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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04904497
Other study ID # Reh-Covid-19
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date April 1, 2021
Est. completion date December 31, 2021

Study information

Verified date May 2021
Source University of Chile
Contact Eduardo Tobar, MD
Phone +56229786009
Email etobar@hcuch.cl
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study evaluates the feasibility of an early occupational therapy (OT) protocol in critical adult patients requiring mechanical ventilation with Covid-19.


Description:

A randomized clinical trial with an experimental-control will be implemented, considering the prospective multicenter group, with parallel groups, in a 1:1 ratio, in 3 Chilean hospitals. A control group will has a standard analgesia, sedation, delirium and mobilization (ASDM) measures or an intervention group will have early OT plus ASDM. The intervention group will receive 20 OT sessions, which considers a predefined protocol of actions according to the patient's condition


Recruitment information / eligibility

Status Recruiting
Enrollment 60
Est. completion date December 31, 2021
Est. primary completion date December 1, 2021
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Age equal to or greater than 18 years. - Need for hospitalization in ICU. - At least 12 h of invasive mechanical ventilation - Informed consent signed by legal representative and / or patient. - Positive covid-19 diagnosis Exclusion Criteria: - Known cognitive impairment before admission with short IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly) Scores> 3.3 were excluded. - Previous functional impairment, FAQ (Functional Activities Questionnaire) defined as > 6 points. - Severe communication disorder and cultural limitation of language (language different from Spanish) - Patient with limited therapeutic proportionality. - Neurocritical patients (moderate-severe Traumatic Brain Injury / stroke of some kind / among others) - Spinal injury or unstable fractures that limit mobilization

Study Design


Intervention

Behavioral:
Early Occupational Therapy
Occupational therapists will implement the following activities: Polysensory stimulation: external stimulation for increasing the level of alertness. It will be implemented with SAS 2 one session each 24 h. Cognitive stimulation: bundle of exercises for activating mental functions, i.e: alertness, visual perception, memory, calculus, problem solving, praxis, language. Patients with SAS 3, 4 and 5. In SAS <2, 6> environmental orientation will be considered Basic activities of daily living (BADLs): promotion of independence that initially practice hygiene, personal grooming. Patients with SAS 3, 4 and 5 Motor function Stimulation: exercises to keep the patient's upper extremities active and functional. Patients with SAS with 3,4 and 5. Patients with SAS 1 and 2 will use adaptations to prevent edema and bedsores on vulnerable body areas Education: trained family members and health staff about the intervention process

Locations

Country Name City State
Chile University of Chile Santiago Metropolitana

Sponsors (3)

Lead Sponsor Collaborator
University of Chile Hospital Base Valdivia, Hospital Santiago Oriente - Dr. Luis Tisné Brousse

Country where clinical trial is conducted

Chile, 

Outcome

Type Measure Description Time frame Safety issue
Primary Functional independence at hospital discharge The FIM (Functional independence measure) instrument will be applied by evaluator team. This scale shows that higher score is better, which will be compared between control and experimental group Day 28 (+/- 3 days) from beginning of mechanical ventilation
Secondary Delirium-free days CAM-ICU (Confusion Assessment Method Intensive Care Unit) instrument will be applied once a day by evaluatorhigher score is better, which will be compared between control and experimental group Defined as the number of days in the first 14 days with the CAM-ICU instrument negative and non-coma day.
Secondary Coma-free days SAS (Sedation-Agitation Scale) instrument will be applied once a day by evaluator. If SAS 1-2: coma day Defined as the number of days in the first 14 days with the SAS.
Secondary Delirium-coma free days SAS and CAM-ICU instruments will be applied once a day by evaluator. Every day without coma or delirium its an delirium-coma free day Defined as the number of days in the first 14 days with the SAS and CAM-ICU
Secondary Functional independence at hospital discharge The FIM (Functional independence measure) instrument will be applied by evaluator team. This scale shows that higher score is better, which will be compared between control and experimental group Day 90 (+/- 7 days) from beginning of mechanical ventilation
Secondary Cognitive status of patients MoCA (Montreal Cognitive Assessment) instrument (cognitive status).This scale shows that higher score is better, which will be compared between control and experimental group Day 28 (+/- 3 days) from beginning of mechanical ventilation and day 90 (+/- 7 days)after hospital discharge
Secondary Motor status of patients Grip strength (motor status) with dynamometer will be applied by evaluator. This scale shows that higher score is better, which will be compared between control and experimental group Day 28 (+/- 3 days) from beginning of mechanical ventilation
Secondary Quality of life of patients EQ-5D-5L (Euro Qol 5 dimensions 5 level) will be applied by evaluator. It will be considered a cut-off point in the Chilean population Day 90 (+/- 7 days) from beginning of mechanical ventilation
Secondary Characterization of occupational therapy interventions Number of sessions implemented, number of sessions suspended Days of patient hospitalization
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