Efficacy of Conventional Rehabilitation, Transcutaneous Electro Nerve Stimulation or Early Mobilization to Reverse the Acquired Weakness of the Intensive Care Unit: Single Blind Controlled Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 18
- 主要终点
- Sessions needs to revert ICUAW
研究概览
简要总结
Experimental study that has how to compare the efficacy between conventional rehabilitation, transcutaneous electrostimulation or early mobilization to reduce the time needed to reverse the muscle weakness evaluated by the muscle strength scale of the MRC in patients with a clinical diagnosis of intensive care unit acquired weakness in the (ICUAW).The ambit of realization is a medical-surgical ICU of a general acute hospital (26 beds). A randomized controlled, uni-centric design was used. The interventions are divided into three groups namely; group 1 (control group) receiving standard or usual rehabilitation (GR-STD); group 2 receives transcutaneous electrostimulation (GR-TEE) and group 3 that consists of an early mobilization protocol (GR-EM). The main outcome variable of the study is the time, in days and sessions of treatment, to reverse the ICUAW.
详细描述
Study hypothesis: the time to revert the intensive care unit acquired weakness is less when applying an early mobilization protocol or transcutaneous electro-nervous stimulation compared with the usual or standard rehabilitative treatment.
Ethical considerations: The research protocol was presented and approved by both the Ethics Committee and the Teaching and Research Committee of our institution. The informed consent of each subject included in the study was obtained.
Sample size and study power: a sample size was defined in 18 subjects (6 subjects per intervention group). The estimation of the sample was calculated for a one-way ANOVA where a minimum difference of 2 sessions was established between the treatments, assuming a standard deviation of 1.8 sessions, an alpha error of 5% and a power of 80%.
Statistical methods: the numerical variables will be presented as mean and standard deviation or median and interquartile range according to the presented distribution. The categorical variables will be presented by frequency and percentage.
For the comparison of continuous variables, Student's t test for independent samples or the Mann-Whitney U test will be used according to the presented distribution and for the categorical variables the Chi² test or the Fisher exact test will be used according to the conformation of the crossed table. The Shapiro-Wilk test will be used to evaluate whether the distribution presented by the numerical variables fits a normal distribution. Equality of variances was assessed by the Levene´s test.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
the person in charge of performing the statistical analysis was blind, by coding the interventions in the database.
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •subjects over 18 years of age,
- •admitted to the ICU who have received invasive mechanical ventilation for a period longer than 24 hours
- •clinical diagnosis of ICUAW (MRC-mss <48 measured over two consecutive days).
排除标准
- •subjects who presented a body mass index> 35 (kg/height x height)
- •presence of edema that prevents the realization of NMES at the time of diagnosis of ICUAW (assessed by the absence of visible contraction
- •pregnant women
- •subjects with pacemakers
- •subjects with injury of the central and / or peripheral nervous system (with motor sequelae)
- •previous neuromuscular disease
- •limitation of the movement of any extremity due to orthopedic or traumatological causes
- •presence of a previous cognitive disorder that impedes the understanding of rehabilitation interventions
- •a value of the index of Barthel less than 35 points at admission
- •subjets who refused to give informed consent.
结局指标
主要结局
Sessions needs to revert ICUAW
时间窗: 3 months
Number of sessions until reaching a value of the MRC-mss ≥ 48 points.
days needs to revert ICUAW
时间窗: 3 months
Number of days until reaching a value of the MRC-mss ≥ 48 points.
次要结局
未报告次要终点
研究者
Ladislao Diaz Ballve
Principal Investigator
Hospital Nacional Profesor Alejandro Posadas
