远程治疗支持培训对护生的影响
与对照组相比,远程治疗引导的锻炼计划是否可以改善患有背痛和颈痛的护生的疼痛强度、残疾和生活质量?
设计:本研究是一项具有两组平行组的试点随机对照试验(RCT),这是确定治疗效果的金标准。 流程图(见附录)概述了研究设计。 参与者按年龄随机分为干预组和等候组。
干预措施是每周 4 次、每次 20 分钟的远程治疗支持的肌肉训练。
干预持续时间总共为六周。 首先收集颈部残疾指数 (NDI)、Oswestry 残疾指数 (ODI)、Short-Form-36 (SF36) 和数字评定量表 (NRS)。 六周后,相同的结果衡量标准和全球评级量表
研究概览
详细说明
兴趣干预:
如前所述,感兴趣的协议是由在线会议(远程治疗)支持的锻炼计划。 与脊柱各个区域作为一个功能单元相关的锻炼程序是根据基于证据的结论创建的,特别是考虑到肌肉链活动和适当的负荷参数
远程治疗锻炼计划由拥有三十年治疗肌肉骨骼疾病患者经验的物理治疗师通过 ZOOM 每周进行一次。 还鼓励参与者每周在家进行三次锻炼计划,以便他们每周进行四次锻炼,持续六周。 每节课的持续时间大约为二十分钟。 共有六个练习,三组,每组三十秒内大约重复十五次。 练习描述以及练习选择的理由”)。 治疗组的受试者还将收到视频、节奏和音乐文件以及书面材料,以帮助他们遵循家里的锻炼程序,以及橡皮筋。 受试者还被要求写日记,记录他们对家庭治疗方案的遵守情况。
在干预开始时和第七周后,每个参与者都会接受患者报告结果 (PROM) 评估,即 ODI、NDI 和 SF36 短量表以及 NRS 11 点量表。 干预结束时,参与者将使用全球评级量表接受采访。 以下是这些仪器的简要说明。
控制组:
对照组的受试者将被建议维持日常生活,但将被要求避免其他治疗,例如物理治疗(PT)、整骨疗法、脊椎按摩疗法以及其他治疗性运动(TE)疗法,以避免在治疗期间的共同干预。 6周的学习期。 然而,所有组中的研究参与者服用止痛药超过 3 个月,例如非甾体抗炎镇痛药 (NSAID),将被允许并记录(采取务实的方法)。 每次就诊时,PT 都会监控并记录药物的任何变化。
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Niedersachsen
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Osnabrück、Niedersachsen、德国、49078
- Diakonie Pflege Schule
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参与标准
资格标准
适合学习的年龄
- 成人
接受健康志愿者
描述
纳入标准:
- 18 至 60 岁之间的护理学生,任何性别
- 自我报告在过去六个月内有慢性颈部和背部疼痛(根据国际疼痛研究协会 (IASP) 的描述,超过三个月)。
- 说并理解德语
排除标准:
去年接受过脊柱、颈椎、胸椎或腰椎手术
- 目前正在病假中
- 急性背痛
- 严重的神经损伤或症状
- 肌肉骨骼系统的急性创伤
- 肾功能不全、透析
- 手部抓握能力严重受损,例如类风湿性关节炎。
- 严重的心血管疾病,例如 心脏衰竭
- 严重呼吸系统疾病,例如慢性阻塞性肺疾病-COPD
- 眼球震颤
- 跌倒倾向/平衡障碍
- 乳胶过敏,因为橡皮筋可能是由乳胶制成的
- 缺乏站立能力,在没有人或物体帮助的情况下无法安全站立。
- 过去三个月内接受过脊柱特异性疼痛治疗药物治疗
学习计划
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:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:干涉
为期六周的肌肉训练计划,包括每周 3 次的 5 项练习,作为单独家庭作业的视频指导练习,以及每周一次由 Zoom 指导的相同练习。
该计划持续6周
|
由在线课程指导的锻炼计划。 受试者每周在家进行三次该锻炼计划,以便他们每周完成四次练习,持续六周。 一次会议的持续时间约为二十分钟。 有六个练习,三组,大约十五次重复。 治疗组的受试者还会收到教学视频。 受试者写日记,记录他们在家中遵守治疗方案的情况。 在干预开始时和第六周后,参与者使用 ODI、NDI、SF36-Short 和 NRS-11 量表进行评估。 最后,我们使用全球评级量表。 |
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其他:等候名单/控制干预/延迟远程治疗干预
6 周后,参与者有机会参加干预计划(见上文)
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对照组的受试者将被建议维持日常生活,但将被要求避免其他治疗,以避免在 6 周的研究期间进行共同干预。
然而,所有组的研究参与者服用止痛药如非甾体类抗炎镇痛药 (NSAID) 超过 3 个月是允许的,并将记录在案(采取务实的方法)。
每次就诊时,PT 都会监控并记录药物的任何变化。
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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 |
|---|---|---|
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NRS 疼痛数字评定量表
大体时间:基线 - 6 周
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疼痛数字评定量表 (NRS) 通常在 0 到 10 之间,其中 0 表示“无疼痛”,10 表示“可以想象到的最严重的疼痛”。数字尺度。
刻度是具有固定范围的有序数字刻度,表示测量值的极值
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基线 - 6 周
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颈部残疾指数 (NDI)
大体时间:基线-6周
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10 个问题,可能的答案范围从“没有疼痛”到“你能想象到的最严重的疼痛”,问题涉及疼痛强度、个人卫生、举重、阅读、头痛、注意力、工作、驾驶、睡眠以及最后一项休闲活动和娱乐。 评分: 轻微投诉0分,最严重投诉最高5分。 最高分50分。 分数除以可能的总分。 该值乘以 100% 即可得到分数。 o (当前限制:50)X 100% = NDI 得分 <=8% 轻度症状。 >40 有非常严重的症状 |
基线-6周
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奥斯威斯特伤残指数 (ODI)
大体时间:基线-6周
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背痛患者与疼痛相关的功能限制的程度。 10 个问题,每个问题有 6 个可能的答案:疼痛强度、自我护理、举重、行走、坐着或站立、睡眠、性生活、社交生活和旅行。 答案选项范围从“由于疼痛而没有限制”到“由于疼痛而对活动造成最大的限制”。 评估: 获得的分数 ( )/最高分数 点 (50) x100 = % 解释:0% = 无限制,100% = 最大。 限制。 |
基线-6周
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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简短形式:SF 36-生活质量
大体时间:基线 - 6 周
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SF 36-生活质量 SF-36 调查问卷(简称健康 36)是一份关于生活质量的调查问卷。 有关一般信息。 8 个不同维度 活力 - 身体功能 - 身体疼痛 - 一般健康认知 - 身体角色功能 - 情绪角色功能 - 社会角色功能 - 心理健康 为了进行评估,所有答案首先借助评估键转换为预定义的分数。 各健康维度所有问题的平均值 |
基线 - 6 周
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全球评级量表
大体时间:6周
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全球评级量表(GRS)被描述为一种有用的测量工具,旨在根据特定的单词维度评估一般水平的临床能力,测量工具以确定干预的效果。 我们在研究中使用该量表来评估患者因治疗或其他干预措施而经历的变化。 我们的受试者被要求使用全球评定量表(GRS)对颈部疼痛和腰痛(LBP)治疗后所经历的变化进行评分。 因此,本问卷仅用于最终测量。 与干预前相比,参与者现在对自己的健康状况进行评分。 值范围从 -7 到 7。 -7 表示“非常差”,0 表示“不变”,7 表示最大最佳值“非常好”。 |
6周
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合作者和调查者
出版物和有用的链接
一般刊物
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