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Physical Activity Intervention for Patients Following Lumbar Spine Surgery (PASS)

30. března 2022 aktualizováno: Hiral Master, Vanderbilt University Medical Center

Developing a Novel Physical Activity Intervention for Patients Following Lumbar Spine Surgery (PASS Trial)

There is a critical need to target physical activity during postoperative management to optimize long-term recovery after lumbar spine surgery. The overall objective of this study is to conduct a two-group randomized control trial (RCT) to examine the feasibility and acceptability of a physical activity telehealth intervention delivered by a physical therapist for improving disability, physical function, pain, and physical activity compared to usual care after spine surgery for a degenerative lumbar condition. The physical activity intervention will include wearable technology and remote physical therapist support to counsel patients on a realistic progression of physical activity (steps per day). The central hypothesis is that this 8-week physical activity intervention performed at two weeks after surgery will be feasible and acceptable. The results of our randomized trial will be used to support a large multi-site clinical trial to test the effectiveness and implementation of this intervention

Přehled studie

Typ studie

Intervenční

Zápis (Aktuální)

16

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • Tennessee
      • Nashville, Tennessee, Spojené státy, 37212
        • Vanderbilt University Medical Center

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria:

  1. Adults age 18 years or older, of both sexes and all races
  2. Scheduled for surgical treatment of a lumbar degenerative condition (spinal stenosis, spondylosis with or without myelopathy, and degenerative spondylolisthesis) using laminectomy with or without arthrodesis (i.e., fusion) procedures.
  3. Participants will be English speaking due to the feasibility of employing study personnel to deliver and assess the study intervention.

Exclusion Criteria:

  1. Patients having microsurgical techniques as the primary procedure, such as an isolated laminotomy or microdiscectomy will be excluded because individuals having these minimally invasive surgical techniques tend to have a less severe case of lumbar degeneration.
  2. Patients having surgery for spinal deformity as the primary indication or surgery secondary to pseudarthrosis, trauma, infection, or tumor
  3. Prior history of lumbar spine surgery
  4. Presence of back and/or lower extremity pain < 3 month
  5. History of neurological disorder, resulting in moderate to severe movement dysfunction
  6. Unable to provide stable address and access to a telephone indicating the inability to participate in the intervention.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Dvojnásobek

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Jiný: Usual postoperative care
Participants randomized to usual care group will receive postoperative care as determined by their treating surgeon.
Participants will receive postoperative care as determined by their treating surgeon. This includes lifting restrictions, advice to stay active, and oral analgesics as needed. Physical therapy referral will be at the discretion of the surgeon. However, physical therapy is not typically started until 12 weeks after surgery.
Experimentální: Usual postoperative care + Physical activity intervention
Participants randomized to the physical activity intervention group will receive usual postoperative care as determined by their treating surgeon and novel physical activity intervention.
Participants will receive postoperative care as determined by their treating surgeon. This includes lifting restrictions, advice to stay active, and oral analgesics as needed. Physical therapy referral will be at the discretion of the surgeon. However, physical therapy is not typically started until 12 weeks after surgery.
Participants will 1) receive Fitbit, 2) be enrolled in a secure electronic platform to access Fitbit data, 3) receive 8-week remote counseling by a physical therapist that will include motivational interviewing and creating SMART goals (1 session per week) through a web-based teleconference platform, and 4) receive usual postoperative care directed by their surgeon. The first session will be 45 minutes and sessions 2-8 will be 30 minutes each. During the sessions, participant's confidence in meeting daily step goals will be assessed using a 0-10 scale. If self-reported confidence to meet their goal is <8, the physical therapist will help participants modify their goal using techniques such as problem-solving, positive statements and affirmations. Progression will be made only if daily steps goals are met for at least 4 out of 7 days a week. If this weekly step goal is not met, a physical therapist will help the participant identify solutions for realistic progression.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Recruitment rate
Časové okno: At 2 weeks after spine surgery
Proportion of potential eligible participants successfully contacted who agreed to participate and randomized.
At 2 weeks after spine surgery
Adherence rate to study protocol at 3 months after spine surgery
Časové okno: From 2 weeks to 3-months after spine surgery
Proportion of participants who will complete the assessment at 2 weeks and 3 months after spine surgery.
From 2 weeks to 3-months after spine surgery
Adherence rate to study protocol at 6 months after spine surgery
Časové okno: From 2 weeks to 6-months after spine surgery
Proportion of participants who will complete the assessment at 2 weeks and 6 months after spine surgery.
From 2 weeks to 6-months after spine surgery
Adherence to physical activity intervention
Časové okno: From 2-weeks to 3-months after spine surgery

Number of weekly step goals completed by participant, which will be examined via Fitabase.

In addition, number of weekly Zoom calls completed with the physical therapist will be recorded

From 2-weeks to 3-months after spine surgery
Number of adverse events
Časové okno: From 2-weeks to 3-months after spine surgery
During the intervention phase, the study physical therapist will document adverse events related to walking to assess safety.
From 2-weeks to 3-months after spine surgery

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Oswestry Disability Index
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A 10-item questionnaire will be used to measure condition-specific disability that assesses the impact of lumbar spinal disorders on activities of daily living. Each item is measured from 0 to 5, representing low and high disability, respectively. Total score ranges from 0 to 50.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
PROMIS Physical Function
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
PROMIS Physical Function 4-item short form will be used to measure physical function. Each item is measured from 1 to 5, representing low to high physical function, respectively. Total score ranges from 4 to 20.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Numeric rating scale for back pain
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Numeric rating scale will be used to assess the pain intensity using the single-item for back, which is scored from 0 to 10, representing no pain and the worst pain, respectively.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Numeric rating scale for leg pain
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Numeric rating scale will be used to assess the pain intensity using the single-item for leg, which is scored from 0 to 10, representing no pain and the worst pain, respectively.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Intensity of physical activity
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A research-grade triaxial accelerometer (Actigraph GT3x) will be used to quantify time spent in different intensities of physical activity per day.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Physical activity volume
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A research-grade triaxial accelerometer (Actigraph GT3x) will be used to quantify total number of steps per day.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Depressive symptoms
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
PROMIS Depression 4 item short form will be used to measure depressive symtpoms. Each item is measured from 1 to 5, representing low to high depressive symptoms. Total score ranges from 4 to 20.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Fear of movement
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A 13-item Tampa Scale for Kinesiophobia will be used to measure fear of movement. It has two sub-scales (activity avoidance and fear of pain) and the total score ranges from 13 to 52 with higher scores indicating greater fear of movement.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery

Další výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Opioid Use
Časové okno: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A single-item Patient-reported opioid use questionnaire (yes vs. no).
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Vyšetřovatelé

  • Ředitel studie: Kristin R Archer, DPT, PhD, Vanderbilt University Medical Center

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

7. října 2020

Primární dokončení (Aktuální)

24. září 2021

Dokončení studie (Aktuální)

1. prosince 2021

Termíny zápisu do studia

První předloženo

9. října 2020

První předloženo, které splnilo kritéria kontroly kvality

9. října 2020

První zveřejněno (Aktuální)

19. října 2020

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

31. března 2022

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

30. března 2022

Naposledy ověřeno

1. března 2022

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • 201126 (GSK eTrack)

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

Ne

Popis plánu IPD

Given the pilot nature of the trial, the IPD will not be available to other researchers.

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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