在熟练护理设施中推进老年人康复范式:一种有效性-实施混合型1型临床试验协议
Emma H Beisheim-Ryan1,2, Katie A Butera1,3, Lauren A Hinrichs1,2
1Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA.
Physical therapy
|May 31, 2023
概括
高强度抵抗训练 (i-STRONGER) 显示出在熟练护理设施中改善身体功能的前景. 本试验将i-STRONGER与常规护理进行比较,以评估其有效性和在有复杂医疗需求的老年人中实施.
科学领域:
- 老年学是一门学科.
- 康复医学 康复医学 康复医学
- 临床试验 临床试验
背景情况:
- 在医疗复杂的老年人中,居住在熟练护理设施 (SNFs) 中,与医院相关的降低条件是常见的.
- 目前的SNF康复经常使用低强度干预措施,不足以显著加强肌肉和功能增长.
- 一项针对高强度抵抗训练 (老年护理院居民的强化治疗康复;i-STRONGER) 的试点研究表明,SNF患者的身体功能得到改善.
研究的目的:
- 为了比较实施i-STRONGER高强度抵抗训练计划的SNF和提供常规护理的SNF之间的患者结果.
- 评估i-STRONGER的有效性和实施,使用有效性-实施混合设计.
- 评估影响i-STRONGER在SNF环境中成功采用和可持续性的因素.
主要方法:
- 一个集群随机试验,涉及32个SNF (16个i-STRONGER,16个常规护理).
- 在i-STRONGER站点的临床医生将接受培训,以提供该计划作为标准护理.
- 身体表现的变化 (例如步行速度,短期身体表现电池) 将在12个月内从入院到退院的时间内进行测量.
- 覆盖范围,有效性,采用,实施和维护 (RE-AIM) 框架将指导评估,包括临床医生调查和重点小组.
主要成果:
- 通过比较i-STRONGER和常规护理组之间的身体功能变化来确定有效性.
- 将量化实施指标,包括覆盖范围,采用率,实施忠诚度和维护持续性.
- 来自调查和重点小组的定性数据将确定i-STRONGER实施的促进者和障碍.
结论:
- 这项试验有可能为SNF的康复建立一个新的标准,改善老年人的功能独立性.
- 调查结果将为全国范围内的基于证据的康复实践的更广泛实施提供信息.
- 了解实施促进者和障碍者对于优化未来SNF的康复干预至关重要.
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