Extended nursing for the recovery of urinary functions and quality of life after robot-assisted laparoscopic radical prostatectomy: a randomized controlled trial

BACKGROUND Prostate cancer has increased in incidence worldwide and is the leading cause of cancer death in 24 countries. The most common treatment is radical prostatectomy. However, surgery is associated with postoperative complications such as urinary incontinence and sexual dysfunction, causing decreased quality of life. If survivors are encouraged to be more active in self-care management, the symptom burden may decrease and quality of life may improve. An electronic health (eHealth) intervention based on motivational behavioral theory has been developed for this purpose. OBJECTIVE This study aimed to compare the effectiveness of standard care in combination with a tailored eHealth and mobile health self-management support system, electronic Patient Activation in Treatment at Home (ePATH), with standard care of adverse effects of prostate cancer treatment (urinary incontinence and sexual functioning) in men undergoing radical prostatectomy. The secondary aim was to test the effect on patient activaftion, motivation, overall well-being, and health literacy over time in and between groups. METHODS A pragmatic multicenter, block-randomized controlled trial with 2 study arms, standard care (control) and eHealth-assisted standard care (intervention), for patients undergoing radical prostatectomy. For 80% power, a sample of 242 men will need to be recruited. RESULTS Recruitment started in January 2018 and is expected to be completed by August 2019. Data collection will be completed in August 2020. The first cross-sectional results from this trial are anticipated to be published in January 2020. CONCLUSIONS With the increasing number of prostate cancer survivors, attention should be paid to rehabilitation, psychosocial care, and support for endurance of self-care to reduce suffering from adverse treatment effects, poor quality of life, and depression because of postoperative complications. This project may increase knowledge of how patients can be supported to feel involved in their care and returning to as normal a life as possible. The anticipated effects of ePATH could improve health outcomes for individuals and facilitate follow-up for health care professionals. CLINICALTRIAL International Standard Randomised Controlled Trial Number: 18055968; http://www.isrctn.com/ISRCTN18055968 (Archived by WebCite at http://www.isrctn.com/ISRCTN18055968). INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11625

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Abstract T P125: The Effects of Robot-assisted Training With Electrical Stimulation on Health-related Conditions in Patients With Chronic Stroke: A Pilot Randomized Controlled Trial

Stroke ◽

10.1161/str.45.suppl_1.tp125 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Ching-yi Wu ◽

Pai-chuan Huang ◽

Fu-han Hsieh ◽

Man-chiao Hsiao ◽

Hsiao-wen Chen

Keyword(s):

Quality Of Life ◽

Randomized Controlled Trial ◽

Electrical Stimulation ◽

Daily Living ◽

Controlled Trial ◽

Chronic Stroke ◽

Robot Assisted ◽

Randomized Controlled ◽

Daily Function

Background: Robot-assisted therapy (RT) is an effective approach to promote upper extremity motor recovery in patients with stroke. Previous research showed that severely affected patients were less responsive to RT than those with mild to moderate motor severity. It’s necessary to develop a combined therapy which can expand the optimal treatment effect of RT to all kinds of stroke patients. Neuromuscular electrical stimulation (ES) could be used to supplement RT to improve movement awareness and output. Purpose: To compare the effects of RT with ES, dose-matched RT with placebo ES, and conventional rehabilitation (CR) on motor and daily function, and quality of life in patients with chronic stroke. Methods: This is a single-blind randomized controlled trial. There were 30 patients with chronic stroke who were randomly assigned to one of the three groups: (1) RT with neuromuscular ES (RT+ES); (2) RT with placebo ES (no stimulations into the electrodes); (3) CR. All participants engaged in 90 to 105 minutes of training in each session, 5 times a week for 4 weeks. Outcome measures were Action Research Arm Test (ARAT) for motor function, accelerometer data of 3-day active level in affected hand for daily function, and Stroke Impact Scale (SIS) for quality of life. Analysis of covariance was used to compare the treatment effects among groups. Results: Significant between-group differences favoring the RT+ES group were shown on the grip subtest of ARAT (η2=.614, p <.05,) and the activity of accelerometer (η2=.260, p <.05) while a non-significant trend but large effect favoring RT+ES was observed on total score of ARAT (η2=.192, p=.411). A group effect favoring CR group on activity of daily living subscale of SIS was revealed (η2=.286, p <.05). There were no statistically significant differences on other outcome measures. Conclusions: Providing four weeks of RT+ES during chronic stroke appears to produce further improvements on hand grip and active level of affected hand in daily living than providing CR alone. Adding ES to RT could provide additional effect, given that active level of affected hand did not improved in the placebo group. Future study may incorporate more task-oriented practice into RT+ES treatment program to enhance treatment effects on life quality.

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