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Functions, Physical Activity and Employment for Individuals With MS: A Pilot Feasibility Study (CoreDISTp)

15. september 2021 oppdatert av: Nordlandssykehuset HF

Innovative Follow-up Across Health Care Levels to Optimize Functions, Physical Activity and Employment for Individuals With MS: A Pilot Feasibility Study

Multiple Sclerosis (MS) is a chronic disease affecting young adults. Impaired balance, walking, reduced physical activity and participation in employment are common, however, less integrated in the health care. The researchers have developed a multidisciplinary intervention and pathway delivered across health care levels targeting the promotion of balance, walking, physical activity and participation in employment. The research team will perform a pilot feasibility Randomized Controlled Trial (RCT) and interviews to investigate the feasibility of the new intervention compared to a standard care for individuals with lower levels of disability.

Studieoversikt

Status

Påmelding etter invitasjon

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

The study addresses core elements in the health services for individuals with MS, constituting approximately 11000 in Norway. The two-armed pilot feasibility-RCT will be performed across the MS-outpatient (MS-OP) clinic, Nordland Hospital Trust, Bodø (NLSH), and in two surrounding municipalities, including 30 employed participants who will be followed for 10-weeks. The new intervention and pathway, CoreDISTparticipation, builds on GroupCoreDIST, which is previously found effective short and long term compared to standard care. CoreDISTparticipation consists of three phases: a) at the MS-OP clinic, in addition to the regular consultations, the patient will have a structured digital conversation with the MS-nurse addressing work related issues and a session with a physiotherapist exploring possibilities for change in balance and walking; b) in the municipality, a physiotherapist will continue exploration of improvements, followed by four weeks of GroupCoreDIST for 60 minutes, 2 times per week supplemented with home exercise programs focusing on balance, walking and physical activity. The participants will have access to exercise programs on videos through an open website at Nord University to digitally support home training.

To promote participation in employment, a structured digital meeting between each patient, the MS-nurse, the patient's employer, and the physiotherapist (who leads the group trainings) will take place in phase b; followed by phase c) which include four weeks of outdoor group based exercises and physical activity led by a physiotherapist, for 60 minutes, 2 times per week supplemented with the same home exercise programs as in phase b.

Evaluation of employment and physical activity will be conducted using an evaluation form.

The control group will receive usual consultations at the MS-OP clinic, as well as a session with a physiotherapist at the MS-OP clinic, exploring possibilities for change in balance and walking. In the municipality the control group will follow standard care (their usual follow-up).

The research team will examine feasibility, preliminary between-group differences regarding balance, walking, physical activity level, health related quality of life and barriers in employment, as well as the users' experiences with participation in the CoreDISTparticipation.

Studietype

Intervensjonell

Registrering (Forventet)

30

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Norge
      • Bodø, Norge
        • Physiotherapy department, Nordlandssykehuset HF
      • Bodø, Norge
        • Bodø Municipality

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 68 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Diagnosed with MS (Mc Donald's criteria), Expanded Disability Status Scale ≤3.5 (no disability-fully ambulatory with moderate disability), ≥18 years, being employed. By these criteria the study will include individuals most accessible for the intervention and who have the best prospects to maintain/improve balance, walking, physical activity and participation in employment.

Exclusion Criteria:

  • Retired, pregnancy at enrolment, exacerbation within two weeks prior to enrolment and other serious conditions compromising balance, walking or work capacity.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: CoreDISTparticipation

a) at the MS-OP clinic, in addition to the regular consultations, the patient will have a structured digital conversation with the MS-nurse addressing work related issues and a session with a physiotherapist exploring possibilities for change in balance and walking; b) in the municipality, a physiotherapist will continue exploration of improvements, followed by four weeks of GroupCoreDIST focusing on balance, walking and physical activity and conducted in groups of 3-5 individuals with MS and led by a physiotherapist.

To promote participation in employment, a structured digital meeting between each patient, the MS-nurse, the patient's employer, and the physiotherapist will take place; followed by c) four weeks of outdoor group based exercises and physical activity led by a physiotherapist, complemented with an evaluation form regarding employment and physical activity.
Atferdsmessig: CoreDISTparticipation
CoreDISTparticipation is a thorough intervention that contains coordination of services (physiotherapy, MS-nursing and work adaptations) between the MS-OP clinic and the municipality aiming to improve function, physical activity and employment in individuals with MS.
Aktiv komparator: Standard care
The control group will receive the usual consultations at the MS-OP clinic including exploration of possibilities for change in balance and walking together with physiotherapist at the MS-OP clinic. The control group will furthermore follow standard care (their usual follow-up) in the municipality.
Atferdsmessig: Standard care
The standard care group will follow regular consultations at the MS-outpatient clinic including a session with the physiotherapist. Furthermore, this group will follow usual care in the municipality which might include other forms of physiotherapy or physical activity. These will be registered.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
MS Work Difficulties Questionnaire-23
Tidsramme: Baseline
How frequently individuals with MS perceive psychological/cognitive (11 items)-, physical (8 items)- and external barriers (4 items) related to their current or most recent job, and is scored by a five point scale (best score 0). (Recently translated to Norwegian).
Baseline
Six-Minutes Walk Test
Tidsramme: Baseline
Walking distance within six minutes
Baseline
MS Work Difficulties Questionnaire-23
Tidsramme: 5 weeks post-test
How frequently individuals with MS perceive psychological/cognitive (11 items)-, physical (8 items)- and external barriers (4 items) related to their current or most recent job, and is scored by a five point scale (best score 0). (Recently translated to Norwegian).
5 weeks post-test
Six-Minutes Walk Test
Tidsramme: 5 weeks post-test
Walking distance within six minutes
5 weeks post-test
MS Work Difficulties Questionnaire-23
Tidsramme: 10 week post-test
How frequently individuals with MS perceive psychological/cognitive (11 items)-, physical (8 items)- and external barriers (4 items) related to their current or most recent job, and is scored by a five point scale (best score 0). (Recently translated to Norwegian).
10 week post-test
Six-Minutes Walk Test
Tidsramme: 10 week post-test
Walking distance within six minutes
10 week post-test

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Trunk Impairment Scale Norwegian Version
Tidsramme: Baseline
Dynamic sitting balance, 6 items, top score 16.
Baseline
Mini Balance Evaluation Systems Test
Tidsramme: Baseline
Pro-and reactive balance, dual task and involving sit to stand, standing and walking, 14 items on a 3 point with a top score of 28
Baseline
Force Platform
Tidsramme: Baseline
The force platform measures control in standing: symmetry/asymmetry of weight bearing with eyes open/closed, postural sway of center of pressure, and weight transfer which all together will present an outcome for standing balance.
Baseline
Activity monitors outcome 1
Tidsramme: Baseline
The monitors measure Physical activity levels (inactive, light, moderate, vigorous) within 7 days
Baseline
Activity monitors outcome 2
Tidsramme: Baseline
The monitors measure number of steps within 7 days
Baseline
European Quality of Life 5-Dimension-3 Level
Tidsramme: Baseline
Self-perceived health related quality of life regarding five domains, each with three items, and a Visual Analog Scale (0-100) recording perceived health.
Baseline
Multiple Sclerosis Walking Scale-12
Tidsramme: Baseline
Limitations in walking due to MS on 12 items with a scale 1-5, best score 12
Baseline
Multiple Sclerosis Impact Scale-29
Tidsramme: baseline
Self-perceived physical (13 items) and psychological (9 items) impact due to MS on health related quality of life recorded by a five point scale (best score 29)
baseline
Weight
Tidsramme: baseline
Self reported weight by kilogram
baseline
Height
Tidsramme: baseline
Self reported height by centimetre
baseline
age
Tidsramme: baseline
Self reported age by years
baseline
Social status
Tidsramme: baseline
Self reported social status; married, cohabitant, living alone
baseline
Type of multiple sclerosis
Tidsramme: baseline
Self reported main types: relapsing remitting, primary progressive, secondary progressive
baseline
Year of diagnosis multiple sclerosis
Tidsramme: baseline
Self reported by year
baseline
Medications
Tidsramme: baseline
Self reported by type of medications
baseline
Expanded disability status scale
Tidsramme: baseline
Self reported or from journal functional status at last yearly control by a neurologist
baseline
Occupation
Tidsramme: baseline
Self reported
baseline
Percentage of work
Tidsramme: baseline
Self reported percentage of work the previous month
baseline
Length of education
Tidsramme: baseline
Self reported choices: elementary school; high school; bachelor; masters degree; Doctor of philosophy degree
baseline
Trunk Impairment Scale Norwegian Version
Tidsramme: 5 weeks post-test
Dynamic sitting balance, 6 items, top score 16.
5 weeks post-test
Mini Balance Evaluation Systems Test
Tidsramme: 5 weeks post-test
Pro-and reactive balance, dual task and involving sit to stand, standing and walking, 14 items on a 3 point with a top score of 28
5 weeks post-test
Force Platform
Tidsramme: 5 weeks post-test
The force platform measures control in standing: symmetry/asymmetry of weight bearing with eyes open/closed, postural sway of center of pressure, and weight transfer which all together will present an outcome for standing balance.
5 weeks post-test
Activity monitors outcome 1
Tidsramme: 5 weeks post-test
The monitors measure Physical activity levels (inactive, light, moderate, vigorous) within 7 days
5 weeks post-test
Activity monitors outcome 2
Tidsramme: 5 weeks post-test
The monitors measure number of steps within 7 days
5 weeks post-test
European Quality of Life 5-Dimension-3 Level
Tidsramme: 5 weeks post-test
Self-perceived health related quality of life regarding
5 weeks post-test
Multiple Sclerosis Walking Scale-12
Tidsramme: 5 weeks post-test
Limitations in walking due to MS on 12 items with a scale 1-5, best score 12
5 weeks post-test
Multiple Sclerosis Impact Scale-29
Tidsramme: 5 weeks post-test
Self-perceived physical (13 items) and psychological (9 items) impact due to MS on health related quality of life recorded by a five point scale (best score 29)
5 weeks post-test
Percentage of work
Tidsramme: 5 weeks post-test
Self reported percentage of work
5 weeks post-test
Trunk Impairment Scale Norwegian Version
Tidsramme: 10 weeks post-test
Dynamic sitting balance, 6 items, top score 16.
10 weeks post-test
Mini Balance Evaluation Systems Test
Tidsramme: 10 weeks post-test
Pro-and reactive balance, dual task and involving sit to stand, standing and walking, 14 items on a 3 point with a top score of 28
10 weeks post-test
Force Platform
Tidsramme: 10 weeks post-test
The force platform measures control in standing: symmetry/asymmetry of weight bearing with eyes open/closed, postural sway of center of pressure, and weight transfer which all together will present an outcome for standing balance.
10 weeks post-test
Activity monitors outcome 1
Tidsramme: 10 weeks post-test
The monitors measure Physical activity levels (inactive, light, moderate, vigorous) within 7 days
10 weeks post-test
Activity monitors outcome 2
Tidsramme: 10 weeks post-test
The monitors measure number of steps within 7 days
10 weeks post-test
European Quality of Life 5-Dimension-3 Level
Tidsramme: 10 weeks post-test
Self-perceived health related quality of life regarding
10 weeks post-test
Multiple Sclerosis Walking Scale-12
Tidsramme: 10 weeks post-test
Limitations in walking due to MS on 12 items with a scale 1-5, best score 12
10 weeks post-test
Multiple Sclerosis Impact Scale-29
Tidsramme: 10 weeks post-test
Self-perceived physical (13 items) and psychological (9 items) impact due to MS on health related quality of life recorded by a five point scale (best score 29)
10 weeks post-test
Percentage of work
Tidsramme: 10 weeks post-test
Self reported percentage of work
10 weeks post-test

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Nordlandssykehuset HF

Samarbeidspartnere

Hasselt University
Helse Nord
Nord University

Etterforskere

  • Studieleder: Petter Oien, PhD, Nordlandssykehuset HF

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

27. august 2021

Primær fullføring (Forventet)

31. desember 2021

Studiet fullført (Forventet)

30. august 2022

Datoer for studieregistrering

Først innsendt

27. august 2021

Først innsendt som oppfylte QC-kriteriene

15. september 2021

Først lagt ut (Faktiske)

27. september 2021

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

27. september 2021

Siste oppdatering sendt inn som oppfylte QC-kriteriene

15. september 2021

Sist bekreftet

1. september 2021

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CoreDISTparticipation

Plan for individuelle deltakerdata (IPD)

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NEI

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Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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