A Comprehensive and Structured Follow-Up for Persons With Multiple Sclerosis (CoreDISTparticipation) to Optimize Physical Functions, Health, and Employment: Protocol for a Prospective, Single-Blinded Randomized Controlled Trial and Health Economic Evaluation
Notice bibliographique
Résumé
BACKGROUND: Multiple sclerosis (MS) is a chronic neurological disease of the central nervous system, primarily affecting young adults. Common challenges in MS include fatigue, physical impairments, and cognitive impairments, associated with low levels of physical activity, unemployment, reduced health-related quality of life (HRQoL), and substantial personal and societal costs. Many leave the workforce or reduce hours even when disability is low and despite a desire to increase work hours if the job is adjusted to their needs. Existing services aiming to optimize physical functions and work participation only initiate retrospectively, and there is a lack of knowledge regarding the possible effect of more proactive services. OBJECTIVE: The objective of this study is to investigate the effects of a comprehensive multidisciplinary intervention, CoreDISTparticipation, delivered across health care levels (hospitals and municipalities) and sectors (health and employment/welfare), on barriers to work, physical activity, and physical functions; fatigue; and HRQoL for employed people with multiple sclerosis (pwMS) and to perform a health economic evaluation. METHODS: This prospective, single-blinded randomized controlled trial (RCT) will include 115 pwMS with Expanded Disability Status Scale (EDSS) scores of 0-4 randomly allocated to either a CoreDISTparticipation intervention group or usual care (control group). The CoreDISTparticipation intervention includes (1) information videos, hospital outpatient physiotherapist assessments, and meetings with employment consultants; (2) group-based physiotherapy in municipalities for 60 minutes over 6 weeks, one indoor CoreDIST balance session, one outdoor CoreDIST balance and high-intensity interval session, and tailored work follow-up; and (3) 6 weeks of digitally supported independent training, twice weekly. Assessments will be conducted at baseline, week 9, and week 16. Primary outcomes include Multiple Sclerosis Work Difficulties Questionnaire-23 - Norwegian version (MSWDQ-23NV) and ActiGraph wGT3x-BT monitor scores. Secondary outcomes include Trunk Impairment Scale - modified Norwegian Version (TIS-modNV), Mini Balance Evaluation Systems Test (MiniBESTest), AccuGait Optimized force platform, 6-minute walk test (6MWT), Multiple Sclerosis Walking Scale-12, Multiple Sclerosis Impact Scale-29 - Norwegian version, EQ-5D-5L, and Fatigue Severity Scale - Norwegian version scores. The study will identify effects of CoreDISTparticipation versus usual care on work barriers, physical activity, balance, walking, fatigue, and quality of life, along with a health economic evaluation. Descriptive statistics and repeated measures mixed models will be performed using IBM SPSS version29. RESULTS: We completed the enrolment phase and enrolled and randomized 115 participants in two phases by August 1, 2024. The 15-week retests were completed in December 2024, and data collection is estimated to be completed by September 2025. Results are expected to be published in the first quarter of 2026. CONCLUSIONS: CoreDISTparticipation is an innovative approach proactively addressing physical functions, physical activity, and work participation. If effective, it can offer a low-cost approach that potentially may enhance the quality of life and workforce sustainability and reduce societal costs. TRIAL REGISTRATION: ClinicalTrials.gov NCT06110468; https://www.clinicaltrials.gov/study/NCT06110468. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/74988.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,044 | 0,035 |
| Méta-épidémiologie (sens strict) | 0,007 | 0,003 |
| Méta-épidémiologie (sens large) | 0,012 | 0,006 |
| Bibliométrie | 0,003 | 0,004 |
| Études des sciences et des technologies | 0,004 | 0,004 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,004 | 0,002 |
| Intégrité de la recherche | 0,008 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,043 | 0,007 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».