Dysvascular Amputation Self-Management of Health (DASH)
Improving Health Self-Management Using Walking Biobehavioral Intervention for People With Dysvascular Lower Limb Amputation
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Eliza A. Biondi, MS
- Phone Number: 303-724-6035
- Email: eliza.biondi@cuanschutz.edu
Study Locations
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Colorado
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Aurora, Colorado, United States, 80045
- University of Colorado Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Within the age range of 50-85 years
- Confirmed diagnosis of Type II Diabetes Mellitus (DM) and/or Peripheral Artery Disease (PAD)
- Transtibial, knee disarticulation, or transfemoral lower-limb amputation (LLA) (or re-amputation) within the past 12 months
- Participant goal of household walking or better using a prosthesis
Exclusion Criteria:
- Trauma or cancer-related etiology of the LLA
- Decisionally challenged individuals (MMSE score below 24)
- Prisoners
- Active cancer treatment
- Recent stroke (within 2 years)
- Clinical discretion of principal investigator to exclude patients who are determined to be unsafe and/or inappropriate to participate in the described intervention.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Walking Biobehavioral Intervention (EXP)
The EXP group will receive biobehavioral training that is integrated into the conventional outpatient training component and is delivered over 5 months.
There will be 10 biobehavioral sessions, 1 of which will be a combined biobehavioral/conventional outpatient session and the other 9 being telehealth sessions.
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Each walking biobehavioral training session includes self-monitoring, tailored feedback, identification of barriers and facilitators, problem solving, action planning and encouragement.
Self-monitoring of walking behavior will occur with participant use of the FitBit sensor and software, reviewed with the interventionist at each session.
Tailored feedback from the FitBit sensor, as well as feedback from the interventionist, will detail progress over time and be compared to baseline data.
Barriers and facilitators of reaching activity goals will be discussed with emphasis on problem solving to take advantage of facilitators and minimize/remove participant-specific barriers.
Action planning will be based on weekly step goals set collaboratively by the interventionist and participant, based the FitBit data.
Finally, encouragement will be provided by the interventionist by putting progress or lack of progress in perspective of the efforts made by the participant.
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Active Comparator: Attention Control (CTL)
The CTL group intervention will include the same conventional outpatient training (10 sessions) as the EXP group and receive the same computer tablets with telehealth software as the EXP group (week 3 of prosthetic training).
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Attention control sessions will include a brief review of the conventional home-exercises, a summary of all healthcare visits and falls, and interventionist-delivered education on safety topics (e.g., fall prevention, wound care, assistive device use).
Outpatient therapists will provide home-based exercises to ensure that the participant receives adequate training and demonstrates safe performance prior to home use.
The CTL interventionist will assess and discuss the safe performance of each home-based exercise with CTL group participants.
Exercises in the CTL group will only be progressed by the outpatient physical therapist and not during the telehealth sessions.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Physical Activity
Time Frame: 3 months and 6 months
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The number of steps per day measured with ActivPAL, assessed for 10 days at 3 months and 6 months.
10-day average at 3 months and at 6 months reported.
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3 months and 6 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Patient Reported Outcomes Measurement Information System: Self-Efficacy for Managing Symptoms
Time Frame: Day 0, 3 months, 6 months and 12 months
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Measures participant's confidence in managing symptoms of chronic disease.
Higher scores indicate greater confidence in symptom management.
Values provided are the theta score which are T scores minus 50, divided by 10, where 50 indicates the population mean and 10 is the standard deviation of the T score scale.
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Day 0, 3 months, 6 months and 12 months
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Patient Reported Outcomes Measurement Information System: Self-Efficacy for Managing Daily Activities
Time Frame: Day 0, 3 months, 6 months and 12 months
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Measures participant's confidence in managing daily activities.
Higher scores indicate greater confidence in managing daily activities.
Values provided are the theta score which are T scores minus 50, divided by 10, where 50 indicates the population mean and 10 is the standard deviation of the T score scale.
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Day 0, 3 months, 6 months and 12 months
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Patient Reported Outcomes Measurement Information System: Ability to Participate in Social Roles and Activities
Time Frame: Day 0, 3 months, 6 months and 12 months
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Measures participant's ability to participate in social roles and activities.
Higher scores indicate more ability to participate.
Values provided are the theta score which are T scores minus 50, divided by 10, where 50 indicates the population mean and 10 is the standard deviation of the T score scale."
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Day 0, 3 months, 6 months and 12 months
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Prosthesis Evaluation Questionnaire - Mobility Score
Time Frame: Day 0, 3 months, 6 months and 12 months
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Self-reported mobility.
Final scores range from 0 (lowest mobility) to 4 (highest mobility)
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Day 0, 3 months, 6 months and 12 months
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Timed Up-and-Go Test
Time Frame: Day 0, 3 months, 6 months and 12 months
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Time required to rise from chair, walk 10 feet, turn around and return to sitting in same chair.
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Day 0, 3 months, 6 months and 12 months
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World Health Organization-Disability Assessment Schedule 2.0
Time Frame: Day 0, 3 months, 6 months and 12 months
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Self-reported disability.
Final scores range from 0 (no disability) to 100 (full disability).
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Day 0, 3 months, 6 months and 12 months
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Self-Efficacy for Managing Chronic Disease
Time Frame: Day 0, 3 months, 6 months and 12 months
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Self-reported confidence in managing different aspects of chronic disease.
Final scores range from 1 (not at all confident in managing chronic disease) to 10 (totally confident in managing chronic disease).
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Day 0, 3 months, 6 months and 12 months
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Activities-specific Balance Confidence Scale
Time Frame: Day 0, 3 months, 6 months and 12 months
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Self-reported balance confidence.
Final scores range from 0% (no confidence in balance) to 100% (complete confidence in balance).
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Day 0, 3 months, 6 months and 12 months
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Two-Minute Walk Test
Time Frame: Day 0, 3 months, 6 months and 12 months
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Distance a participant can walk in two minutes.
Use of assistive device is noted
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Day 0, 3 months, 6 months and 12 months
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Five Meter Walk
Time Frame: Day 0, 3 months, 6 months and 12 months
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Evaluates gait speed and functional mobility.
The participant walks 5 meters, at a comfortable walking pace.
Higher speed indicates better mobility.
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Day 0, 3 months, 6 months and 12 months
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Cory Christiansen, PT, PhD, University of Colorado, Denver
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Endocrine System Diseases
- Vascular Diseases
- Cardiovascular Diseases
- Metabolic Diseases
- Glucose Metabolism Disorders
- Atherosclerosis
- Arteriosclerosis
- Arterial Occlusive Diseases
- Peripheral Vascular Diseases
- Behavior
- Nutritional and Metabolic Diseases
- Diabetes Mellitus
- Peripheral Arterial Disease
- Motor Activity
Other Study ID Numbers
Other Study ID Numbers
- 19-0534
- R01NR018450 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- ICF
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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