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Motiverende interventioner og fysisk træning hos patienter med skrøbelighedsfraktur (PREVFRAILTY)

Effektiviteten af ​​et opfølgningsprogram baseret på motiverende interventioner og fysisk træning hos patienter med skrøbelighedsfraktur: Randomiseret kontrolleret klinisk forsøg.

Patients with a fragility fracture are twice as likely to have future fractures compared to their non-fractured peers. Furthermore, the 30% who suffer a fragility fracture do not regain the level of functioning in terms of activities of daily living after one year. A recent ecological study, in several European countries, estimates that if fracture patients were enrolled in fracture follow-up services, at least 19,000 fractures could be prevented each year. Clinical trials carried out in the research group have shown that the prescription of physical exercise in severe underlying pathologies is effective in improving physical function, quality of life and long-term results.

Hypothesis: The implementation of a motivational intervention and physical exercise program, in a staggered manner, taking into account the basic exercise capacity, improves the functional status of the patient (basic activities of daily life), adherence to interventions and the level of physical activity, and therefore reduces the number of hospital admissions, refractures and other associated complications.

Objective: To evaluate the effect of a rehabilitation intervention based on physical exercise and motivation, applied in a staggered manner and according to the functional capacity of patients with fragility fracture.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Method: Single-blind, randomized, controlled clinical study, with 2 parallel arms and single-center. Study subjects: Patients who underwent surgery for a fragility hip fracture between September 2021 and September 2022 in a tertiary hospital in southern Spain. A progressive physical exercise and motivational intervention adjusted for functional capacity will be compared versus usual rehabilitation care. Follow-up of patients for 3 months and a final visit at 6 months. The primary outcome variables will be functional status for the development of activities of daily living (individual ability to care for himself) and number of hospital readmissions (reasons and consequences). Variables related to quality of life, cognitive status, laboratory markers and densitometry will also be analyzed.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

100

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Cordoba
      • Córdoba, Cordoba, Spanien, 14004
        • Maimónides Biomedical Research Institute of Córdoba

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

50 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Present a hip fracture (includes cervical fracture and trochanteric), classified in the 10th version of the International Classification of Diseases (ICD-10-ES) with codes S72-S72.26X;
  • In addition, the fracture must be due to fragility: fracture due to a low-energy trauma or not proportional to the consequences (Hermoso de Mendoza, 2003);
  • To have received a surgical repair by replacement arthroplasty or internal fixation (ICD-10-ES procedures: 0SU and 0SR) in a period of less than one week;
  • To be recovering in a trauma and orthopedic unit and/or be transferred to a rehabilitation unit or discharged;
  • Before the fracture, independent or mild dependence for activities of daily living (Barthel index> 60) and living at home;
  • To have the cognitive ability to give informed consent (ANNEX I);
  • To live and be domiciled in a basic health area covered by the study hospital complex
  • To be over 50 years of age

Exclusion Criteria:

  • Presence of low cognitive level (scores below 23 points in Lobo's Mini-cognitive exam);
  • Patients with pathological fractures due to skeletal alterations other than osteoporosis;
  • Presence of more than one fall (other than the cause of hospital admission) in the last year;
  • Presence of uncorrected anemia (hemoglobin concentration <9/dL), acute infectious disease (C-reactive protein> 10 mg / L), severe cardiorespiratory disease (for example: unstable angina; severe heart failure identified by the New York Heart Association as class III-IV), musculoskeletal or neurological diseases (for example, major amputation of lower limbs) that make physical exercise impossible.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Physical activity program and motivational intervention

Physical activity program agreed with the patient / family and according to functional status (based on the 6-minute walk test) and motivational intervention. In addition to the care provided in usual care, a progressive physical exercise program based on basal functional capacity is prescribed. The exercise will be developed at home.

Physical and motivational follow-up treatment

Aktiv komparator: Treatment as usual

Multidisciplinary rehabilitation provided by professionals in the hospital and primary care settings, according to the individual needs of patients at different times of their recovery and the accessibility and availability of services in the different care settings.

Usual rehabilitation program

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Barthel index
Tidsramme: 6 months

Functional status for the development of activities of daily living (individual ability to take care of himself)

6 months
Number of hospital readmissions
Tidsramme: 6 months

Other clinical outcomes, such as mortality and all-cause hospitalization,

6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Mini-Mental State Examination
Tidsramme: 6 months

A 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment

6 months
Minnesota Leisure Time Physical Activity Questionnaire
Tidsramme: 6 months

To assess the quantity (total activity metabolic index) and quality (heavy, moderate, and light) of physical activity performed

6 months
Geriatric Depression Scale
Tidsramme: 6 months

is a brief, 30-item questionnaire in which participants are asked to respond by answering yes or no in reference to how they felt over the past week

6 months
Visual analogue scale
Tidsramme: 6 months

A validated, subjective measure for acute and chronic pain

6 months
Falls Efficacy Scale-International
Tidsramme: 6 months

It is a 16 item questionnaire, useful to the researchers and clinicians interested in fear of falling, with a score ranging from minimum 16 (no concern about falling) to maximum 64 (severe concern about falling)

6 months
5-level EQ-5D version
Tidsramme: 6 months

A standardised measure of health-related quality of life

6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

10. januar 2022

Primær færdiggørelse (Faktiske)

31. december 2022

Studieafslutning (Faktiske)

31. december 2024

Datoer for studieregistrering

Først indsendt

14. juni 2021

Først indsendt, der opfyldte QC-kriterier

14. juni 2021

Først opslået (Faktiske)

22. juni 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

5. november 2026

Sidst verificeret

1. april 2024

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • PIGE-0040-2020

Plan for individuelle deltagerdata (IPD)

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UBESLUTET

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