- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04074252
Mobility Impairment in the Northern Region of Malawi
July 10, 2023 updated by: Rachel Thompson, MD, University of California, Los Angeles
Coupling the Surveillance of Mobility Impaired Adults With Large-Scale Assistive Device Donations and the Suitability of the Long-Term Use of Lofstrand (Forearm) Versus Axillary (Underarm) Crutches Among Mobility Impaired Adults in the Northern Region of Malawi
The purpose of this study is to investigate whether Lofstrand or axillary crutches are better suited to treat mobility impairments and improve physical activity levels in rural, resource-limited, settings like the Northern Region of Malawi.
To do this, we are proposing the implementation of a randomized controlled trial (RCT) to measure and compare the physical activity and satisfaction of mobility aid recipients sorted into two groups - one receiving a set of Lofstrand crutches (Group 1) and the other a set of axillary crutches (Group 2).
Changes in physical activity, disability, and life satisfaction levels will measured with a follow-up data collection period conducted one year after the distribution of the devices.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Detailed Description
STAGE 1 - BASELINE DATA COLLECTION:
- Potential participants will be identified at outreach clinics in the Mzimba, Rumphi, and Nkhata Bay Districts for participation in the study.
- Potential participants will take the Washington Group Extended Set Questions on Disability (WGES) and those that meet a baseline level of disability/mobility impairment - validated by physiotherapist opinion - are invited to participate in the study.
- 100 or more participants (50+ per group) who fulfill the inclusion criteria will be selected for participation.
- Participants will complete a Demographic Survey to determine their age, gender, health barriers, social determinants of health etc.
- Participants will complete the Global Physical Activity Questionnaire (GPAQ) to determine a baseline of their physical activity.
- Participants will complete the PROMIS Satisfaction with Participation in Social Roles - Short Form 8a (SPSR) and General Life Satisfaction (Ages 18+) - Fixed Form A (GLS) questionnaires to determine a baseline of their overall life satisfaction.
- Treatment groups will be randomized through the use of randomization envelopes.
- Selected devices, as determined in the randomization process, will be distributed to participants in each treatment group.
- The addresses/villages of residences of selected participants will be recorded and marked manually on a detailed satellite map. A list of study participants will be provided to the local Health Surveillance Assistant (HSA) for record keeping and monitoring purposes. (HSAs have intimate knowledge of the communities they serve and will be useful partners to help find participants in the follow-up stages of the trial.)
STAGE 2 - ONE-YEAR FOLLOW-UP DATA COLLECTION:
- Participants will be located using the assistance of the local HSA, address records, and map markings from Stage 1.
- Participants will complete follow-up SPSR, GLS, WGES and GPAQ questionnaires, and will complete the Crutch Satisfaction Survey.
- Reports of missing and damaged crutches will be taken.
STAGE 3 - DATA ANALYSIS:
The two study groups will be compared using the following metrics:
- Stratified by level of disability based on Washington Group Extended Set Questions on Disability
- Changes in GLS and SPSR scores between baseline and follow-up data collection will be used to determine changes in participants' overall life satisfaction.
- Changes in Global Physical Activity Questionnaire scores between baseline and follow-up data collection will be used to determine changes in participants' mobility impairments and day-to-day activity levels.
- Scores from the Crutch Satisfaction Survey will be used determine participants' subjective experiences with their respective mobility devices.
Study Type
Interventional
Phase
- 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 Locations
-
-
California
-
Los Angeles, California, United States, 90007
- Orthopaedic Institute for Children
-
-
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
Ages Eligible for Study
18 years to 45 years (Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Persons fluent in English, Tumbuka, and/or Chichewa.
- Persons diagnosed with a moderate to severe mobility impairment and/or lower extremity disabilities as determined by the WGES Questions on Disability.
- Persons untreated or undertreated for mobility impairment. We consider undertreated persons as those treating their mobility impairments with self-made devices (i.e. wooden crutches or walking sticks), or with devices considered lower than standard of care for their level of impairment (i.e. using a cane instead of crutches).
- Persons who are candidates for both axillary and Lofstrand crutch treatment - as determined by gait analysis conducted by local physiotherapists.
- Persons accessing one of the following 15 outreach distribution clinics located throughout the Mzimba, Rumphi, and Nkhata Bay Districts: Mzuzu Central Hospital, Ekwendeni Mission Hospital, Mtwalo Health Centre, Rumphi MAP Office, Bolero Health Centre, Hewe Health Centre, Livingstonia Mission Hospital, Mhuju Health Centre, Mzimba District Hospital, Jenda Health Centre, Nkhata Bay District Hospital, Mpamba Health Centre, Maula Health Centre, Chintheche Health Centre, and Kande Health Centre.
Exclusion Criteria:
- Persons diagnosed with degenerative conditions that may lead to further deterioration in mobility between data collection periods (i.e. ALS, Muscular Dystrophy, Corticobasal Degeneration etc.)
- Persons with developmental delays that will preclude them from participation in any of the surveys
- Persons with upper extremity disabilities that may preclude them from using crutches.
- Persons who are not permanent residents of the area or have any plans on moving out of the area.
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: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Lofstrand Crutches
This group is given a set of Lofstrand crutches.
|
Device: Set of Lofstrand Crutches
|
Active Comparator: Axillary Crutches
This group is given a set of axillary crutches.
|
Device: Set of Axillary Crutches
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in scores between baseline and follow-up from the Global Physical Activity Questionnaire (QPAQ)
Time Frame: Baseline and 1 year
|
Questionnaire used to measure the patient's self reported level of physical activity.
There are 16 questions total.
The majority of the questions are binary, but there are a few questions that include a measurement of time (in minutes, hours, and days).
There is a numerical output.
|
Baseline and 1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in scores between baseline and follow-up from the PROMIS Satisfaction with Participation in Social Roles (SPSR) survey
Time Frame: Baseline and 1 year
|
Questionnaire used to measure the patient's self reported level of satisfaction with current social roles.
There are 7 ordinal type questions, each with 5 different rating options to choose from.
There is a numerical output.
|
Baseline and 1 year
|
Change in scores between baseline and follow-up from the PROMIS General Life Satisfaction (GLS) survey
Time Frame: Baseline and 1 year
|
Questionnaire used to measure the patient's self reported level of satisfaction with general life satisfaction.
There are 7 ordinal type questions, each with 5 different rating options to choose from.
There is a numerical output.
|
Baseline and 1 year
|
Satisfaction Survey
Time Frame: 1 year
|
Questionnaire used to measure the patient's self reported satisfaction with their assigned devices.
There is a numerical output.
|
1 year
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Rachel M Thompson, MD, UCLA/OIC
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)
May 1, 2019
Primary Completion (Actual)
July 15, 2022
Study Completion (Actual)
July 15, 2022
Study Registration Dates
First Submitted
June 10, 2019
First Submitted That Met QC Criteria
August 28, 2019
First Posted (Actual)
August 30, 2019
Study Record Updates
Last Update Posted (Actual)
July 12, 2023
Last Update Submitted That Met QC Criteria
July 10, 2023
Last Verified
July 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 19-000773
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
product manufactured in and exported from the U.S.
Yes
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 Mobility Limitation
-
University of British ColumbiaCanadian Institutes of Health Research (CIHR)RecruitingOlder Adults | Limitation, MobilityCanada
-
University of North GeorgiaUnknownRelaxation; Joint | Limitation, Mobility | Relaxation; LumbosacralUnited States
-
Centre de Recherche de l'Institut Universitaire...Completed
-
Saint Joseph Mercy Health SystemTerminatedMobility LimitationsUnited States
-
US Department of Veterans AffairsCompletedAging | Mobility LimitationsUnited States
-
National Institute on Aging (NIA)Spaulding Rehabilitation Hospital PM&RCompletedAging | Mobility LimitationsUnited States
-
Klinik ValensState Secretariat for Education Research and Innovation, Switzerland; Office...CompletedGeriatric Disorder | Mobility LimitationsSwitzerland
-
University of MalayaCompletedPressure Injury | Limitation, MobilityMalaysia
-
Chang Gung Memorial HospitalCompleted
-
Western University, CanadaCompleted
Clinical Trials on Lofstrand Crutches
-
NYU Langone HealthCompleted
-
Cedars-Sinai Medical CenterTerminated
-
Weill Medical College of Cornell UniversityNew York Presbyterian HospitalCompletedNausea | Vomiting | Cesarean SectionUnited States
-
Georgetown UniversityBristol-Myers Squibb; Advanced Accelerator ApplicationsCompletedSmall Cell Lung Cancer | Small Cell Lung Cancer Extensive StageUnited States