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App-based Exercise Intervention for Persons With Acute Ankle Sprain

2019년 11월 11일 업데이트: 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.

연구 개요

상태

완전한

정황

상세 설명

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.

연구 유형

중재적

등록 (실제)

60

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Hvidove
      • Copenhagen, Hvidove, 덴마크, 2650
        • Hvidovre University Hospital

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

5년 (어린이, 성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

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.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 해당 없음
  • 중재 모델: 단일 그룹 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 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.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Return to work
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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.
기간: 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.
기간: 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.
기간: 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.
기간: 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.
기간: 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.
기간: Four months from ankle injury
The number of sessions completed in each week is extracted from the app database.
Four months from ankle injury

기타 결과 측정

결과 측정
측정값 설명
기간
semi-structured interviews
기간: 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.

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Jonas Bak, MSc, Hvidovre University Hospital

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2018년 7월 3일

기본 완료 (실제)

2019년 8월 3일

연구 완료 (실제)

2019년 8월 3일

연구 등록 날짜

최초 제출

2018년 5월 1일

QC 기준을 충족하는 최초 제출

2018년 6월 7일

처음 게시됨 (실제)

2018년 6월 8일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2019년 11월 13일

QC 기준을 충족하는 마지막 업데이트 제출

2019년 11월 11일

마지막으로 확인됨

2019년 11월 1일

추가 정보

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미정

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미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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