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This multi-centre, randomised controlled trial (RCT) investigates the effects of intensive upper limb (UL) motor training on neurophysiological and functional recovery in individuals with cervical spinal cord injury (c-SCI) during the sub-acute phase. The study aims first to assess neurophysiological adaptations in the central and peripheral nervous systems and functional changes to evaluate the impact of intensive UL motor training on recovery. Second, it determines dose dimensions and their correlation with neural and functional improvements.
A total of 44 individuals with c-SCI within 13 weeks post-injury will be recruited from five rehabilitation centres in Belgium and the Netherlands. They will be randomised into an intervention group, receiving six additional hours of goal-directed UL training per week for 8 weeks, or a control group receiving standard care. Primary outcomes are changes in resting motor threshold, a proxy for corticospinal tract integrity; compound muscle action potential amplitude, indicating peripheral nerve excitability and functionality; and assessments of strength, sensory function and prehension, with the primary comparison between groups at baseline and after the intervention period. Secondary outcomes cover additional neurophysiological assessments and motor function. Dose dimensions will be quantified and related to primary and secondary outcomes.
The central medical ethics committees, METC Máxima MC (NL84212.015.23) and MEC Gent (B6702023000227), as well as local ethics committees, reviewed and approved this trial. The protocol is registered (ClinicalTrials.gov; NCT06065384). The findings of this RCT will be disseminated through articles in peer-reviewed journals and at neurological rehabilitation conferences.
The aim of the study is to explore the experiences of adult relatives who cohabit with patients receiving hospital-at-home (HaH) care. The healthcare system is increasingly adopting HaH as a response to hospital overcrowding and the growing need for personalised, home-based care. While HaH has been shown to benefit patients, there is limited understanding of the impact on cohabiting relatives, who often assume a caregiving role without adequate preparation or support.
A qualitative inductive approach.
Semi-structured interviews were carried out with 10 cohabiting relatives of HaH patients from North Zealand and Denmark. Data collection took place over two periods between March 2023 and February– April 2024. Data were analysed using inductive qualitative content analysis to identify key themes in the relatives' experiences.
Relatives reported mixed feelings about HaH. While they appreciated the ability to be close to their loved ones and maintain a more normal daily routine, some felt overwhelmed by the caregiving responsibilities imposed upon them. The lack of involvement in treatment decisions, sometimes inadequate communication from healthcare professionals, and the pressure to manage both practical and emotional aspects of care were among the concerns. However, despite these challenges, relatives strongly preferred HaH over conventional hospital admissions due to the reduced disruption to their daily lives and the perceived improvement in their loved ones' well-being.
Although HaH presents additional burdens and concerns for relatives, they prefer this model of care over traditional hospitalisations. However, it is crucial that relatives are actively involved in the decision-making process and provided with adequate support to manage the caregiving responsibilities effectively. This involvement can help ensure a more positive experience for both relatives and patients, contributing to the overall success of HaH.
This study emphasises the vital role of relatives in HaH care, highlighting their preference for HaH despite the additional burden. Healthcare professionals must involve relatives in decision-making and provide adequate support to manage caregiving responsibilities. A more individualised approach can enhance the caregiving experience, reduce stress and improve patient outcomes.
This study fills a gap in understanding relatives' experiences in HaH care, stressing the need for better communication and support. By involving relatives more effectively, healthcare professionals can improve the success of HaH and reduce strain on healthcare systems.
This study adhered to the COREQ criteria.
No patient or public contribution.
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