MS Spasticity: Take Control (STC) for ambulatory adults: protocol for a randomized controlled trial.
MS Spasticity: Take Control (STC) for ambulatory adults: protocol for a randomized controlled trial.
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DOI：
10.1186/s12883-020-01902-1
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发表时间：
2020-10-07
期刊：
影响因子：
2.6
通讯作者：
Cameron MH
中科院分区：
文献类型：
--
作者：
Hugos CL;Cameron MH
痉挛影响60-80%的多发性硬化症（MS）患者，影响活动，参与和生活质量。我们开发了一个团体提供的痉挛自我管理计划，“MS痉挛：采取控制”（STC），与DVD的教育和下肢伸展。STC基于国际指南和系统评价的建议，并强调了拉伸运动的重要性。我们的试点试验（n = 38）比较了STC，然后是一个月的家庭拉伸实践，以无指导地使用国家MS协会（NMSS）的小册子，标题为“MS患者的拉伸：图解手册”，也随后是一个月的家庭拉伸实践。在这项初步试验中，STC对痉挛（MS痉挛量表-88）和其他自我报告和身体表现指标的影响显示出有希望的效果。我们现在将进行一项完全有效的试验，以评估STC与一种随机递送的对照方案相比对MS和自我报告的下肢痉挛患者痉挛的影响和严重程度的影响。220名患有MS自我报告的痉挛干扰日常活动的非卧床成人将使用与试点研究相同的NMSS手册，以1：1的比例随机分配至STC或对照组，两种方案均由经过培训的促进者分组提供。结果是MS痉挛量表-88痉挛的影响，痉挛的严重程度与痉挛的数字评定量表，其他自我报告问卷，和身体性能步行措施在基线和1个月和6个月后的干预。伸展是痉挛管理的基石。伸展运动每天都需要时间和精力。不幸的是，除了常规拉伸应该有助于防止痉挛状态下肌肉缩短和挛缩的逻辑预期之外，关于拉伸对MS或任何其他疾病患者痉挛状态的影响的数据很少。我们的STC试点试验表明，教育和伸展有助于减少痉挛的影响。为了明确确定这种教育和教学计划与日常拉伸练习是否有效，需要一个完全有效的试验，具有可比的对照干预和没有创建STC的促进者。在这里，我们报告本试验的方案。NCT 03166930 2017年5月25日。
Spasticity affects 60–80% of people with multiple sclerosis (MS), impacting activity, participation and quality of life. We developed the group delivered spasticity self-management program, “MS Spasticity: Take Control” (STC), with DVDs for education and lower extremity stretching. STC is based on an international guideline and recommendations from systematic reviews and emphasizes the importance of stretching with specific stretching exercises. Our pilot trial (n = 38) compared STC followed by one month of home stretching practice to unguided use of the National MS Society (NMSS) brochure titled “Stretching for People with MS: An Illustrated Manual,” also followed by one month of home stretching practice. In this pilot trial, STC showed promising effects on the impact of spasticity (MS Spasticity Scale-88) and other self-report and physical performance measures. We will now carry out a fully-powered trial to evaluate the effect of STC compared to a comparably delivered control program on the impact and severity of spasticity in people with MS and self-reported lower extremity spasticity. Two hundred-twenty ambulatory adults with MS self-reported spasticity interfering with daily activities will be randomized 1:1 to STC or control, using the same NMSS brochure used in the pilot study, with both programs delivered in groups with trained facilitators. Outcomes are the impact of spasticity with the MS Spasticity Scale-88, the severity of spasticity with the Numeric Rating Scale for Spasticity, other self-report questionnaires, and physical performance walking measures at baseline and one and 6 months after the interventions. Stretching is the cornerstone of spasticity management. Stretching takes time and energy every day. Unfortunately, beyond the logical expectation that regular stretching should help prevent muscle shortening and contractures in the presence of spasticity, there is very little data on the effects of stretching on spasticity in people with MS or any other condition. Our pilot trial of STC suggested that education and stretching help reduce the impact of spasticity. To definitively determine if this education and instructional program with daily stretching practice is effective, a fully powered trial with a comparable control intervention and facilitators who did not create STC is needed. Here we report the protocol for this trial. NCT03166930 May 25, 2017.
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3.6
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