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临床试验/NCT06352788
NCT06352788招募中不适用

From Opinion to Evidence: Multi-site Evaluation of Custom Dynamic Orthosis Best Practices

Jason Wilken6 个研究点 分布在 1 个国家目标入组 35 人开始时间: 2024年7月2日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
招募中
发起方
入组人数
35
试验地点
6
主要终点
PROMIS Physical Function

研究概览

简要总结

This study is designed to support evidence-based practice and optimal care by evaluating how different configurations of two types of carbon fiber custom dynamic orthoses (CDOs) influences outcomes following traumatic lower extremity injury.

详细描述

This study is designed to evaluate how different configurations of two types of carbon fiber custom dynamic orthoses (CDOs) influence outcomes following traumatic lower extremity injury. In this study, adult participants who still experiencing deficits including weakness and/or immobility more than two years post traumatic lower extremity injury will be randomized and fit with either modular or monolithic CDO.

Participants will then be evaluated without a CDO and with the CDO in three configurations in a randomized order: a proposed optimal benchmark configuration, a variation with the device in more dorsiflexion, and a variation with the device in greater plantarflexion. Multiple well-established tests will be used to compare outcomes between the different configurations.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Crossover
主要目的
Treatment
盲法
Triple (Participant, Investigator, Outcomes Assessor)

盲法说明

Study participants, investigators, and outcome assessors will be blinded to the condition being tested and will only be introduced to each condition as A, B, or C. Only study coordinators, who will verify adherence with the study protocol (CDO configuration), will not be blinded.

入排标准

年龄范围
18 Years 至 65 Years(Adult, Older Adult)
性别
All
接受健康志愿者
否

入选标准

  • •Between the ages of 18 and 65
  • •2 or more years from a traumatic injury below the knee
  • •Ability to be fit with an orthosis
  • •Any of the following:
  • •Weakness of ankle plantarflexors (<4/5 on manual muscle test)
  • •Limited pain-free ankle motion (dorsiflexion (DF) <10° or plantarflexion (PF) <20°)
  • •Mechanical pain with loading to hindfoot/midfoot (>=4/10 Numerical pain rating scale)
  • •Fusion or candidate for fusion of the ankle or hindfoot
  • •Candidate for amputation secondary to ankle/foot injury and impairment

排除标准

  • •Pain greater than 8/10 at rest
  • •Ankle weakness or spasticity as a result of spinal cord injury or central nervous system pathology
  • •Use of an orthosis including the knee
  • •Non-ambulatory
  • •Surgery on study limb anticipated in next 4 months
  • •Medical or psychological conditions that would influence functional testing (e.g., severe traumatic brain injury, stroke, heart disease, vestibular disorder)
  • •Neurologic, musculoskeletal, or other conditions limiting function of the contralateral extremity
  • •Uncorrected visual or hearing impairments
  • •Pregnancy
  • •Non-English speaking
  • •BMI > 40

研究组 & 干预措施

NoCDO, A, B, C

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration A, CDO configuration B, and finally CDO configuration C.

干预措施: Modular Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, A, B, C

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration A, CDO configuration B, and finally CDO configuration C.

干预措施: Mono Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, A, C, B

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration A, CDO configuration C, and finally CDO configuration B.

干预措施: Modular Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, A, C, B

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration A, CDO configuration C, and finally CDO configuration B.

干预措施: Mono Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, B, A, C

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration B, CDO configuration A, and finally CDO configuration C.

干预措施: Modular Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, B, A, C

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration B, CDO configuration A, and finally CDO configuration C.

干预措施: Mono Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, B, C, A

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration B, CDO configuration C, and finally CDO configuration A.

干预措施: Modular Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, B, C, A

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration B, CDO configuration C, and finally CDO configuration A.

干预措施: Mono Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, C, A, B

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration C, CDO configuration A, and finally CDO configuration B.

干预措施: Modular Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, C, A, B

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration C, CDO configuration A, and finally CDO configuration B.

干预措施: Mono Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, C, B, A

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration C, CDO configuration B, and finally CDO configuration A.

干预措施: Modular Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

NoCDO, C, B, A

Experimental

Participants will first be evaluated without a CDO (NoCDO), then in CDO configuration C, CDO configuration B, and finally CDO configuration A.

干预措施: Mono Carbon Fiber Custom Dynamic Orthosis (CDO) (Device)

结局指标

主要结局

PROMIS Physical Function

时间窗: Baseline

The Patient Reported Outcome Information System (PROMIS) Physical Function Computer Adaptive Test (CAT) is a computerized assessment measuring physical function. It is scored using a T-score in which 50 is the mean of a relevant reference population and 10 is the standard deviation (SD) of that population. In a given PROMIS domain, a T-score above 50 represents greater physical function than the population average. Larger scores are better.

Preference - Ranked

时间窗: Baseline

The participant will be asked to rank order the conditions they have completed testing for at each visit: at the 3rd visit they will rank order their preference for using no orthosis or using the CDO in the first configuration, at the 4th visit they will rank order their preference for using no orthosis, using the CDO in the first configuration, and using the CDO in the second configuration, at the 5th visit they will rank order their preference for using no orthosis, using the CDO in the first configuration, using the CDO in the second configuration, and using the CDO in the third configuration.

OPUS Satisfaction with Device and Services

时间窗: Baseline

Satisfaction with device and services will be assessed using the Orthotics Prosthetics Users' Survey Satisfaction With Device and Services Score (11-55). Lower scores indicate a better outcome and more satisfaction with the CDO and accompanying services.

PROMIS Pain Interference

时间窗: Baseline

The Patient Reported Outcome Information System (PROMIS) Pain Interference Computer Adaptive Test (CAT) is a computerized assessment measuring pain interference. It is scored using a T-score in which 50 is the mean of a relevant reference population and 10 is the standard deviation (SD) of that population. In a given PROMIS domain, a T-score above 50 represents greater pain interference than the population average. Lower scores are better.

Modified Socket Comfort Score - Comfort

时间窗: Baseline

Participants were asked to rate the comfort of each CDO configuration on a scale from 0-10 with 0 = most uncomfortable to 10 = most comfortable. Higher scores indicate more comfortable conditions, and are considered better.

Modified Socket Comfort Score - Smoothness

时间窗: Baseline

Participants were asked to rate the smoothness of each CDO configuration on a scale from 0-10 with 0 = most smooth to 10 = least smooth. Lower scores indicate smoother conditions, and are considered better.

Four Square Step Test (seconds)

时间窗: Baseline

The 4SST (seconds) is a standardized timed test of balance and agility. Participants start in the lower left quadrant of a Maltese cross setting on the floor and are timed as they move counterclockwise (forward, right, backward, left) and then clockwise (right, forward, left, backward) around the cross. Participants are instructed to move as quickly as they safely can. Lower times indicate faster completion of the test and are considered better results.

Sit to Stand 5 Times (seconds)

时间窗: Baseline

STS5 (seconds) is a well-established timed measure of lower limb muscle strength and power. Participants are instructed to stand up and sit down 5 times as fast as possible. Lower scores indicate a faster time to complete the test and are considered better results.

Peak Ankle Plantarflexion Moment (Nm/kg)

时间窗: Baseline

Participants completed a biomechanical gait analysis session. Sagittal plane peak ankle joint plantarflexion moment normalized to participant body weight (Nm/kg) that occurs late in the stance phase of gait.

Peak Ankle Push-Off Power (W/kg)

时间窗: Baseline

Participants completed a biomechanical gait analysis session. Sagittal plane peak ankle joint power normalized to body weight (W/kg) occurs late in the stance phase of gait.

Numerical Pain Rating Scale

时间窗: Baseline

Pain will be assessed using a standard 11-point numerical pain rating scale (NPRS), in which 0 = no pain and 10 = worst pain imaginable. Lower scores are considered better.

Preference - CDO Configuration

时间窗: Baseline

For each CDO configuration, participants will be asked to rank their preference on a scale from 0 (least preferred) to 10 (most preferred) for a number of questions concerning CDO use. Higher scores indicate higher preferences and are considered better.

Center of Pressure Velocity Magnitude (m/s)

时间窗: Baseline

The center of pressure (CoP) is the centroid of the forces acting on the foot during gait. The magnitude of the peak center of pressure velocity (m/s) is the fastest the CoP moves during gait.

Center of Pressure Velocity Timing (%stance)

时间窗: Baseline

The center of pressure (CoP) is the centroid of the forces acting on the foot during gait. The timing of the peak center of pressure velocity, is the percent of the stance phase (%stance) where the CoP is moving fastest during gait.

Ankle Zero Moment Crossing (%stance)

时间窗: Baseline

The ankle zero moment crossing is the point during the stance phase of gait (%stance) where the ankle moment transitions from a dorsiflexion to a plantarflexion moment.

Peak Ankle Dorsiflexion (degree)

时间窗: Baseline

Participants completed a biomechanical gait analysis session. Sagittal plane peak ankle joint dorsiflexion angle (degree) that occurs late in the stance phase of gait.

次要结局

  • PROMIS Depression(Baseline)
  • PROMIS Satisfaction with Participation in Discretionary Social Activities(Baseline)
  • PROMIS Satisfaction with Participation in Social Activities(Baseline)

研究者

发起方
Jason Wilken
申办方类型
Other
责任方
Sponsor Investigator
主要研究者

Jason Wilken

Associate Professor

University of Iowa

研究点 (6)

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