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Effectiveness of Respiratory Physiotherapy in Children With Neuromuscular Disease

2016年5月30日 更新者:JJ JIMENEZ-REJANO、University of Seville

Effectiveness of a Protocol of Respiratory Physiotherapy for Improvement or Maintenance of Respiratory Function, and Incidence of Respiratory Infections in Children With Neuromuscular Diseases, Compared With no Approach by Respiratory Physiotherapy of Respiratory Difficulties: A Randomized Clinical Trial With Two Groups in Parallel With Blinded Evaluator.

The main objective of this study is to determine whether the Respiratory Physiotherapy allows improvement or maintenance of respiratory function in children with Neuromuscular Diseases, against respiratory deterioration that occurs in the group of subjects who did not receive this treatment. And to determine whether decreasing the number of respiratory infections and secondly the need for antibiotics and the number of emergency room visits and hospital admissions related to these.

研究概览

详细说明

Background:

Many authors have demonstrated the efficacy of Physiotherapy in Respiratory attending respiratory difficulties associated with different types of pathologies (Chronic Obstructive Pulmonary Disease, cystic fibrosis, tumors), however the investigators did not find studies with scientific evidence demonstrating the effectiveness of these programs in children with Neuromuscular Diseases (NMD), whose quality and life expectancy depends largely on the proper handling of Bronchial secretions and delay the deterioration of respiratory function.

The main objective of this study focuses on determining the effectiveness of physiotherapy for the treatment of respiratory breathing difficulties in children with NMD. Deducing other aspects such as the impact of this program on the number of visits to hospital emergencies department each year, hospital admissions and respiratory infections suffered by these children, and the need or not of antibiotics.

Material and method:

This research is an analytical, longitudinal, prospective, experimental, evaluator blinded study. It is controlled with two parallel groups, randomized clinical trial.

The sample consisted of children diagnosed with NMD. For the evolution of different variables spirometric test was used for variables related to the function respiratory, and a tracking sheet designed by the researchers to collect the number hospital emergency visits each year, as well as hospital admissions, respiratory infections and need of antibiotics. These assessments were made before and after the start of program and during every four months.

Patients were randomized to control or experimental group, no apply any Respiratory Physical Therapy treatment in subjects in the first group and performing a Respiratory Physical Therapy program in the second. This program was carried out once in week by the physiotherapist, and four times weekly at home, by family, during one year.

研究类型

介入性

注册 (实际的)

21

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Sevilla、西班牙、41009
        • Grupo de Investigación Área de Fisioterapia CTS 305 - Universidad de Sevilla

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

3年 至 18年 (孩子、成人)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Being diagnosed with a Disease of the Neuromuscular junction, according to International Classification of Diseases 10.
  • Be aged between 3 and 18 years.

Exclusion Criteria:

  • Being unable to perform spirometry, for physical or psychological difficulties.
  • Be involved in another program Respiratory Physiotherapy.
  • Present some kind of associated pathology (such as broken ribs, state epilepticus ...) in which it is contraindicated any maneuvers of the respiratory therapy protocol designed.
  • If researchers are informed of the existence of a serious illness of the father / mother / tutor that preclude to carrying out the program of respiratory Physiotherapy at home.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:单身的

武器和干预

参与者组/臂
干预/治疗
实验性的:GROUP RECEIVING RESPIRATORY PHYSIOTHERAPY
Respiratory Physiotherapy sessions were held once a week by the physiotherapist, and four times more for the family at home, for one year. The sessions have a duration between 30 and 45 minutes, varying according to the level of patient cooperation. The exercise program should be repeated in three cycles, although younger children took longer than older in performing them.

The protocol designed was composed of the following exercises:

  • supine position: inhalation and exhalation with abdominal and thoracic pressures. 5 times
  • lateral decubitus, with incentive spirometer lung inflation are made on right/left sides. 3 sets on each side
  • sitting position, with the body leaning slightly forward, head and shoulders bent inwardly directed. It inspire called for 3 times, sent off in air through the mouth, after that the child was coughing
  • diaphragmatic breathing in a sitting position: after a slow exhalation requested, child should steam a mirror with his mouth slightly open. 3 replications
  • in a sitting position, with help of an ambu bag, we made inflations. Repeated 3 times
  • exercises of upper member coupled to respiratory rhythm: shoulder flexion and extension was carried out during the inspiratory phase and the extension and adduction of them during expiration. 3 times
实验性的:GROUP RECEIVING THEIR USUAL THERAPIES
This group received no approach of their respiratory difficulties by Physiotherapy. Only continued their usual therapies.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Change From Baseline Vital Capacity at One Year.
大体时间:At baseline and at 1 year
Change from Baseline vital capacity at one year evaluated by spirometer.
At baseline and at 1 year

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2012年6月1日

初级完成 (实际的)

2014年6月1日

研究完成 (实际的)

2014年12月1日

研究注册日期

首次提交

2016年4月5日

首先提交符合 QC 标准的

2016年4月14日

首次发布 (估计)

2016年4月19日

研究记录更新

最后更新发布 (估计)

2016年7月11日

上次提交的符合 QC 标准的更新

2016年5月30日

最后验证

2016年5月1日

更多信息

与本研究相关的术语

其他相关的 MeSH 术语

其他研究编号

  • USeville-JJIMENEZ-REJANO

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