钝性胸壁创伤的耳部锻炼：多中心平行随机对照试验（ELECT2 试验）。

IF 2.2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-05-01 DOI:10.1016/j.injury.2024.112075

Ceri Battle , Timothy Driscoll , Deborah Fitzsimmons , Shaun Harris , Fiona Lecky , Claire O'Neill , Alan Watkins , Jane Barnett , Susan Davies , Hayley Anne Hutchings

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引用次数: 0

摘要

简介本试验的目的是研究与普通护理相比，早期胸廓和肩部锻炼对钝性胸壁外伤患者慢性疼痛和与健康相关的生活质量的影响：一项多中心、平行、随机对照试验，将因胸壁钝挫伤住院的成年患者分配到对照组或干预组。干预措施是一项锻炼计划，包括四项简单的胸廓和肩腰部锻炼，为期一周。结果测量包括使用简易疼痛量表测量慢性疼痛的发生率和严重程度、使用 EQ-5D-5 L 测量与健康相关的生活质量以及在初次就诊时和受伤后三个月测量成本效益：结果：共招募了 360 名参与者。参与者的平均年龄为 63.6 岁（标准差（SD）：17.9 岁），其中 213 人（59.8%）为男性。在失去随访后，三个月的调查回复率为 73.0%（251/344 名参与者）。对受伤后三个月的慢性疼痛患病率进行的主要分析发现，干预组和对照组之间没有显著的统计学差异，对照组的患病率较低（干预组：35/126（27.8%），对照组：25/126（27.8%））：干预组：35/126（27.8%），对照组：20/117（17.1%）；调整后的几率比 1.862；95 % CI：0.892 至 3.893，p = 0.098）。干预组和对照组在受伤后三个月的疼痛严重程度（干预组平均值（标清）：2.15 (2.49)，对照组：1.81 (2.10)；调整后差异为 0.196，95 % CI：0.340 至 0.731；p = 0.473）或与健康相关的生活质量（干预组平均值（标清）：0.715 (0.291)，对照组：0.704 (0.265)；调整后差异为 0.030；95 % CI：0.340 至 0.731；p = 0.473）方面没有统计学意义上的差异：0.030; 95 % CI:0.033 to 0.094; p = 0.350）。健康经济分析发现，与普通护理相比，干预的相关费用更高：这项试验的结果并不支持针对钝性胸壁创伤患者的 "一刀切 "式简单早期锻炼计划。未来的研究应考虑由患者在受伤后至少一周开始的个性化锻炼计划的影响。

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EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial)

Introduction

The aim of this trial was to investigate the impact of early thoracic and shoulder girdle exercises on chronic pain and Health-Related Quality of Life in patients with blunt chest wall trauma, when compared to normal care.

Methods

A multi-centre, parallel, randomised controlled trial, in which adult patients presenting to hospital with blunt chest wall trauma were allocated to either control or intervention group. The intervention was an exercise programme consisting of four simple thoracic and shoulder girdle exercises, completed for one week. Outcomes measures included prevalence and severity of chronic pain using the Brief Pain Inventory, health-related quality of life using EQ-5D-5 L, and cost effectiveness, measured at initial presentation and three months post-injury.

Results

360 participants were recruited. Participants’ mean age was 63.6 years (standard deviation (SD): 17.9 years) and 213 (59.8 %) were men. After loss-to-follow-up, the survey response rate at three months was 73.0 % (251/344 participants). The primary analysis, for chronic pain prevalence at three months post-injury, found no statistically significant differences between intervention and control groups, with lower rates in the control (intervention: 35/126 (27.8 %), control: 20/117 (17.1 %); adjusted odds ratio 1.862; 95 % CI: 0.892 to 3.893, p = 0.098). There were no statistically significant differences between intervention and control groups for pain severity at three months post-injury, (intervention mean (SD): 2.15 (2.49), control: 1.81 (2.10); adjusted difference 0.196, 95 % CI:0.340 to 0.731; p = 0.473); or Health-Related Quality of Life (intervention mean (SD): 0.715 (0.291), control: 0.704 (0.265); adjusted difference: 0.030; 95 % CI:0.033 to 0.094; p = 0.350). The health economic analysis found the intervention was associated with higher costs compared to normal care.

Conclusion

The results of this trial did not support a ‘one-size fits all’ simple, early exercise programme for patients with blunt chest wall trauma. Future research should consider the impact of a personalised exercise programme, commenced by the patient at least one week post-injury.

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来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.