Pressure Ulcer Prevention Study in SCI

NCT ID: NCT01999816

Last Updated: 2016-10-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

170 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-09-30

Study Completion Date

2015-09-30

Brief Summary

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The purpose of this study is to conduct a randomized controlled trial of a lifestyle redesign intervention's ability to (1)reduce the incidence of medically serious pressure ulcers and associated surgeries in adults with spinal cord injury, and (2)assess the intervention's cost-effectiveness and potential cost savings and its effects on participants' quality of life.

Detailed Description

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Medically serious pressure ulcers are a common complication of spinal cord injury (SCI), and are associated with high treatment costs and reduced quality of life. This study will examine the efficacy and cost-effectiveness of a promising lifestyle-based intervention designed to reduce the incidence of pressure ulcers among culturally diverse, community dwelling adults with SCI who have had serious pressure ulcers.

The intervention being tested, termed lifestyle redesign (LR), is based on prior SCI literature as well as on the results of a qualitative pilot study undertaken by our study group. This intervention targets several psychosocial mediating variables that have been shown to be important in prevention of pressure ulcers in daily living contexts. Participants assigned to the LR condition receive individualized in-home sessions, personal phone calls, and incident-based contacts for a 12-month period, followed by 12 months of no intervention. Participants in the control condition do not receive any study-based intervention, but (along with the LR group) have continuing access to the standard options for prevention and treatment that are available through Rancho Los Amigos National Rehabilitation Center.

In addition to identifying a pressure ulcer prevention strategy, the planned research will lead to the development of testable theoretical models of the intervening process mechanisms that link the intervention to pressure ulcer reduction.

Conditions

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Spinal Cord Injuries

Keywords

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pressure ulcer lifestyle redesign spinal cord injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Lifestyle Redesign

Occupational therapist led lifestyle redesign program to prevent pressure ulcers

Group Type EXPERIMENTAL

Lifestyle Redesign

Intervention Type BEHAVIORAL

Individualized program for lifestyle redesign aimed at decreasing the risk of medically serious pressure ulcers led by licensed occupational therapists trained in the implementation of the lifestyle redesign program

Control

Usual care

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Lifestyle Redesign

Individualized program for lifestyle redesign aimed at decreasing the risk of medically serious pressure ulcers led by licensed occupational therapists trained in the implementation of the lifestyle redesign program

Intervention Type BEHAVIORAL

Other Intervention Names

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Occupational therapy

Eligibility Criteria

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Inclusion Criteria

* Spinal cord injury (paraplegia or tetraplegia)
* Non-ambulatory
* Able to undergo intervention and testing in English or Spanish
* At least 6 months post-injury
* History of at least one serious (Stage 3 or 4) pressure ulcer in the past 5 years
* Cognitively intact
* Personally expressed willingness to undertake recommended lifestyle changes for ulcer prevention.
* Can be reached by telephone.
* Reside in or within 100 miles of Rancho Los Amigos National Rehabilitation Center (Downey, CA) with no plans to relocate beyond this area.
* Agreement to participate and completion of consent form.

Exclusion Criteria

* Present serious stage 4 pressure ulcer
* Participation in our preliminary research studies
* Participating in the neuromuscular stimulation study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

University of Southern California

OTHER

Sponsor Role lead

Responsible Party

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Florence Clark

Associate Dean, Chair, and Professor Occupational Science and Occupational Therapy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Florence Clark, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Southern California

Salah Rubayi, MD

Role: PRINCIPAL_INVESTIGATOR

Rancho Los Amigos National Rehabilitation Center

Locations

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Rancho Los Amigos National Rehabilitation Center (RLANRC)

Downey, California, United States

Site Status

University of Southern California

Los Angeles, California, United States

Site Status

Countries

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United States

References

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Pyatak EA, Blanche EI, Garber SL, Diaz J, Blanchard J, Florindez L, Clark FA. Conducting intervention research among underserved populations: lessons learned and recommendations for researchers. Arch Phys Med Rehabil. 2013 Jun;94(6):1190-8. doi: 10.1016/j.apmr.2012.12.009. Epub 2012 Dec 21.

Reference Type BACKGROUND
PMID: 23262157 (View on PubMed)

Blanche EI, Fogelberg D, Diaz J, Carlson M, Clark F. Manualization of occupational therapy interventions: illustrations from the pressure ulcer prevention research program. Am J Occup Ther. 2011 Nov-Dec;65(6):711-9. doi: 10.5014/ajot.2011.001172.

Reference Type BACKGROUND
PMID: 22214116 (View on PubMed)

Vaishampayan A, Clark F, Carlson M, Blanche EI. Preventing pressure ulcers in people with spinal cord injury: targeting risky life circumstances through community-based interventions. Adv Skin Wound Care. 2011 Jun;24(6):275-84; quiz 285-6. doi: 10.1097/01.ASW.0000398663.66530.46.

Reference Type BACKGROUND
PMID: 21586911 (View on PubMed)

Fogelberg D, Atkins M, Blanche EI, Carlson M, Clark F. Decisions and Dilemmas in Everyday Life: Daily Use of Wheelchairs by Individuals with Spinal Cord Injury and the Impact on Pressure Ulcer Risk. Top Spinal Cord Inj Rehabil. 2009 Fall;15(2):16-32. doi: 10.1310/sci1502-16.

Reference Type BACKGROUND
PMID: 21603085 (View on PubMed)

Clark F, Pyatak EA, Carlson M, Blanche EI, Vigen C, Hay J, Mallinson T, Blanchard J, Unger JB, Garber SL, Diaz J, Florindez LI, Atkins M, Rubayi S, Azen SP; PUPS Study Group. Implementing trials of complex interventions in community settings: the USC-Rancho Los Amigos pressure ulcer prevention study (PUPS). Clin Trials. 2014 Apr;11(2):218-29. doi: 10.1177/1740774514521904. Epub 2014 Feb 26.

Reference Type BACKGROUND
PMID: 24577972 (View on PubMed)

Blanchard J, Vigen C, Mallinson T, Carlson M, Garber SL, Bates-Jensen B. Pressure Injury Data Reconciliation in a Randomized Controlled Trial. Arch Phys Med Rehabil. 2023 Nov;104(11):1833-1839. doi: 10.1016/j.apmr.2023.04.009. Epub 2023 Apr 28.

Reference Type DERIVED
PMID: 37121533 (View on PubMed)

Carlson M, Vigen CLP, Rubayi S, Blanche EI, Blanchard J, Atkins M, Bates-Jensen B, Garber SL, Pyatak EA, Diaz J, Florindez LI, Hay JW, Mallinson T, Unger JB, Azen SP, Scott M, Cogan A, Clark F. Lifestyle intervention for adults with spinal cord injury: Results of the USC-RLANRC Pressure Ulcer Prevention Study. J Spinal Cord Med. 2019 Jan;42(1):2-19. doi: 10.1080/10790268.2017.1313931. Epub 2017 Apr 17.

Reference Type DERIVED
PMID: 28414254 (View on PubMed)

Other Identifiers

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R01HD056267

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HS-06-00064

Identifier Type: -

Identifier Source: org_study_id