- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03651830
A Test-Drive Strategy for the Prescription of Prosthetic Feet for People With Leg Amputations
A Prosthetic Foot Emulator to Optimize Prescription of Prosthetic Feet in Veterans and Service Members With Leg Amputations
Objective/Hypotheses and Specific Aims: The primary aim of this proposal is to determine whether a PFE can be used to predict foot preference and mobility outcomes with corresponding commercial prosthetic feet in people with a unilateral transtibial amputation (TTA). Secondarily, the investigators aim to determine whether a brief trial of commercial prosthetic feet would be able to similarly predict longer-term foot preference and mobility outcomes with those feet.
Study Design: The investigators will use a participant blinded cross-over study with repeated measurements. Participants with TTA will be enrolled at each of the three study sites: two VA sites (Puget Sound and Minneapolis), and one Department of Defense site (Center for the Intrepid). Participants will complete up to 6 visits. After an initial assessment visit, participants will be assigned to the high or low mobility group, and then during visit 2 they will be randomized to use the PFE in three foot modes or the three corresponding actual (commercially available) feet during walking tests in the laboratory. During visit 3 participants will repeat the procedures in the other condition (e.g., PFE if Day 2 included actual feet testing). At the end of visit 3 participants will be fit with one of the actual feet and wear it at home and in the community for approximately two weeks. At visit 4 participants will be fit with the next actual foot and repeat the 2 week use window. The same process will be followed for the final foot at visit 5, and the study foot will be returned at visit 6. Participants' preference, satisfaction and perceived mobility, and functional mobility will be measured and compared across all foot conditions (emulated and actual). After participants complete the procedures detailed above, they may be eligible to be invited to participate in follow-up phone interviews. A subset of participants may also be invited to participate in follow-up biomechanical data collection comparing the PFE foot conditions to the respective actual prosthetic feet during walking. Additionally, a subset of participants may also be invited to participate in follow-up data collection comparing prosthetic foot conditions of different stiffness categories.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Minnesota
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Minneapolis, Minnesota, United States, 55417
- Minneapolis VA Medical Center
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Texas
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San Antonio, Texas, United States, 78234
- Center for the Intrepid
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Washington
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Seattle, Washington, United States, 98108
- VA Puget Sound Health Care System
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- has a unilateral (one leg) transtibial (below-knee) amputation
- has used a prosthetic limb for walking for at least six months
- has a comfortably fitting prosthetic socket
- be able to walk with a prosthetic limb sufficiently to participate in the experiment walking trials
- be age 18 to 89 years
Exclusion Criteria:
- contralateral limb or upper limb amputation
- are unable to use test feet for any reason (e.g., excessively long residual limb that is not compatible with wearing study prosthetic feet)
- unable to walk under the minimal necessary study walking conditions in order to complete the study procedures without undo stress
- currently pregnant (determined via self-report during screening)
- current surgical, neurological, rheumatologic, or lower limb musculoskeletal problem that significantly impairs ambulation (e.g., current ulcer, terminal illness, lower extremity joint replacement)
- weight greater than 250lbs.
- inadequate cognitive or language function to consent to participate
- currently incarcerated
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Prosthetic Foot Emulator
The Prosthetic Foot Emulator (PFE) is a customizable robotic prosthetic foot that can mimic commercial feet to predict how individual patients will respond to candidate feet.
Participants will walk with the PFE using three different modes (emulating three commercial feet) under different walking conditions.
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Participants will walk in the laboratory with the Prosthetic Foot Emulator (PFE) in three foot modes corresponding to actual study feet.
Walking conditions will include self-selected speed, slow speed, fast speed, incline, and up stairs.
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Active Comparator: Commercially available prosthetic feet
Participants will walk under different walking conditions using three different commercial prosthetic feet.
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Participants will walk in the laboratory with three different commercially available prosthetic feet. Walking conditions will include self-selected speed, slow speed, fast speed, incline, and up stairs. Additionally, participants will be fit with one of the actual feet and wear it at home and in the community for approximately two weeks. This will be followed by two-week periods in the community with each of the other two commercially available prosthetic feet. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Foot Preference Survey
Time Frame: Administered during initial testing with prosthetic foot emulator (approximately 2 hours).
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Self-report survey related to prosthetic foot preference, satisfaction, and perceived mobility, with questions answered on 0-10 scale.
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Administered during initial testing with prosthetic foot emulator (approximately 2 hours).
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Foot Preference Survey
Time Frame: Administered during initial testing with actual prosthetic feet (approximately 2 hours).
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Self-report survey related to prosthetic foot preference, satisfaction, and perceived mobility, with questions answered on 0-10 scale.
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Administered during initial testing with actual prosthetic feet (approximately 2 hours).
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Foot Preference Survey
Time Frame: Administered at 2-week follow up for prosthetic foot A.
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Self-report survey related to prosthetic foot preference, satisfaction, and perceived mobility, with questions answered on 0-10 scale.
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Administered at 2-week follow up for prosthetic foot A.
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Foot Preference Survey
Time Frame: Administered at 2-week follow up for prosthetic foot B.
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Self-report survey related to prosthetic foot preference, satisfaction, and perceived mobility, with questions answered on 0-10 scale.
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Administered at 2-week follow up for prosthetic foot B.
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Foot Preference Survey
Time Frame: Administered at 2-week follow up for prosthetic foot C.
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Self-report survey related to prosthetic foot preference, satisfaction, and perceived mobility, with questions answered on 0-10 scale.
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Administered at 2-week follow up for prosthetic foot C.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Two Minute Walk Test
Time Frame: Administered at baseline and at 2-week follow up for each foot condition.
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Participants are asked to walk for 2 minutes at their fastest possible speed and distance walked is recorded.
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Administered at baseline and at 2-week follow up for each foot condition.
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Prosthetic Limb Users Survey of Mobility (PLUS-M), tailored short-form
Time Frame: Administered at baseline and at 2-week follow up for each foot condition.
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Standardized self-report item bank.
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Administered at baseline and at 2-week follow up for each foot condition.
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Activities Specific Balance Confidence Scale (ABC)
Time Frame: Administered at baseline and at 2-week follow up for each foot condition.
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This is a subjective measure of confidence in performing ambulatory activities without falling or feeling unsteady.
The investigators are using a revised version of the ABC recommended to ease administration and improve scoring.
Questions answered on 0-4 scale (0 = No Confidence; 4 = Complete Confidence).
Scores for 16 questions combined and averaged.
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Administered at baseline and at 2-week follow up for each foot condition.
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Trinity Amputation and Prosthesis Experience Scales (TAPES)
Time Frame: Administered at baseline and at 2-week follow up for each foot condition.
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Multidimensional health instrument that measures self-reported activity restrictions (TAPES-AR) and satisfaction with the function (TAPES-FUN) of a prosthesis.
Other subscales of TAPES will not be used.
Questions answered on 0-2 scale (0 = No, not limited; 2 = Yes, limited a lot for TAPES-AR, and 0= Not satisfied; 2 = Very satisfied for TAPES-FUN).
Subscales will be scored separately.
For TAPES-AR, scores of all items answered will be combined and averaged.
For TAPES-FUN, scores for all items will be added together.
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Administered at baseline and at 2-week follow up for each foot condition.
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Four Square Step Test (FSST)
Time Frame: Administered at baseline and at 2-week follow up for each foot condition.
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Participants are asked to step over canes in a specific sequence as quickly as possible and two trials are timed and recorded.
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Administered at baseline and at 2-week follow up for each foot condition.
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Timed Up and Go (TUG)
Time Frame: Administered at baseline and at 2-week follow up for each foot condition.
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Participants are asked to start at sitting, stand and walk around a cone, and return to a seated position.
Two trials are performed at both a comfortable pace and at a fast pace.
All trials are timed and times are recorded.
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Administered at baseline and at 2-week follow up for each foot condition.
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Narrowing Beam Walking Test (NBWT)
Time Frame: Administered at baseline and at 2-week follow up for each foot condition.
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Participants are asked to walk as far as possible along a narrowing beam without using arms or assistance for balance.
Five trails are completed and distances are recorded.
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Administered at baseline and at 2-week follow up for each foot condition.
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Berg Balance Scale (BBS)
Time Frame: Administered at baseline and at 2-week follow up for each foot condition.
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Participants are asked to perform a variety of tasks such as sitting, standing, turning, and transferring between chairs, in order to measure balance.
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Administered at baseline and at 2-week follow up for each foot condition.
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Kinematic and kinetic outcome analysis
Time Frame: up to 100 weeks
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Some participants are asked to complete biomechanical gait analysis while walking with the PFE and the corresponding actual prosthetic feet while wearing reflective markers in a motion capture laboratory (Vicon motion capture system).
Ankle, knee, hip, trunk, and upper body motion data will be collected while participants walk at self-selected speeds on an instrumented treadmill.
These kinematic and kinetic outcome data will be collected at follow-up study visits up to 100 weeks after enrollment and after participants complete previous study activities (note: only a subset of participants).
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up to 100 weeks
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: David Morgenroth, MD, VA Puget Sound Health Care System and SIBCR
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- MD13
- W81XWH-16-1-056 (Other Grant/Funding Number: Department of Defense)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
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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