- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02783066
Novel Offloading for Diabetic Foot Ulcers With PulseFlow: A Prospective Study
Diabetic foot ulceration (DFU) is a common and largely preventable complication of diabetes. While most of these ulcers can be treated successfully, some will persist and become infected. Ultimately, nearly one fifth of patients with infected lower-extremity diabetic ulcers will require amputation of the affected limb, resulting in staggering costs for both the patient and the healthcare system. Prevention by identifying people at higher risk is key for better clinical management of such patients. It is not uncommon for patients suffering from diabetes to have concomitant lower extremity edema or venous insufficiency and they subsequently may benefit from graduated compression. However, because of the common association of peripheral arterial disease (PAD) in patients with diabetes, most clinicians are reluctant to apply compressive dressings in fear of exacerbating the symptoms of PAD and possibility of gangrene.
A novel low voltage, battery powered medical device, PulseFlow DF® (The Diabetic Boot Company, Ltd. UK) has endeavored to assist in the treatment of Diabetic Foot Ulcers. The device provides hybrid functionality i.e. mobile air bladder pump at plantar arch and offloading boot. The air bladder inflates to 160 mmHg for approx. 1 second then deflates back to atmospheric pressure, allowing the plantar vessels sufficient time to refill. The offloading boot design holds the foot and lower leg in a position that reduces shear and friction forces and provides a reduction in plantar pressure.
The PulseFlow DF is designed to record how many hours of blood pumping it has delivered. This data will be downloaded at each clinic visit. The boot cannot pump blood around the participant's foot unless fitted correctly and the battery is charged up overnight.
The purpose of this study is to conduct an interventional study study with N=15 diabetic subjects with active foot ulcers to assess whether PulseFlow foot compression device can help improve lower extremity perfusion, whilst improving balance and spatio-temporal parameters of gait.
The key goals of the proposed project are to test whether a specially designed compression device can improve lower extremity perfusion, whilst also simultaneously improving the balance and walking performance. Investigators envision the use of this specially designed offloading device with compression capability will help reduce the incidence of diabetic foot ulcers in high-risk diabetic patients. In addition, investigators assumed the proposed device might enhance daily physical activity as well as walking performance. Investigators will conduct a prospective clinical study to validate these hypotheses. Potential changes in walking and spontaneous daily physical activities will be assessed using validated technologies that include walking analyzer system, balance assessment using body worn sensors, and computerized pressure insoles.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
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Texas
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Houston, Texas, United States, 77030
- Baylor College of Medicine
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 18- 80 years old
- type II diabetes with active plantar ulcer,
Exclusion Criteria:
- Non-ambulatory or unable to stand without help or walk a distance of at least 6 feet without assistance
- Plantar ulcer on arch of the foot
- Patients with PAD (Ankle Brachial Index < 0.5)
- Acute foot fracture
- Heart failure
- Pregnant women
- Patients on immunosuppressive drugs
- Participation in an interventional study in the last 30 days
- Major amputation
- Patients unable or unwilling to participate in all procedures and follow-up evaluations.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: "PulseFlow" group
Eligible subjects will try a new offloading boot for 4 weeks
|
A new offloading boot, which may enhance balance, gait, and lower extremity blood flow
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Lower Extremity Perfusion Change From Baseline to 4 Weeks
Time Frame: baseline and 4 weeks
|
Skin perfusion measured in the ankle using Sensilase device.
To measure Skin Perfusion Pressure (SPP), a pressure cuff is first automatically inflated to occlude arterial bed blood flow; this is verified by PAD-IQ by determining when perfusion has stopped.
The pressure is then automatically released at a controlled rate while the cuff pressure and skin perfusion are measured.
A graph displays pressure and perfusion during cuff deflation and indicates the pressure at which skin perfusion is found to return.
|
baseline and 4 weeks
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Gait Speed Difference Between Pulseflow Offflaoding and Standard Offloading
Time Frame: baseline
|
the quality of walking while wearing Pulseflow offflaoding compared to standard offloading
|
baseline
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adherence
Time Frame: 4 weeks
|
adherence to wear offloading boot by downloading from the study device to a specific developed software.
The measure is the mean number of minutes the offloading boot was worn for over the course of 4 weeks
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4 weeks
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Wound Size Change From Baseline to 4 Weeks.
Time Frame: baselineand and 4 weeks
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measuring the size of the wound (W, L,H)
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baselineand and 4 weeks
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Stride Length Difference Between Pulseflow Offflaoding and Standard Offloading
Time Frame: baseline
|
the quality of walking while wearing Pulseflow offflaoding compared to standard offloading
|
baseline
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Limp Difference Between Pulseflow Offflaoding and Standard Offloading
Time Frame: baseline
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Limp: the difference in stance percent between right and left feet
|
baseline
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Peak Swing Angular Velocity
Time Frame: baseline
|
Angular Velocity of leg swing during walking for each side
|
baseline
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Ratio of Propulsion Time to Stance Time
Time Frame: baseline
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Propulsion time and stance time for each stride is caulcated by wearable sensors.
The measure is ratio of propulsion time to stance time as percentage value.
|
baseline
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Center of Mass Sway While Wearing Standard Offloading Boot
Time Frame: baseline
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Center of Mass (COM) sway measured by wearable inertial sensors
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baseline
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Center of Mass Sway While Wearing Pulseflow Offloading
Time Frame: baseline
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center of mass sway measured by a wearable inertial sensor
|
baseline
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Peak Forefoot Pressure
Time Frame: baseline
|
baseline
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-37713
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
Clinical Trials on Diabetic Foot Ulcer
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-
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University of PadovaUnknownDiabetic Foot | Diabetic Foot Ulcer | Diabetic Foot Infection | Diabetic Foot Ulcer Neuropathic | Deformities FootItaly
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Johns Hopkins UniversityWithdrawnDiabetic Foot | Diabetic Foot Ulcer | Diabetic Foot Infection | Diabetic Foot Ulcer Mixed | Vascular Ulcer (Arterial or Venous Including Diabetic Ulcers Not Located on the Foot)
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Corporacion Parc TauliCompletedDiabetic Foot Ulcer | Diabetic Foot Ulcer NeuropathicPakistan
-
Baylor College of MedicineLifeNet HealthCompletedDiabetic Foot Ulcer | Deep Diabetic Foot UlcerUnited States
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Exciton Technologies Inc.CompletedDiabetic Foot Ulcer | Diabetic Foot Infection | Non-healing Diabetic Foot UlcerCanada
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ETS Wound Care, LLCProfessional Education and Research InstituteCompletedDiabetic Foot | Diabetic Foot Ulcer | Ulcer FootUnited States
-
National and Kapodistrian University of AthensTerminatedDiabetic Foot | Chronic Diabetic Foot Ulcer of Right Foot | Neuropathic Foot Ulcer | Chronic Diabetic Ulcer of Left Foot (Diagnosis)Greece
-
University of the PunjabHigher Education Commission (Pakistan); Centre of Excellence in Molecular Biology... and other collaboratorsRecruitingDiabetes Mellitus | Diabetic Foot | Foot Ulcer | Diabetes Complications | Diabetic Foot Ulcer | Diabetic Foot Infection | Diabetic Foot Ulcer Neuropathic | Foot Ulcer Due to Type 1 Diabetes Mellitus | Foot Ulcer Due to Type 2 Diabetes Mellitus | Chronic Diabetic Ulcer of Left Foot | Chronic Diabetic Foot...Pakistan
Clinical Trials on Offloading boot: PulseFlow
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University of LeedsThe Leeds Teaching Hospitals NHS TrustCompletedDiabetic Foot UlcerUnited Kingdom
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MiMedx Group, Inc.Completed
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Lower Extremity Institute for Research and TherapyMusculoskeletal Transplant FoundationUnknownDiabetic Foot | Foot Ulcer; DiabeticUnited States
-
DeRoyal Industries, Inc.Lincoln Memorial UniversityCompletedHeel Pressure Ulceration Prevention StrategiesUnited States
-
Diabetica Solutions Inc.National Institutes of Health (NIH)UnknownDiabetes | Elevated Temperature | Neuropathic Limb | Shear Pressure | Increased TemperaturesUnited States
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Musculoskeletal Transplant FoundationProfessional Education and Research InstituteCompletedDiabetic; Foot UlcersUnited States
-
Medical Corps, Israel Defense ForceCompletedBack Pain | Blister | Ankle Sprain | Stress Fracture | Patellofemoral Pain Syndrome | Abrasion
-
University of Southern CaliforniaBaylor College of MedicineRecruiting
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Jeffrey A. Gusenoff, MDCompletedHeel Pain Syndrome | Plantar Fasciitis, Chronic | Fat Pad SyndromeUnited States