Evaluating Mobility Interventions in the Real World
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Minimum Foot Clearance With Different Prostheses
研究概览
简要总结
This study is intended to test the comparative biomechanical benefits of different lower-limb prostheses and orthoses using data collected over extended periods of everyday life using wearable sensors. Investigators seek to improve physical health, functional activity level, independence, workforce participation, and mental health in participants with lower limb amputation and other lower-limb impairments. Investigators seek to study the similarities and differences in participants' movement using prostheses and orthoses with different technological features or designs. Study team also seek to develop technologies that enhance the methods for using wearable sensor technology to perform this type of study.
Participants with lower-limb amputation, participants who use lower limb orthoses, and participants with drop-foot (including a specific group with Multiple Sclerosis).
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Target Populations:
- •Participants with amputation must have used a prosthesis for more than 6 months, and wear it for at least 8 hours per day.
- •Participants must be more than 6 months past their most recent surgery (if any).
- •Participants must be free of musculoskeletal and cardiovascular conditions that would limit their ability to safely complete testing.
- •Participants should consider themselves in good health; be able to wear their prostheses or orthoses all day long; be able to perform all of their activities of daily living (ADL) with their prostheses or orthoses as appropriate; have a comfortably fitting functional prosthesis (if applicable) that does not cause any skin problems; and have a stable residual limb (or impaired limb).
- •Participants may use a narrow-base cane (single point, narrow tripod base, etc.) as an ambulatory aid but not a small-base quad cane or walker.
- •Participants must be able to walk with their prostheses or orthoses for 30 minutes (total) and stand for 30 minutes (total), in individual bouts of at least 6 minutes, without becoming fatigued, feeling dizzy, having chest pain or shortness of breath, or experiencing claudication symptoms.
- •Participants involved in running tests must be able to run for 30 minutes (total) in bouts of at least 6 minutes, without becoming fatigued, feeling dizzy, having chest pain, or experiencing claudication symptoms.
- •Participants must have no known cognitive disability.
- •Participants must be fluent in spoken and written English.
- •Running portions of the study will be limited to participants who self-report regular engagement in recreational or competitive running.
- •Participants in the branch that uses only their own prostheses must have at least a daily use prosthesis and a running-specific prosthesis; additional prostheses may also be included
- •Multiple Sclerosis group:
- •For the specific subgroup targeting Multiple Sclerosis, participants must have a clinical diagnosis of Multiple Sclerosis and a clinician must determine they are experiencing foot drop.
- •Participants must be able to comfortably wear and ambulate with both study devices with effective management of foot-drop, without significant discomfort
- •Participants must be able to perform all of their activities of daily living (ADL) with only minimal use of ambulatory aids. Subjects may use a narrow-base cane (single point, narrow tripod base, etc.) as an ambulatory aid in any amount. Use of more comprehensive ambulatory aids (e.g. a small-base quad cane, wide-base quad cane or walker) must be limited to no more than 20% of their walking time when not at home. Participants who do use an assistive device occasionally should report a threshold for use of greater than 100 feet, i.e., they are unlikely to use their device unless they anticipate ambulating greater than this distance.
排除标准
- •Target Populations:
- •Allergy to electrode gel, surgical tape and metals.
- •Participants who currently use the Bioness L300 Go or similar neuro-orthoses or use a carbon fiber ankle-foot orthosis at the time of the study will be excluded to avoid biasing results for one device or the other. Participants with past experience not currently using these devices will be eligible.
- •Participants enrolled in physical therapy or other rehabilitative care for treatment of gait, balance, or lower extremity strength or coordination at the time of the study will be excluded to avoid confounding effects from therapy and device-based management of their condition.
- •For the orthotics study, participants with peripheral neuropathy impacting control of the tibialis anterior muscle via the peroneal nerve will be excluded.
- •Participants under treatment for infectious diseases will be excluded from the study.
- •Women who are pregnant or planning to become pregnant during the course of the study will be excluded.
- •Symptomatic musculoskeletal conditions that prevent unaided walking, such as back pain or knee arthritis.
- •Cardiovascular conditions that make moderate exercise unsafe, including (but not limited to) history of angina, peripheral vascular disease, congestive heart failure, history of myocardial infarction, and history of stroke. Potential participants will be excluded if they self-report that a physician has told them to avoid moderate exercise.
- •History of chest pain, shortness of breath, or claudication symptoms during ambulation
- •History of significant neuropathy with altered balance
- •History of serious residual limb pain or phantom limb pain within the past six months.
- •History of chronic skin breakdown.
- •Inability to perform the tasks involved in the study.
研究组 & 干预措施
Prosthesis user with transtibial or transfemoral amputation
Experiments will use standard commercially available prostheses for participants with lower-limb amputation. Specific prostheses will be determined at the time of the study, but they will include prostheses that are fully passive such as energy storage-and-return (ESR) feet, ESR feet with mobilized ankles such as passive hydraulic ankles (PHA), and ESR feet with microprocessor-controlled ankles (MPA).
干预措施: Lower limb prostheses (Device)
Orthoses user with drop-foot
This arm will consists of participants with drop-foot. A subset of the drop-foot population will be persons with Multiple Sclerosis and currently drop-foot.
For participants in this arm, standard commercially-available orthoses or standard-of-care custom orthoses will be used, as well as standard commercially-available electrical stimulation neuro-orthoses.
干预措施: Orthoses for Drop-foot (Device)
结局指标
主要结局
Minimum Foot Clearance With Different Prostheses
时间窗: Weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study
Minimum Foot Clearance with different prostheses, participants crossover to each of 4 different conditions at different study visits, data collected up to 12 weeks on study.
Minimum Foot Clearance With Different Orthoses
时间窗: Baseline, 10 days, and 20 days for Orthotic interventions
Minimum Foot Clearance with different orthoses, participants crossover to each of 3 different conditions at different study visits, data collected up to 20 days on study.
次要结局
- Behavioral Gait Function as Measured From Daily Stride Count(Weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study)
- Behavioral Gait Function as Measured From Stride Speed During Walking Bouts of Different Durations(Weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study)
- Prosthetic Limb Users Survey of Mobility Score(up to 12 weeks)
- Change in Movement Quality as Determined by Stride Width: Prosthesis(Weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study)
- Change in Movement Quality as Determined by Stride Width: Orthoses(Baseline, 10 days, and 20 days for Orthotic interventions)
- Change in Gait Performance as Determined by Average Speed(Weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study)
- Gait Performance as Determined by Stride Frequency at Identical Speed(Weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study)
- Change in Gait Performance as Determined by Ground Reaction Forces(Baseline, 10 days, and 20 days for Orthotic interventions, weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study)
- Change in Gait Performance as Determined by Socket Torques(Baseline, 10 days, and 20 days for Orthotic interventions, weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study)
- Change in Functional Gait Assessment Score(Baseline, 10 days, and 20 days for Orthotic interventions)
- Change in 6 Minute Walking Test Distance(Baseline, 10 days, and 20 days study visits to test conditions for Orthotic interventions)
- Stride Length at Identical Walking Speed(Weekly time points for Prosthetic interventions (baseline, 1, 2, 3, and 4 weeks), data collected anytime up to 12 weeks on study)