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- Ensaio Clínico NCT07661836
Personalized Online Occupational Therapy Intervention for Adults With Scleroderma
Pilot Exploratory Parallel-Group Randomized Controlled Trial to Evaluate a Personalized Online Occupational Therapy Intervention Versus Usual Care in Adults With Scleroderma
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
Scleroderma is a chronic connective tissue disease that may be associated with skin and visceral fibrosis, pain, fatigue, stiffness, respiratory symptoms, gastrointestinal symptoms, vascular alterations, and functional limitations. From an occupational perspective, these manifestations may affect activities of daily living, self-care, work, leisure, social participation, quality of life, hand function, and occupational balance.
This study is based on a previous cohort of adults with scleroderma in Spain, in which information was collected on functioning, quality of life, occupational balance, hand function, symptoms, assistive products, and unmet needs. The present phase aims to implement and preliminarily evaluate a personalized, occupation-centered, online occupational therapy intervention.
The study is a pilot exploratory parallel-group randomized controlled trial with individual allocation in a 1:1 ratio. It is coordinated by the University of Zaragoza and delivered remotely. Participants take part from their home or community environment in Spain. The intervention group receives eight individual online occupational therapy sessions, approximately 50-60 minutes each, twice weekly over four weeks, through Google Meet and without recording. The intervention is individualized according to baseline assessment and the first session, including personalized occupational goals using SMART criteria and Goal Attainment Scaling. The control group continues with usual care and does not receive additional intervention from the research team during the intervention and follow-up period. After completing follow-up, the control group will receive access to general educational materials and will be offered an online educational group session.
The primary feasibility outcome is the proportion of intervention-group participants who complete at least six of the eight planned sessions at post-intervention assessment. The pre-specified feasibility threshold is at least 70%. Secondary outcomes include acceptability, adherence, safety, and technical feasibility. Exploratory clinical and occupational outcomes include WHODAS 2.0, WHOQOL-BREF, Occupational Balance Questionnaire, Cochin Hand Function Scale, and Goal Attainment Scaling in the intervention group.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Zaragoza / Aragón
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Zaragoza, Zaragoza / Aragón, Espanha, 50009
- Universidad de Zaragoza
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Adults aged 18 years or older with scleroderma from the previous project cohort and meeting the general eligibility criteria of the initial study.
- Current residence in Spain.
- Sufficient Spanish language ability to provide informed consent, participate in the intervention, and complete study assessments.
- Ability to understand the study information and provide informed consent, with support if needed.
- Access to the internet and to a device compatible with Google Meet and Hefora.
- Availability to participate in eight online sessions of approximately 60 minutes, twice weekly over four weeks.
- Not currently participating in a specific occupational therapy program or another intervention that could substantially influence functioning, activities of daily living, quality of life, or occupational balance.
- Provision of informed consent and completion of the baseline assessment.
Exclusion Criteria:
- Clinical condition or severe comorbidity preventing safe participation.
- Current residence outside Spain.
- Inability to provide informed consent or complete the baseline assessment.
- Concurrent participation in a specific occupational therapy program or another intensive, potentially interfering rehabilitation or therapeutic education intervention.
- Withdrawal of interest before the effective start of the intervention or inability to participate during the planned study dates.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Cuidados de suporte
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: Personalized Online Occupational Therapy Plus Usual Care
Participants allocated to the intervention group will receive eight individual online occupational therapy sessions over four weeks, with two sessions per week, delivered by videoconference and added to usual care.
Sessions will be individualized according to baseline assessment and participant goals and may include goal setting, hand preparation for occupation, self-care and pain management, energy conservation, daily planning, environmental adaptations, assistive product guidance, occupational balance, functional integration, and a maintenance plan.
Sessions will not be recorded.
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The intervention consists of eight individual online occupational therapy sessions delivered over four weeks, with two sessions per week, through videoconference and without recording.
Sessions are individualized according to baseline assessment, participant needs, and personalized occupational goals.
The intervention may include goal setting using SMART criteria and Goal Attainment Scaling, hand preparation for occupation, self-care and pain management strategies, energy conservation, daily planning, environmental adaptations, assistive product guidance, occupational balance strategies, functional integration, and a maintenance plan.
The intervention is delivered in addition to usual care.
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Comparador Ativo: Usual Care
Participants allocated to the control group will continue with their usual health and social care during the intervention and follow-up period.
They will not receive additional occupational therapy from the research team during this period.
Changes in usual care will be recorded at post-intervention and follow-up assessments.
After completing follow-up, participants in this arm will receive access to general educational materials and will be offered an online educational group session.
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Usual care refers to the ordinary health and social care that participants receive in their usual context.
It is not administered by the research team.
Participants allocated to this arm will not receive additional occupational therapy from the research team during the intervention and follow-up period.
Changes in usual care will be recorded at post-intervention and follow-up assessments.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Feasibility: intervention completion
Prazo: From baseline to post-intervention, approximately 4 weeks.
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Percentage of participants allocated to the intervention group who complete at least 6 of the 8 planned online occupational therapy sessions.
The pre-specified feasibility threshold is 70% or higher.
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From baseline to post-intervention, approximately 4 weeks.
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Acceptability: session satisfaction
Prazo: After each intervention session during the 4-week intervention period.
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Participant satisfaction after each intervention session, assessed using Likert-type items scored from 1 to 5 and open-ended questions.
Items address perceived usefulness, integration into daily routine, comprehension, self-efficacy, perceived safety, and suggestions for improvement.
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After each intervention session during the 4-week intervention period.
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Acceptability: final intervention satisfaction questionnaire score
Prazo: Post-intervention, approximately 4 weeks after baseline.
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Final satisfaction with the intervention will be assessed in the intervention group using a structured final intervention satisfaction questionnaire administered at post-intervention.
The questionnaire includes Likert-type items scored from 1 to 5. A mean satisfaction score will be calculated across the Likert-type items, with higher scores indicating greater intervention acceptability and satisfaction.Open-ended questions will also be used to collect qualitative feedback on acceptability, perceived usefulness, and suggestions for improvement; these qualitative responses will be summarized descriptively and will not be included in the numerical score.
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Post-intervention, approximately 4 weeks after baseline.
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Complementary adherence: Percentage of expected weekly diaries completed
Prazo: Weekly during the 4-week intervention period.
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Complementary adherence will be assessed in the intervention group using the weekly participant diary.
The outcome will be reported as the percentage of expected weekly diaries completed by each participant during the 4-week intervention period.
Four weekly diaries are expected per participant.
The percentage ranges from 0% to 100%, with higher percentages indicating greater adherence to weekly diary completion.
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Weekly during the 4-week intervention period.
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Complementary adherence: Percentage of agreed home-based tasks completed
Prazo: Weekly during the 4-week intervention period and post-intervention, approximately 4 weeks after baseline.
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Completion of agreed home-based tasks will be assessed in the intervention group using participant self-reports recorded in the weekly diary and adherence record.
Each week, task completion will be recorded as completed, partially completed, or not completed.
The outcome will be reported as the percentage of agreed home-based tasks completed during the intervention period.
The percentage ranges from 0% to 100%, with higher percentages indicating greater adherence to the agreed home-based tasks.
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Weekly during the 4-week intervention period and post-intervention, approximately 4 weeks after baseline.
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Complementary adherence: Percentage of intervention materials reviewed
Prazo: Weekly during the 4-week intervention period and post-intervention, approximately 4 weeks after baseline.
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Review of intervention materials will be assessed in the intervention group using participant self-reports recorded in the weekly diary and adherence record.
Each week, participants will report whether they reviewed the materials shared with them.
The outcome will be reported as the percentage of intervention materials reviewed during the intervention period.
The percentage ranges from 0% to 100%, with higher percentages indicating greater adherence to reviewing the intervention materials.
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Weekly during the 4-week intervention period and post-intervention, approximately 4 weeks after baseline.
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Safety: adverse events
Prazo: Continuously during the intervention period and at post-intervention and follow-up assessments, up to approximately 8 weeks after baseline.
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Number of adverse events and number of participants with at least one adverse event, classified by severity, relationship with the intervention, outcome, and whether the event led to interruption, adaptation, or discontinuation of a session.
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Continuously during the intervention period and at post-intervention and follow-up assessments, up to approximately 8 weeks after baseline.
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Technical feasibility
Prazo: Continuously during the intervention period and assessment windows, up to approximately 8 weeks after baseline.
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Frequency, type, and impact of technical incidents affecting online intervention delivery, participant participation, or online data collection.
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Continuously during the intervention period and assessment windows, up to approximately 8 weeks after baseline.
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Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in functioning assessed by the Spanish version of the World Health Organization Disability Assessment Schedule 2.0
Prazo: Baseline, post-intervention at approximately 4 weeks, and follow-up at approximately 8 weeks.
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Functioning will be assessed using the World Health Organization Disability Assessment Schedule 2.0.
Scores will be transformed to a 0 to 100 scale, where 0 indicates no disability and 100 indicates full disability.
Higher scores indicate worse functioning or greater disability.
Change from baseline to post-intervention and from baseline to follow-up will be described.
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Baseline, post-intervention at approximately 4 weeks, and follow-up at approximately 8 weeks.
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Change in quality of life assessed by the Spanish version of the World Health Organization Quality of Life-BREF
Prazo: Baseline, post-intervention at approximately 4 weeks, and follow-up at approximately 8 weeks.
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Quality of life will be assessed using the World Health Organization Quality of Life-BREF.
The questionnaire provides four domain scores: physical health, psychological health, social relationships, and environment.
Domain scores will be transformed to a 0 to 100 scale.
Higher scores indicate a better quality of life.
Change from baseline to post-intervention and from baseline to follow-up will be described.
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Baseline, post-intervention at approximately 4 weeks, and follow-up at approximately 8 weeks.
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Change in occupational balance assessed by the Spanish version of the Occupational Balance Questionnaire
Prazo: Baseline, post-intervention at approximately 4 weeks, and follow-up at approximately 8 weeks.
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Occupational balance will be assessed using the Spanish version of the Occupational Balance Questionnaire.
The questionnaire consists of 13 items, each scored from 0 to 5. The total score ranges from 0 to 65, with higher scores indicating greater occupational balance.
Change from baseline to post-intervention and from baseline to follow-up will be described.
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Baseline, post-intervention at approximately 4 weeks, and follow-up at approximately 8 weeks.
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Change in hand function assessed by the Spanish version of the Cochin Hand Function Scale
Prazo: Baseline, post-intervention at approximately 4 weeks, and follow-up at approximately 8 weeks.
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Hand function will be assessed using the Cochin Hand Function Scale.
The scale includes 18 items assessing difficulty in performing hand-related daily activities.
The total score ranges from 0 to 90, with higher scores indicating worse hand function or greater hand-related disability.
Change from baseline to post-intervention and from baseline to follow-up will be described.
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Baseline, post-intervention at approximately 4 weeks, and follow-up at approximately 8 weeks.
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Sandra M Espín Tello, PhD, Universidad de Zaragoza
Publicações e links úteis
Publicações Gerais
- Garin O, Ayuso-Mateos JL, Almansa J, Nieto M, Chatterji S, Vilagut G, Alonso J, Cieza A, Svetskova O, Burger H, Racca V, Francescutti C, Vieta E, Kostanjsek N, Raggi A, Leonardi M, Ferrer M; MHADIE consortium. Validation of the "World Health Organization Disability Assessment Schedule, WHODAS-2" in patients with chronic diseases. Health Qual Life Outcomes. 2010 May 19;8:51. doi: 10.1186/1477-7525-8-51.
- Skevington SM, Lotfy M, O'Connell KA; WHOQOL Group. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004 Mar;13(2):299-310. doi: 10.1023/B:QURE.0000018486.91360.00.
- Lucas-Carrasco R. The WHO quality of life (WHOQOL) questionnaire: Spanish development and validation studies. Qual Life Res. 2012 Feb;21(1):161-5. doi: 10.1007/s11136-011-9926-3. Epub 2011 May 25.
- Peral-Gomez P, Lopez-Roig S, Pastor-Mira MA, Abad-Navarro E, Valera-Gran D, Hakansson C, Wagman P. Cultural Adaptation and Psychometric Properties of the Spanish Version of the Occupational Balance Questionnaire: An Instrument for Occupation-Based Research. Int J Environ Res Public Health. 2021 Jul 14;18(14):7506. doi: 10.3390/ijerph18147506.
- Chan AW, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne DR, Farmer AJ, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson DJ, Vohra S, White IR, Hrobjartsson A. SPIRIT 2025 statement: updated guideline for protocols of randomised trials. BMJ. 2025 Apr 28;389:e081477. doi: 10.1136/bmj-2024-081477.
- Arreguin Reyes R, Lopez Lopez CO, Alvarez Hernandez E, Medrano Ramirez G, Montes Castillo Mde L, Vazquez-Mellado J. Evaluation of hand function in rheumatic disease. Validation and usefulness of the Spanish version AUSCAN, m-SACRAH and Cochin questionnaires. Reumatol Clin. 2012 Sep-Oct;8(5):250-4. doi: 10.1016/j.reuma.2012.03.005. Epub 2012 May 17.
Datas de registro do estudo
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Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
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Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- C.I. PI26/254
- 216213 (Número de outro subsídio/financiamento: Asociación Española de Esclerodermia)
Plano para dados de participantes individuais (IPD)
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Descrição do plano IPD
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