Targeting Balance Confidence to Increase Community Integration in Users of Prostheses
31. mai 2022 oppdatert av: 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.
Studieoversikt
Status
Fullført
Forhold
Detaljert beskrivelse
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.
Studietype
Intervensjonell
Registrering (Faktiske)
22
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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Illinois
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North Chicago, Illinois, Forente stater, 60064
- Captain James A. Lovell Federal Health Care Center
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North Chicago, Illinois, Forente stater, 60064
- Rosalind Franklin University of Medicine and Science
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
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
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: Exercise Group A
Weekly exercise sessions with physical therapist and psychologist
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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.
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Placebo komparator: Exercise Group B
Home-based exercises
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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.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Community integration
Tidsramme: 24 weeks
|
number of steps taken outside of the home
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24 weeks
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Social Functioning scale from the 36-item Short Form Health Survey
Tidsramme: 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
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24 weeks
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Role Limitation due to Emotional Problems scale from the Short Form Health Survey (SF36)
Tidsramme: 24 weeks
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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
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24 weeks
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Extent of Participation scale from the Measure of Community Reintegration of Servicemembers
Tidsramme: 24 weeks
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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
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24 weeks
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Perceived Limitation scale from the Measure of Community Reintegration of Servicemembers
Tidsramme: 24 weeks
|
The scale measures self-perceived limitations in community participation n a score of 10-70 with higher scores indicating less limitation
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24 weeks
|
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Frenchay Activity Index
Tidsramme: 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.
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24 weeks
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Change from baseline in Activity-specific balance confidence scale following the intervention
Tidsramme: 8 weeks
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The ABC scale measures balance confidence on a scale of 0-100 with higher values indicating greater confidence
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8 weeks
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Activity-specific balance confidence scale
Tidsramme: 24 weeks
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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
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24 weeks
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Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Well-being scale from the Prosthetic Evaluation Questionnaire
Tidsramme: 24 weeks
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The scale measures overall quality of life on a score of 0-100 with higher scores indicating increased quality of life.
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24 weeks
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Change from baseline in Berg Balance Scale
Tidsramme: 8 wks
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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.
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8 wks
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Change from baseline on L-test performance
Tidsramme: 8 wks
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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.
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8 wks
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Publikasjoner og nyttige lenker
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Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
5. april 2018
Primær fullføring (Faktiske)
1. mai 2022
Studiet fullført (Faktiske)
1. mai 2022
Datoer for studieregistrering
Først innsendt
10. januar 2018
Først innsendt som oppfylte QC-kriteriene
18. januar 2018
Først lagt ut (Faktiske)
26. januar 2018
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
1. juni 2022
Siste oppdatering sendt inn som oppfylte QC-kriteriene
31. mai 2022
Sist bekreftet
1. mai 2022
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
- OP160044
- W81XWH-17-1-0697 (Annet stipend/finansieringsnummer: Department of Defense)
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Nei
Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
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