COMPARISON OF THE EFFECTS OF TELEREHABILITATION AND FACE-TO-FACE SPINAL STABILIZATION TRAININGS ON GAIT BIOMECHANICS, BALANCE AND JOINT POSITION SENSE IN TRANSTIBIAL AMPUTEES: A RANDOMIZED CONTROLLED, SINGLE BLIND STUDY

December 24, 2024 updated by: Ankara Yildirim Beyazıt University
After transtibial amputations, biomechanical changes in the trunk, pelvis, and lumbar region cause asymmetrical strength and core muscle activation on the amputated side, which negatively affects the gait biomechanics of individuals. However, routine treatment programs do not use treatment approaches based on the core region. This study will focus on the effects of telerehabilitation and face-to-face spinal stabilization exercise training on gait, balance, joint position sense, core muscle function, and perceived mobility in transtibial amputees, after treatment, and after long-term follow-up.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
28

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Turkey
      • Ankara, Turkey
        • Ankara Yildirim Beyazit University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Individuals who use total contact sockets
  • have been using prostheses for at least 1 year,
  • can walk independently without a walking aid
  • functionally at least K2

Exclusion Criteria:

  • Bilateral amputation
  • Upper extremity amputation
  • Neurological problems
  • Other orthopedic problems

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Group 1
Individuals in this group will receive spinal stabilization training through telerehabilitation.
Other: Spinal stabilization training through telerehabilitation
Individuals in both groups will receive spinal stabilization training 3 times a week for 8 weeks.
Active Comparator: Group 2
Individuals in this group will receive spinal stabilization training face-to-face.
Other: Spinal stabilization training face-to-face
Individuals in both groups will receive spinal stabilization training 3 times a week for 8 weeks.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
gait speed
Time Frame: Change from baseline at 8 weeks and 5 months
Participants will be asked to walk on flat ground for 10 meters. At this time, the speed will be evaluated by the BTS G-Walk sensor.
Change from baseline at 8 weeks and 5 months

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
spatial parameter of gait
Time Frame: Change from baseline at 8 weeks and 5 months
Participants will be asked to walk on flat ground for 10 meters. At this time, the spatial variable of gait will be evaluated by the BTS G-Walk sensor.
Change from baseline at 8 weeks and 5 months
temporal parameter of gait
Time Frame: Change from baseline at 8 weeks and 5 months
Participants will be asked to walk on flat ground for 10 meters. At this time, the temporal variable of gait will be evaluated by the BTS G-Walk sensor.
Change from baseline at 8 weeks and 5 months
Dynamic Balance
Time Frame: Change from baseline at 8 weeks and 5 months
Dynamic balance; will be evaluated with the "Four Square Step Test", which is a valid and reliable measure in the evaluation of gait, mobility and dynamic balance. The time to complete four frames is recorded. If the duration is more than 24 seconds, it is considered that there is a risk of falling.
Change from baseline at 8 weeks and 5 months
Balance confidence
Time Frame: Change from baseline at 8 weeks and 5 months
Balance confidence of individuals will be evaluated with the "Activity-Specific Balance Confidence Scale". On this scale, individuals score their balance confidence between 0% and 100% during various ambulatory activities. A mean score of 50% or less indicates low physical function, 50-80% indicates moderate physical function, and 80% or higher indicates high physical function.
Change from baseline at 8 weeks and 5 months
Core Muscle Strength
Time Frame: Change from baseline at 8 weeks and 5 months
The strength of the core muscles will be evaluated using "The Stabilizer Pressure Biofeedback Unit". The pressure values for the measurement will be recorded 3 times in a row, at the beginning and end of the 10-second contraction, and the average value will be taken.
Change from baseline at 8 weeks and 5 months
Core Muscle Endurance- Trunk Flexor
Time Frame: Change from baseline at 8 weeks and 5 months
The trunk flexor test will be performed with the arms crossed over the thorax, the trunk at 55 degrees of flexion, and the knees and hips flexed to 90 degrees. The test will be finished when the participant is unable to maintain the position. The time will be recorded.
Change from baseline at 8 weeks and 5 months
Core Muscle Endurance- Trunk Extansor
Time Frame: Change from baseline at 8 weeks and 5 months
The trunk extensor test will be performed in the prone position, with the pelvis, hips and knees fixed to the bed. The participant will be asked to cross his arms over his body and position his body horizontally. The test will be finished when the participant is unable to maintain the horizontal position. The time will be recorded.
Change from baseline at 8 weeks and 5 months
Core Muscle Endurance- Side Bridge
Time Frame: Change from baseline at 8 weeks and 5 months
While the participants are in the side-lying position, they will raise their hips and align their bodies in a straight line by getting support from their feet and elbows. The time will be recorded by asking them to maintain the position as much as possible.
Change from baseline at 8 weeks and 5 months
Perceived Mobility
Time Frame: Change from baseline at 8 weeks and 5 months
The Prosthetic Limb Users Survey of Mobility (PLUS-M) Short Form will be used. The questionnaire consists of a total of 12 items, each of which is evaluated over 0-5 points. All items evaluate the degree of ability of the individual to perform the activity rather than the actual performance of the individual, and reflect the difficulty experienced by the individual while performing the activity. Higher scores indicate better mobility.
Change from baseline at 8 weeks and 5 months
Joint Position Sense-Knee
Time Frame: Change from baseline at 8 weeks and 5 months
It will be evaluated with a dual digital inclinometer (ACUMAR™).While the participants are in the prone position, the inclinometer will be placed on the femur and fibula and they will be asked to flex the knee at 40 degrees. It will be asked to feel the angle completely by keeping it in this position for a certain period of time and then return to the neutral position. The patient will then be asked to find the target angle. The difference between the target angle and the obtained angle will be determined as an absolute value and recorded in degrees.
Change from baseline at 8 weeks and 5 months
Joint Position Sense-Trunk
Time Frame: Change from baseline at 8 weeks and 5 months
It will be evaluated with a dual digital inclinometer (ACUMAR™). The test will be performed in a standing position with eyes closed, barefoot on a hard floor, with the support surface shoulder-width apart. The inclinometer will be fixed on the T1 and S1 spinous processes and 30 degrees of trunk flexion will be required. It will be asked to feel the angle completely by keeping it in this position for a certain period of time and then return to the neutral position. The patient will then be asked to find the target angle. The difference between the target angle and the obtained angle will be determined as an absolute value and recorded in degrees.
Change from baseline at 8 weeks and 5 months
pelvic parameter of gait
Time Frame: Change from baseline at 8 weeks and 5 months
Participants will be asked to walk on flat ground for 10 meters. At this time, the pelvic parameter of gait will be evaluated by the BTS G-Walk sensor.
Change from baseline at 8 weeks and 5 months
Step symmetry
Time Frame: Change from baseline at 8 weeks and 5 months
The time-distance characteristics of the gait will be used to calculate the gait symmetry. The step time of the non-amputee will be calculated in proportion to the amputated side.
Change from baseline at 8 weeks and 5 months
Stance symmetry
Time Frame: Change from baseline at 8 weeks and 5 months
The time-distance characteristics of the gait will be used to calculate the gait symmetry. The stance time of the non-amputee will be calculated in proportion to the amputated side.
Change from baseline at 8 weeks and 5 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ankara Yildirim Beyazıt University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 25, 2022

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 30, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 30, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 4, 2022

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 4, 2022

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 6, 2022

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 25, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 24, 2024

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2022-986/12

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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