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App-based Exercise Intervention for Persons With Acute Ankle Sprain

11 de noviembre de 2019 actualizado por: Jonas Bak, Hvidovre University Hospital

A Pilot Study Investigating the Use and Preliminary Effect of the App "Injury-map" in Providing Exercise Rehabilitation for Persons With Acute Lateral Ankle Sprains Seen at the Emergency Department - a Mixed-method Pilot Study

Acute lateral ankle sprains (ALAS) account for 4-5% of all Emergency Department visits in Denmark. Up to 2/3 of individuals with a history of lateral ankle sprain have prolonged symptoms for several years after their initial injury. Exercise therapy has proven to be a cost-effective rehabilitation in treating ALAS and in preventing re-injury. Injury-map© is an exercise app designed for treating different musculoskeletal problems including ALAS. The app has currently not been tested in a clinical trial with patients suffering from ALAS. This mixed method pilot cohort study aims to investigate the use and preliminary effect of an exercise program on a mobile device in patients with ALAS. The exercise program is designed to be completed within approximately 3 months. However, participants will be followed as long as they complete minimum 1 exercise session per week. If a participant is inactive for two weeks they will be considered completed and contacted for follow-up assessment.

Descripción general del estudio

Estado

Terminado

Condiciones

Descripción detallada

Acute lateral ankle sprains (ALAS) account for 4-5% of all Emergency Department visits in Denmark and is the most common injury in sporting activities. It is often regarded as an innocuous injury but in truth up to 2/3 of individuals with a history of lateral ankle sprain have prolonged symptoms such as pain, decreased function and subjective instability for several years after their initial injury. Exercise therapy has proven to be a cost-effective rehabilitation in treating ALAS and in preventing re-injury. The financial modality of ALAS is high but exercise therapy has proven to be a cost-effective rehabilitation in treating ALAS and in preventing re-injury.

Modern technology has the potential to be a powerful tool in providing easily accessible exercise programs. Injury-map© is an exercise app designed for treating different musculoskeletal problems including ALAS. The exercise program has been developed by health professionals and has the potential to provide an easy-accessible management of ALAS rehabilitation. However, the app has currently not been tested in a clinical trial with patients suffering from ALAS. Before undertaking a large scale trial, the investigators wish to pilot test the app to assess the use and preliminary effect of the app-based exercise program.

This study aims to investigate the use and preliminary effect of an exercise program on a mobile device in patients with ALAS when seen in the Emergency Room at a public hospital. It is designed as a mixed method pilot cohort study. The SPIRIT checklist for trial protocols and the PREPARE trial guide have been used for the overall framework of this protocol.

Approximately 60 participants will be recruited from the Emergency Department (ED) at Hvidovre Hospital (HvH). Health specialists associated with the ED and responsible for ankle examinations will recruit participants . If a health specialist deems a person eligible, they will deliver a bag containing a rubber band and project description. If a participant is willing to participate in the project, they can contact the study administrator by the contact information in the written material. When contact is established participants will receive a voucher for the app, informed consent and a baseline questionnaire.

The exercise program will be available on any mobile device and/or tablet using Android or iOS. It is expected that patients primarily will exercise mainly at home. Participants will be followed as long as they actively use the exercise app or for a maximum of four months. When a participant has been inactive for more than two weeks, the participants are considered finalized and will be contacted for follow-up assessment.

Participants will receive a weekly SMS string where information of return to activity and subjective feeling of instability will be collected. The SMS string will send ever for four months. At follow-up assessment participants will receive a questionnaire containing questions of their experience with the exercise app. A number of participants will be selected to semi-structured interview to elaborate their user experience with the app. This selection will be based on the participants completion of exercises in the app. AT the ED and in the app system recruitment rates and adherence to the exercise program will be extracted.

Baseline characteristics will be summarized with suitable descriptive statistics.

For the aim of investigating the use of the App, adherence will be presented as the number of exercise sessions completed each week as well as average estimations. The results will be compared to an evidence-based exercise dose. Recruitment rates, retention rates will be presented in suitable descriptive tables. Any harms will be addressed individually.

Intervention outcomes will be summarized and tendencies in treatment effect will be compared with comparable literature, however no formal hypothesis testing will be performed, as the study uses a pilot design. Being an exploratory pilot study, the study is designed with a flat outcome structure with multiple evenly valued outcome measures.

Interviews will be recorded and transcribed verbatim. The data will be analysed using a thematic approach. The data will be coded and recurring phrases or words will be grouped into basic themes. These themes will be clustered into global themes which will be verified by comparison to the coded data [23]. Differences between participants who complete the intervention and those who do not will be discussed.

The enrollment process will start in April 2018 and conclude when 60 participants have been enrolled in the study.

Tipo de estudio

Intervencionista

Inscripción (Actual)

60

Fase

  • No aplica

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

    • Hvidove
      • Copenhagen, Hvidove, Dinamarca, 2650
        • Hvidovre University 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

5 años a 120 años (Niño, Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Acute lateral ankle sprain (< 48 hours) evaluated by a relevant health specialist in the hospital Emergency department (HvH)

Exclusion Criteria:

  • Fracture of the leg or foot (Ottawa rules and/or x-ray)
  • Previous surgery in the ankle or as a consequence of the current ankle distortion.
  • Other serious injury to the body in relation to the ankle injury incidence.
  • Serious illness (terminal patients, RA, Fibromyalgia etc).
  • Not having a smartphone or tablet.
  • Unable to understand Danish.

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: App-based exercise rehabilitation
Persons with Acute lateral ankle sprain (<48 hours) evaluated by a relevant health specialist in the hospital Emergency Department.

App-based exercise rehabilitation available on any mobile device and/or tablet using Android or iOS operating systems. The app Injurymap© is hosting the exercise program. The app requires user-registrations and a monthly paid subscription fee to access the exercise program. The participants in this study will not be charged for using the app.

The exercise program consists of three phases with increasing difficulty. Each phase consists of several categories of exercise types. The categories are 1) mobility, 2) stability/balance, 3) strength and 4) stretching. Within each phase, there can be more than one exercise for each category. This makes it possible to adjust the difficulty of the exercises depending on user-feedback.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Return to work
Periodo de tiempo: Four months from ankle injury
Number of whole days absent from work due to the ankle injury
Four months from ankle injury
Return to sport
Periodo de tiempo: Four months from ankle injury
Number of exercise sessions not able to fully attend due to the ankle injury
Four months from ankle injury
Re-injuries in the same ankle
Periodo de tiempo: Four months from ankle injury
Total number of re-sprains categorized into two groups. 1) Ankle sprains with no time loss and 2) ankle sprains with time-loss defined as unable to continue current activity and/or unable to participate in work/sport activities the next days because of the ankle.
Four months from ankle injury
Subjective feeling of ankle stability
Periodo de tiempo: Every week from ankle injury until four months after
0-10 points, where 0 is completely stable and 10 is very unstable. The participant writes a number within the indicated range that equates to their subjective feeling of stability.
Every week from ankle injury until four months after
Subjective feeling of recovery
Periodo de tiempo: Four months from ankle injury
Do you feel able to do the same activities on the same level as before the injury. answer: YES or NO.
Four months from ankle injury
Recruitment rate: Number of potentially eligible participants at the Emergency Department
Periodo de tiempo: From start of recruitment to the minimum of 60 participants has been achieved, but maximum 3 months
Database search off registered ankle injuries at the Emergency Department in the recruitment period
From start of recruitment to the minimum of 60 participants has been achieved, but maximum 3 months
Recruitment rate: Number of persons contacted by the health specialist for information about the study
Periodo de tiempo: From start of recruitment to the minimum of 60 participants has been achieved, but maximum 3 months
Number of delivered recruitment bags containing project information and rubber bands by the health personel at the Emergency Department.
From start of recruitment to the minimum of 60 participants has been achieved, but maximum 3 months
Recruitment rate: Number of persons willing to participate.
Periodo de tiempo: From start of recruitment to the minimum of 60 participants has been achieved, but maximum 3 months
Number of participants who contacts the project administration for participation in the exercise project.
From start of recruitment to the minimum of 60 participants has been achieved, but maximum 3 months
Recruitment rate: Number of persons commencing the exercise program.
Periodo de tiempo: From start of recruitment to two weeks after the minimum of 60 participants has been achieved, but maximum 3 months and two weeks.
Number of participants included in the project who commence the exercise program.
From start of recruitment to two weeks after the minimum of 60 participants has been achieved, but maximum 3 months and two weeks.
Retention rate: Number of persons completing follow-up assessment.
Periodo de tiempo: Four months from ankle injury
The number of participants completing the four month follow-up questionnaire of the total number included participants.
Four months from ankle injury
Retention rate: Number of sms responded.
Periodo de tiempo: Four months from ankle injury
The number of sms responded of the total number of sms send.
Four months from ankle injury
Adherence to exercise program: Number of exercise sessions completed.
Periodo de tiempo: Four months from ankle injury
The number of sessions completed is extracted from the app database.
Four months from ankle injury
Adherence to exercise program: Number of weeks with minimum one exercise session.
Periodo de tiempo: Four months from ankle injury
The number of sessions completed in each week is extracted from the app database.
Four months from ankle injury

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
semi-structured interviews
Periodo de tiempo: two weeks after ended intervention but maximum 4 months and two weeks after the initial ankle injury.
To uncover user experiences with the app-based exercise program.
two weeks after ended intervention but maximum 4 months and two weeks after the initial ankle injury.

Colaboradores e Investigadores

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

Investigadores

  • Investigador principal: Jonas Bak, MSc, Hvidovre University Hospital

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 (Actual)

3 de julio de 2018

Finalización primaria (Actual)

3 de agosto de 2019

Finalización del estudio (Actual)

3 de agosto de 2019

Fechas de registro del estudio

Enviado por primera vez

1 de mayo de 2018

Primero enviado que cumplió con los criterios de control de calidad

7 de junio de 2018

Publicado por primera vez (Actual)

8 de junio de 2018

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

13 de noviembre de 2019

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

11 de noviembre de 2019

Última verificación

1 de noviembre de 2019

Más información

Términos relacionados con este estudio

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

INDECISO

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

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. .

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