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Early Rehabilitation in Critically Ill Children Pilot Study (WeeHab in PCCU)

4 de noviembre de 2013 actualizado por: McMaster University

Early Rehabilitation in Critically Ill Children, a Pilot Study

Critically ill patients are often confined to bedrest, because of the nature of their illness. However, it has now been shown that prolonged bedrest and immobility, particularly in critically ill adults and children, can lead to serious outcomes such as muscle weakness and prolonged stay in the intensive care unit (ICU). Research in adults has demonstrated that preventing immobility and introducing exercise and rehabilitation in adult patients early during their ICU illness can prevent these serious outcomes, reduce the duration of hospital stay, and enhance their recovery after they leave the ICU. The purpose of our research is to investigate if early mobilization and rehabilitation can also be performed in critically ill children, and eventually evaluate this results in beneficial outcomes in these children, as it has been shown to be in adults. However, given that children are not the same as adults, but have varying abilities to understand and participate in activities when they are sick, the investigators first have to evaluate the most appropriate and safe ways of helping children "exercise" while they are in the ICU. This objective of this study is to evaluate if 2 methods of rehabilitation (a stationary bike and interactive video game) can be implemented in critically ill children. These methods have been used in hospitalized children and in critically ill adults. The investigators will evaluate if these methods are safe for critically ill children.

Descripción general del estudio

Estado

Terminado

Condiciones

Descripción detallada

In this prospective cohort pilot study, eligible critically ill children aged 3 to 17 years will receive in addition to their usual care, a passive and/or an active mobility intervention, depending on their level of consciousness or cognitive ability. The active intervention will consist of an interactive video game (X Box 360 Kinect), while a cycle ergometer will be used as the passive intervention. The mobility interventions will be applied for a minimum of 10 minutes on day 1, and 20 minutes on day 2. For unconscious patients, or eligible patients who cognitively impaired, the passive intervention will be applied. As soon as the patient is conscious and cooperative, the active intervention will be applied.

The primary outcomes of interest in this pilot study are feasibility (defined as the ability to screen and enroll patients, consent rate and protocol adherence). Secondary outcomes of interest include safety outcomes, clinical outcomes and patient and caregiver satisfaction with the intervention.

Tipo de estudio

Intervencionista

Inscripción (Actual)

20

Fase

  • Fase 1

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • Ontario
      • Hamilton, Ontario, Canadá, L8N 3Z5
        • McMaster Children's Hospital

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

3 años a 17 años (Niño)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  1. Anticipated PCCU stay of more than 24 hours.
  2. Clinical stable children at PCCU
  3. Informed consent and or assent where appropriate
  4. Agreement of the most responsible PCCU physician
  5. Age ≥ 3years to < 18 years

Exclusion Criteria:

  1. Hemodynamic instability, defined as requiring escalation in vasoactive agents or volume resuscitation within the preceding 4 hours. (Patients who are on stable or weaning doses of vasoactive agents will be considered eligible).
  2. Anticipated death and/ or withholding of life-sustaining therapies
  3. The presence of a contraindication to mobilization- e.g. Suspected or actual evidence of cerebral edema or elevated ICP, unstable spinal cord injuries, musculoskeletal injuries/ fixed deformities in the lower limbs (for the use of cycle ergometer) or the upper limbs (for the use of interactive video-gaming)
  4. Unstable airway (defined as impending respiratory failure and/or endotracheal intubation is anticipated within the next 4 hours).
  5. Patients who are already mobilizing well/or at their baseline level of function

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Single Arm: Study Intervention
Cycle ergometry and/or Interactive video-game
  1. Passive mobility: cycle ergometer
  2. Active mobility: interactive video-game (X Box 360 Kinect) Each intervention will be applied for a maximum of 2 days respectively. If a participant is unconscious on Day 1 and receives the passive intervention, and thereafter becomes alert and cooperative on day 2, then he/she can receive the active intervention.
Otros nombres:
  • Cycle Ergometer
  • X Box 360 Kinect

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Feasibility
Periodo de tiempo: 2 days

The primary outcome of interest in this pilot study is feasibility. Feasibility is defined as follows:

  1. The ability to screen and enroll eligible patients - enrolment rate of at least 70% of those approached for consent (benchmark for PCCU trials)
  2. Time to application of acute rehabilitation intervention.
  3. Protocol adherence - a protocol violation rate of < 10%.
2 days

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Safety
Periodo de tiempo: Study period
The proportion of patients with adverse events attributable to the rehabilitation intervention (e.g. cardiorespiratory events, tube dislodgement's).
Study period
Change in activity from baseline
Periodo de tiempo: From baseline to end of intervention
Change in activity from baseline, during and following the intervention as measured by accelerometer, and patient
From baseline to end of intervention
Caregiver/user perception of intervention
Periodo de tiempo: At end of study period
Self-administered survey of caregiver and or user, to evaluate perceptions of intervention
At end of study period

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Investigadores

  • Investigador principal: Karen Choong, MB, BCh, MSc, McMaster University

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de febrero de 2012

Finalización primaria (Actual)

1 de mayo de 2013

Finalización del estudio (Actual)

1 de mayo de 2013

Fechas de registro del estudio

Enviado por primera vez

7 de febrero de 2012

Primero enviado que cumplió con los criterios de control de calidad

10 de febrero de 2012

Publicado por primera vez (Estimar)

13 de febrero de 2012

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

5 de noviembre de 2013

Última actualización enviada que cumplió con los criterios de control de calidad

4 de noviembre de 2013

Última verificación

1 de noviembre de 2013

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • 12-008

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

Ensayos clínicos sobre Early Rehabilitation intervention

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