sample. The content and format was integrated in a comprehensive, patient-centered program combining exercise, preparedness for surgery, motivational interviewing, and pain management principles. This patient-centered program has the potential to improve postoperative pain, function, and patient-oriented outcomes, decrease postoperative opioid use and short- and long-term healthcare costs. This pilot randomized controlled trial will evaluate feasibility and satisfaction with our program for individuals undergoing a shoulder replacement.

METHODS

Participants ( = 90) undergoing a shoulder replacement will be randomized into (1) a 6-week self-directed online pre-rehab and education program, (2) a 6-week online pre-rehab and education program with a therapist to monitor progression of PREPS or (3) a standard of care group. The PREPS program intervention groups will be delivered virtually with an online program of modules and a written handbook. Feasibility outcomes include recruitment rate, adherence, content acceptability, study acceptability, outcome measure completion rates and treatment fidelity. Outcomes will be assessed at baseline and 1 day before surgery, then post-operatively at 6 weeks and 3,6 and 12 months.

DISCUSSION

The proposed project will include the feasibility testing of a prehabilitation and education program with potential to improve surgical outcomes for shoulder replacement patients. Results of this study will provide the foundation for a future fully powered multicenter trial.

TRIAL REGISTRATION

NCT05965986.

摘要

背景

我们设计了一项肩关节置换术前康复与教育计划(PREPS),该计划基于对相关文献的综述,并与从肩关节置换等待名单中招募的患者以及跨学科医疗样本的偏好共同设计。其内容和形式被整合到一个全面的、以患者为中心的计划中,该计划结合了运动、手术准备、动机性访谈和疼痛管理原则。这个以患者为中心的计划有可能改善术后疼痛、功能和以患者为导向的结果,减少术后阿片类药物的使用以及短期和长期医疗成本。这项试点随机对照试验将评估我们的计划对接受肩关节置换术的个体的可行性和满意度。

方法

接受肩关节置换术的参与者(n = 90)将被随机分为(1)一个为期6周的自主在线术前康复与教育计划,(2)一个为期6周的有治疗师监测PREPS进展的在线术前康复与教育计划,或(3)一个标准护理组。PREPS计划干预组将通过在线模块计划和书面手册以虚拟方式提供。可行性结果包括招募率、依从性、内容可接受性、研究可接受性、结果测量完成率和治疗保真度。结果将在基线、手术前1天进行评估,然后在术后6周、3个月、6个月和12个月进行评估。

讨论

拟议的项目将包括对一项术前康复与教育计划的可行性测试,该计划有可能改善肩关节置换患者的手术结果。本研究结果将为未来的全规模多中心试验奠定基础。

试验注册

NCT05965986。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c96a/12181192/0e57e68d79de/10.1177_17589983251345393-fig1.jpg

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