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Efficacy of a novel sensory discrimination training device for the management of phantom limb pain: protocol for a randomised placebo-controlled trial

Por: Oatway · S. · Martin · D. · Graham · A. · Batterham · A. · MacSween · A. · Smith · S. · Ravindran · D. · Ryan · C.
Introduction

Many amputees experience phantom limb pain (PLP). Pharmacological management is the mainstay of treatment, but effectiveness is limited, and it is associated with significant side effects. Sensory discrimination training (SDT) is a non-pharmacological treatment for PLP. Previously, SDT required a clinician, or carer, to administer it, creating a barrier to real world use. In this trial, an automated SDT device (SP1X, 2pd Ltd, Middlesbrough, United Kingdom) for the self-management of PLP will be investigated for efficacy.

Methods and analysis

The Phantom Relief is a decentralised, randomised, placebo-controlled, mixed-methods, superiority trial. Participants will take part from their own homes, using an electronic data capture tool to complete all trial documentation. Eligible, consenting individuals with PLP (intensity rated as ≥4 on a 0–10 scale; n=100) will be randomised to receive the SP1X device (intervention group) or a placebo device SP1X7 (placebo group). The first and second treatment sessions will be observed via video call to provide set-up guidance and any additional advice needed. The primary outcome measure will be the McGill Pain Questionnaire revised (SF-MPQ-2). Outcome measures will be collected at baseline, 3 weeks (immediately post intervention) and 3 months follow-up. Statistical analysis will be carried out by a blinded statistician (analysis of covariance model conditioning on the baseline and stratification factors). Semi-structured interviews will be carried out with a sub-sample (n=10–15) of intervention group participants. Participants will be provided with their allocated device for home use. Online video calls will be used to instruct participants on how to set up and use the device by the research assistant (RA). The RA will observe the first and second treatment sessions and provide any additional advice needed. Participants in both groups will be asked to use the device for 60 min/day for at least 15 days of the 21-day treatment period and to record device use in a study diary.

Ethics and dissemination

Approval has been obtained from Teesside University School of Health and Life Sciences Research and Ethics Committee, the North of Scotland Research Ethics Service, Health Research Authority, and a letter of no objection was obtained from the Medicines and Healthcare products Regulatory Authority. The results will be disseminated through peer-reviewed articles, conference presentations and a doctoral thesis.

Trial registration number

NCT04103983.

Development, content and planned evaluation of a behavioural support intervention to reduce ultraprocessed food intake and increase physical activity in UK healthcare workers: UPDATE trial stage 2 study protocol

Por: Heuchan · G. N. · Buck · C. · Conway · R. · Dicken · S. · Brown · A. C. · Jassil · F. C. · Makaronidis · J. · Van Tulleken · C. · Gandini Wheeler-Kingshott · C. A. · Batterham · R. · Fisher · A.
Introduction

Diets high in ultraprocessed food (UPF) are associated with poor health outcomes and weight gain. Healthcare workers are particularly at risk of consuming diets high in UPF due to erratic work patterns, high stress and limited access to fresh food at work. Despite this, no interventions to date have specifically targeted a reduction in UPF intake in healthcare workers.

Methods and analysis

This article describes the development and content of a 6-month behavioural support intervention targeting a reduction in UPF intake in UK healthcare workers. The intervention was offered to all participants who took part in the UltraProcessed versus minimally processed Diets following UK dietAry guidance on healTh outcomEs trial—a two-stage study in which Stage 1 was a controlled-feeding crossover randomised controlled trial of provided UPF versus minimally processed food (MPF) diets (published previously) and was completed before the start of Stage 2. Stage 2, reported here, aimed to support participants to reduce their UPF consumption, increase MPF and increase physical activity in real-world settings. The intervention was developed using the behaviour change wheel framework, which systematically links behavioural diagnoses to intervention functions, incorporating the capability, opportunity and motivation model for behaviour change. It included tailored one-to-one and group support sessions, bespoke digital and print resources and a mobile-optimised website. The detailed description is intended to support future replication and adaptation. The acceptability and feasibility of the intervention will be assessed using quantitative and qualitative data in a future paper.

Ethics and dissemination

Sheffield Research Ethics Committee approved the trial (22/YH/0281). Findings will be disseminated through peer-reviewed publications, conference presentations and summaries shared with participants and stakeholders.

Trial registration number

NCT05627570.

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