Targeting Balance Confidence to Increase Community Integration in Users of Prostheses
31 mai 2022 mis à jour par: Noah Rosenblatt, Rosalind Franklin University of Medicine and Science
Targeting Balance Confidence as a Strategy to Increase Integration and Improve Outcomes in Users of Lower-Limb Prostheses
Low balance confidence occurs when an individual perceives they have limited ability to maintain their balance while performing a specific task of daily living.
It is a prevalent problem in lower limb prosthesis users and is a strong predictor of prosthesis use and community participation.
Balance confidence is not necessarily related to functional abilities.
It is possible to improve functional ability as a result of rehabilitation, without concurrently improving balance confidence.
Interventions to address low balance confidence may need to target both functional abilities as well as beliefs regarding these abilities.
The purpose of this study is to test whether, for users of lower limb prostheses, an intervention combining physical therapy exercise to improve function with cognitive behavioral therapy to address fears and thoughts associated with low confidence can improve balance confidence and promote community participation.
Aperçu de l'étude
Statut
Complété
Les conditions
Description détaillée
Lower limb prosthesis users, with self-reported low balance confidence complete baseline gait analysis and balance testing, as well as a series of validated self-reported outcome scales addressing balance confidence, quality of life, and community integration.
Participants are then provided a step activity monitor (SAM) and a global position sensing (GPS) tracker to be worn for one week, the data from which is linked and used to objectively quantify baseline community participation.
At the conclusion of the one week, participants are randomized to one of two groups, each of which will last for 8 weeks.
At the conclusion of the eight weeks, participants repeat baseline assessments and are again provided a SAM and GPS tracker to wear for one week.
Baseline measures and activity monitoring occur again 8 and 16 weeks thereafter.
Type d'étude
Interventionnel
Inscription (Réel)
22
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
-
-
Illinois
-
North Chicago, Illinois, États-Unis, 60064
- Captain James A. Lovell Federal Health Care Center
-
North Chicago, Illinois, États-Unis, 60064
- Rosalind Franklin University of Medicine and Science
-
-
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- age ≥18 years
- unilateral lower limb amputation without serious complications
- at least 6 months experience using a definitive lower limb prosthesis
- Activity Specific Balance Confidence (ABC) scale score≤80
- self-reported concern about balance that limit activities
Exclusion Criteria:
- active wounds on weight bearing surfaces
- inability to perform the protocol without an assistive device
- currently seeing a physical therapist for any reason
- history of neurodegenerative disease
- history of stroke
- ill-fitting or ill-functioning prosthesis (to be verified by research prosthetist during screening)
- prohibited by primary care physician or research physician to participate in mild exercise
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Exercise Group A
Weekly exercise sessions with physical therapist and psychologist
|
Eight weekly sessions integrating techniques from physical therapy and cognitive behavioral therapy.
At the start of each session participants play virtual reality games that target balance and functional gait and then discuss their balance confidence and activity avoidance behaviors with a behavioural counselor.
Weekly homework assignments ask participants to report on thoughts causing them to avoid activities and to slowly engage in activities that present increasing levels of fear.
|
|
Comparateur placebo: Exercise Group B
Home-based exercises
|
Stretching and other exercises are safely taught by physical therapist and then practiced at home following a provided schedule.
Participants receive periodic calls to discuss progress.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Community integration
Délai: 24 weeks
|
number of steps taken outside of the home
|
24 weeks
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Social Functioning scale from the 36-item Short Form Health Survey
Délai: 24 weeks
|
The scale measures the extent to which physical and emotional problems interfere with social activities on a scale of 0-100 with higher scores indicating less interference
|
24 weeks
|
|
Role Limitation due to Emotional Problems scale from the Short Form Health Survey (SF36)
Délai: 24 weeks
|
The scale measures the extent to which emotional problems interfere with work and daily activities on a scale of 0-100 with higher scores indicating less interference
|
24 weeks
|
|
Extent of Participation scale from the Measure of Community Reintegration of Servicemembers
Délai: 24 weeks
|
The scale measures community participation in terms of how often an individual engages in certain activities on a score of 10-70 with higher scores indicating greater participation
|
24 weeks
|
|
Perceived Limitation scale from the Measure of Community Reintegration of Servicemembers
Délai: 24 weeks
|
The scale measures self-perceived limitations in community participation n a score of 10-70 with higher scores indicating less limitation
|
24 weeks
|
|
Frenchay Activity Index
Délai: 24 weeks
|
This is a behavioral scale that primarily measures social participation, as well as daily activities on a score of 0-45 with higher scores indicating greater social activity.
|
24 weeks
|
|
Change from baseline in Activity-specific balance confidence scale following the intervention
Délai: 8 weeks
|
The ABC scale measures balance confidence on a scale of 0-100 with higher values indicating greater confidence
|
8 weeks
|
|
Activity-specific balance confidence scale
Délai: 24 weeks
|
The ABC scale measures balance confidence on a scale of 0-100 with higher values indicating greater confidence.
Measurement at this time point will indicate the lasting impact of the intervention on balance confidence
|
24 weeks
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Well-being scale from the Prosthetic Evaluation Questionnaire
Délai: 24 weeks
|
The scale measures overall quality of life on a score of 0-100 with higher scores indicating increased quality of life.
|
24 weeks
|
|
Change from baseline in Berg Balance Scale
Délai: 8 wks
|
This scale measures measures balance function by assessing the performance of functional tasks.
It is scored from 0-45 with high scores indicating better balance.
|
8 wks
|
|
Change from baseline on L-test performance
Délai: 8 wks
|
Participants rise from a chair without armrests, walk 3m, turn right, walk 7m, turn around and trace their path back to the start.
Time to complete the task is noted.
|
8 wks
|
Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
5 avril 2018
Achèvement primaire (Réel)
1 mai 2022
Achèvement de l'étude (Réel)
1 mai 2022
Dates d'inscription aux études
Première soumission
10 janvier 2018
Première soumission répondant aux critères de contrôle qualité
18 janvier 2018
Première publication (Réel)
26 janvier 2018
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
1 juin 2022
Dernière mise à jour soumise répondant aux critères de contrôle qualité
31 mai 2022
Dernière vérification
1 mai 2022
Plus d'information
Termes liés à cette étude
Mots clés
Autres numéros d'identification d'étude
- OP160044
- W81XWH-17-1-0697 (Autre subvention/numéro de financement: Department of Defense)
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
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