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Physical Activity Intervention for Patients Following Lumbar Spine Surgery (PASS)

30 марта 2022 г. обновлено: Hiral Master, Vanderbilt University Medical Center

Developing a Novel Physical Activity Intervention for Patients Following Lumbar Spine Surgery (PASS Trial)

There is a critical need to target physical activity during postoperative management to optimize long-term recovery after lumbar spine surgery. The overall objective of this study is to conduct a two-group randomized control trial (RCT) to examine the feasibility and acceptability of a physical activity telehealth intervention delivered by a physical therapist for improving disability, physical function, pain, and physical activity compared to usual care after spine surgery for a degenerative lumbar condition. The physical activity intervention will include wearable technology and remote physical therapist support to counsel patients on a realistic progression of physical activity (steps per day). The central hypothesis is that this 8-week physical activity intervention performed at two weeks after surgery will be feasible and acceptable. The results of our randomized trial will be used to support a large multi-site clinical trial to test the effectiveness and implementation of this intervention

Обзор исследования

Тип исследования

Интервенционный

Регистрация (Действительный)

16

Фаза

  • Непригодный

Контакты и местонахождение

В этом разделе приведены контактные данные лиц, проводящих исследование, и информация о том, где проводится это исследование.

Места учебы

Критерии участия

Исследователи ищут людей, которые соответствуют определенному описанию, называемому критериям приемлемости. Некоторыми примерами этих критериев являются общее состояние здоровья человека или предшествующее лечение.

Критерии приемлемости

Возраст, подходящий для обучения

18 лет и старше (Взрослый, Пожилой взрослый)

Принимает здоровых добровольцев

Нет

Полы, имеющие право на обучение

Все

Описание

Inclusion Criteria:

  1. Adults age 18 years or older, of both sexes and all races
  2. Scheduled for surgical treatment of a lumbar degenerative condition (spinal stenosis, spondylosis with or without myelopathy, and degenerative spondylolisthesis) using laminectomy with or without arthrodesis (i.e., fusion) procedures.
  3. Participants will be English speaking due to the feasibility of employing study personnel to deliver and assess the study intervention.

Exclusion Criteria:

  1. Patients having microsurgical techniques as the primary procedure, such as an isolated laminotomy or microdiscectomy will be excluded because individuals having these minimally invasive surgical techniques tend to have a less severe case of lumbar degeneration.
  2. Patients having surgery for spinal deformity as the primary indication or surgery secondary to pseudarthrosis, trauma, infection, or tumor
  3. Prior history of lumbar spine surgery
  4. Presence of back and/or lower extremity pain < 3 month
  5. History of neurological disorder, resulting in moderate to severe movement dysfunction
  6. Unable to provide stable address and access to a telephone indicating the inability to participate in the intervention.

Учебный план

В этом разделе представлена ​​подробная информация о плане исследования, в том числе о том, как планируется исследование и что оно измеряет.

Как устроено исследование?

Детали дизайна

  • Основная цель: Уход
  • Распределение: Рандомизированный
  • Интервенционная модель: Параллельное назначение
  • Маскировка: Двойной

Оружие и интервенции

Группа участников / Армия
Вмешательство/лечение
Другой: Usual postoperative care
Participants randomized to usual care group will receive postoperative care as determined by their treating surgeon.
Participants will receive postoperative care as determined by their treating surgeon. This includes lifting restrictions, advice to stay active, and oral analgesics as needed. Physical therapy referral will be at the discretion of the surgeon. However, physical therapy is not typically started until 12 weeks after surgery.
Экспериментальный: Usual postoperative care + Physical activity intervention
Participants randomized to the physical activity intervention group will receive usual postoperative care as determined by their treating surgeon and novel physical activity intervention.
Participants will receive postoperative care as determined by their treating surgeon. This includes lifting restrictions, advice to stay active, and oral analgesics as needed. Physical therapy referral will be at the discretion of the surgeon. However, physical therapy is not typically started until 12 weeks after surgery.
Participants will 1) receive Fitbit, 2) be enrolled in a secure electronic platform to access Fitbit data, 3) receive 8-week remote counseling by a physical therapist that will include motivational interviewing and creating SMART goals (1 session per week) through a web-based teleconference platform, and 4) receive usual postoperative care directed by their surgeon. The first session will be 45 minutes and sessions 2-8 will be 30 minutes each. During the sessions, participant's confidence in meeting daily step goals will be assessed using a 0-10 scale. If self-reported confidence to meet their goal is <8, the physical therapist will help participants modify their goal using techniques such as problem-solving, positive statements and affirmations. Progression will be made only if daily steps goals are met for at least 4 out of 7 days a week. If this weekly step goal is not met, a physical therapist will help the participant identify solutions for realistic progression.

Что измеряет исследование?

Первичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Recruitment rate
Временное ограничение: At 2 weeks after spine surgery
Proportion of potential eligible participants successfully contacted who agreed to participate and randomized.
At 2 weeks after spine surgery
Adherence rate to study protocol at 3 months after spine surgery
Временное ограничение: From 2 weeks to 3-months after spine surgery
Proportion of participants who will complete the assessment at 2 weeks and 3 months after spine surgery.
From 2 weeks to 3-months after spine surgery
Adherence rate to study protocol at 6 months after spine surgery
Временное ограничение: From 2 weeks to 6-months after spine surgery
Proportion of participants who will complete the assessment at 2 weeks and 6 months after spine surgery.
From 2 weeks to 6-months after spine surgery
Adherence to physical activity intervention
Временное ограничение: From 2-weeks to 3-months after spine surgery

Number of weekly step goals completed by participant, which will be examined via Fitabase.

In addition, number of weekly Zoom calls completed with the physical therapist will be recorded

From 2-weeks to 3-months after spine surgery
Number of adverse events
Временное ограничение: From 2-weeks to 3-months after spine surgery
During the intervention phase, the study physical therapist will document adverse events related to walking to assess safety.
From 2-weeks to 3-months after spine surgery

Вторичные показатели результатов

Мера результата
Мера Описание
Временное ограничение
Oswestry Disability Index
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A 10-item questionnaire will be used to measure condition-specific disability that assesses the impact of lumbar spinal disorders on activities of daily living. Each item is measured from 0 to 5, representing low and high disability, respectively. Total score ranges from 0 to 50.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
PROMIS Physical Function
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
PROMIS Physical Function 4-item short form will be used to measure physical function. Each item is measured from 1 to 5, representing low to high physical function, respectively. Total score ranges from 4 to 20.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Numeric rating scale for back pain
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Numeric rating scale will be used to assess the pain intensity using the single-item for back, which is scored from 0 to 10, representing no pain and the worst pain, respectively.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Numeric rating scale for leg pain
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Numeric rating scale will be used to assess the pain intensity using the single-item for leg, which is scored from 0 to 10, representing no pain and the worst pain, respectively.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Intensity of physical activity
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A research-grade triaxial accelerometer (Actigraph GT3x) will be used to quantify time spent in different intensities of physical activity per day.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Physical activity volume
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A research-grade triaxial accelerometer (Actigraph GT3x) will be used to quantify total number of steps per day.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Depressive symptoms
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
PROMIS Depression 4 item short form will be used to measure depressive symtpoms. Each item is measured from 1 to 5, representing low to high depressive symptoms. Total score ranges from 4 to 20.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
Fear of movement
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A 13-item Tampa Scale for Kinesiophobia will be used to measure fear of movement. It has two sub-scales (activity avoidance and fear of pain) and the total score ranges from 13 to 52 with higher scores indicating greater fear of movement.
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery

Другие показатели результатов

Мера результата
Мера Описание
Временное ограничение
Opioid Use
Временное ограничение: Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery
A single-item Patient-reported opioid use questionnaire (yes vs. no).
Preoperative, and at 2 weeks (baseline), 3-, and 6-months after spine surgery

Соавторы и исследователи

Здесь вы найдете людей и организации, участвующие в этом исследовании.

Следователи

  • Директор по исследованиям: Kristin R Archer, DPT, PhD, Vanderbilt University Medical Center

Публикации и полезные ссылки

Лицо, ответственное за внесение сведений об исследовании, добровольно предоставляет эти публикации. Это может быть что угодно, связанное с исследованием.

Даты записи исследования

Эти даты отслеживают ход отправки отчетов об исследованиях и сводных результатов на сайт ClinicalTrials.gov. Записи исследований и сообщаемые результаты проверяются Национальной медицинской библиотекой (NLM), чтобы убедиться, что они соответствуют определенным стандартам контроля качества, прежде чем публиковать их на общедоступном веб-сайте.

Изучение основных дат

Начало исследования (Действительный)

7 октября 2020 г.

Первичное завершение (Действительный)

24 сентября 2021 г.

Завершение исследования (Действительный)

1 декабря 2021 г.

Даты регистрации исследования

Первый отправленный

9 октября 2020 г.

Впервые представлено, что соответствует критериям контроля качества

9 октября 2020 г.

Первый опубликованный (Действительный)

19 октября 2020 г.

Обновления учебных записей

Последнее опубликованное обновление (Действительный)

31 марта 2022 г.

Последнее отправленное обновление, отвечающее критериям контроля качества

30 марта 2022 г.

Последняя проверка

1 марта 2022 г.

Дополнительная информация

Термины, связанные с этим исследованием

Планирование данных отдельных участников (IPD)

Планируете делиться данными об отдельных участниках (IPD)?

Нет

Описание плана IPD

Given the pilot nature of the trial, the IPD will not be available to other researchers.

Информация о лекарствах и устройствах, исследовательские документы

Изучает лекарственный продукт, регулируемый FDA США.

Нет

Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.

Нет

Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .

Клинические исследования Usual care

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