Preventing Pneumonia and Other Respiratory Problems in Persons With Spinal Cord Injury
Prevention of Long-Term Respiratory Complications of Spinal Cord Injury: a Randomized Controlled Trial
It is known that individuals with spinal cord injury are at increased risk for respiratory tract infections like pneumonia. Part of this risk is due to weakened chest and abdominal muscles that are vital to deep breathing and the ability to cough. The purpose of this study is to look at the effectiveness of two different treatments in preventing pneumonia and other respiratory problems in persons with SCI.
This is a randomized controlled trial investigating the effectiveness of two different treatments. Participants will be randomly assigned to one of the two treatment groups. They will not be told the details of the other intervention since this could influence or change their activities during the study.
調査の概要
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
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New Jersey
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West Orange、New Jersey、アメリカ、07052
- Kessler Institute for Rehabilitation
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Chronic spinal cord injury that occurred more than 6 months ago
- An impaired ability to cough (cough peak flow less than 300 L/min)
- Oxygen saturation greater than or equal to 95% when awake and not receiving supplemental oxygen
- End-tidal carbon dioxide level less than 43 mm Hg
- Without a fever or other signs of an acute illness for the previous 2 weeks
- Able to learn the treatment protocol and have someone available at home to assist if needed to help set-up and use the equipment
Exclusion Criteria:
- Under 18 years of age
- Currently have a tracheotomy tube
- Have a history of an acute illness in the last 2 weeks
- Have lung disease as seen on chest x-ray that results in a baseline oxygen saturation decreasing below 95% during daytime hours and cannot be normalized by usual way of coughing
- Already utilizing an oximetry protocol
- Have a significant medical complication and psychiatric condition that would interfere with the conduct of the study or interpretation of the study results.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:防止
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Manual and mechanical assisted cough
Individuals will be given a pulse oximeter and taught both manually assisted and mechanically assisted coughing techniques to maximize their cough peak flow.
Manually assisted coughing consists of air stacking to deep insufflations.
An abdominal thrust is then applied upon glottic opening to augment the cough peak flow.
Subjects will also have rapid access to a mechanical in-exsufflator (CoughAssistTM) and will be trained on how to access and use this device.
Mechanically assisted coughing (MAC) involves the use of the CoughAssistTM to expand the lungs and then quickly reverse the pressure to rapidly empty the lungs with expiratory (cough) flows of 600 L/m.
An abdominal (manual) thrust is applied in conjunction with the negative pressure (exsufflation) to further increase cough.
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Individuals will be given a pulse oximeter and taught both manually assisted and mechanically assisted coughing techniques to maximize their cough.
Manually assisted coughing consists of air stacking to deep insufflations.
An abdominal thrust is then applied upon glottic opening to augment the cough.
These subjects will also have rapid access to a mechanical in-exsufflator (CoughAssistTM) and will be trained on how to access and use this device.
Mechanically assisted coughing (MAC) involves the use of the CoughAssistTM to expand the lungs and then quickly reverse the pressure to rapidly empty the lungs with expiratory (cough) flows of 600 L/m.
An abdominal (manual) thrust is applied in conjunction with the negative pressure (exsufflation) to further increase cough.
他の名前:
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アクティブコンパレータ:Incentive spirometry
The active control group will consist of individuals assigned to the oximetry with incentive spirometry group.
These individuals will be given a pulse oximeter and an incentive spirometer (AirLife Company) and taught how to use them.
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These individuals will be given a pulse oximeter and an incentive spirometer (AirLife Company) and taught how to use them.
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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Reductions in episodes of community acquired pneumonia (CAP) and related severe respiratory complications
時間枠:3 years
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3 years
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Reductions in hospitalizations due to a primary diagnosis of a respiratory complications
時間枠:3 years
|
3 years
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Duration of illness and hospitalization
時間枠:3 years
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3 years
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Impact of respiratory complications on quality of life and participation
時間枠:3 years
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3 years
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協力者と研究者
スポンサー
捜査官
- 主任研究者:John Bach, M.D.、University of Medicine and Dentistry - The New Jersey Medical School, Newark, N.J.
- 主任研究者:Steven Kirshblum, M.D.、Kessler Institute for Rehabilitation, West Orange, N.J.
- スタディディレクター:Trevor A. Dyson-Hudson, M.D.、Kessler Foundation
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。