Bioimpedance as a Diagnostic Tool for Assessing the Need for Socket Modification in Transtibial Amputees

NCT ID: NCT03164356

Last Updated: 2023-05-03

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

68 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-09

Study Completion Date

2020-12-23

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of the proposed study is to conduct research on individuals with lower limb amputation, evaluating if residual limb fluid volume data collected using a novel non-invasive device is beneficial towards prosthetic prescription, fit, and comfort as determined by amputee test subjects and practitioners (prosthetists). Participants' residual limb fluid volume will be monitored through bioimpedance analysis both before and after a practitioner-issued modification to the prosthesis as an observational cohort study and then as a blinded randomized control trial in which the data may or may not be shared with the practitioner before the modification is made to the prosthesis.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Transtibial Amputee

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Participants

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Arm 1

In Arm 1, bioimpedance measurements are taken by research staff. The participants also wear an ActiGraph monitor for at least one week prior to their prosthetist preforming modifications to their socket.

Group Type NO_INTERVENTION

No interventions assigned to this group

Arm 2 - Experimental

Conclusions drawn from data gathered in Arm 1 will be given to the participant's prosthetist, along with their bioimpedance data from Arm 2, to inform the practitioner's decision on when a modification to the socket is warranted. The results will be compared to those of Arm 3.

Group Type EXPERIMENTAL

Bioimpedance monitor

Intervention Type DEVICE

Participant in aim 1 will be monitored using the bioimpedance monitor. Data obtained from the arm 1 cohort will be used to inform socket modifications made for arm 2 cohort.

Arm 3 - Control

Bioimpedance data will be collected from participants in Arm 3 in parallel with those in Arm 2. However, no data will be provided to the participant's prosthetist.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Bioimpedance monitor

Participant in aim 1 will be monitored using the bioimpedance monitor. Data obtained from the arm 1 cohort will be used to inform socket modifications made for arm 2 cohort.

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Transtibial amputees, unilateral or bilateral
* Amputation at least 18 months prior
* Walking activity of at least 7 hours per week
* Medicare functional classification level of 2 or higher
* Residual limb length of at least 9 centimeters
* Detrimental impacts to socket fit caused by residual limb volume fluctuations
* Indication for augmented suspension, socket modification/change, sock application removal or activity modification

Exclusion Criteria

* Incidence of skin breakdown
* Inability to ambulate continuously on a level walkway
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Washington

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Joan Sanders

Professor, Bioengineering

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Joan E Sanders, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Washington Bioengineering

Seattle, Washington, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Sanders JE, Severance MR, Allyn KJ. Computer-socket manufacturing error: how much before it is clinically apparent? J Rehabil Res Dev. 2012;49(4):567-82. doi: 10.1682/jrrd.2011.05.0097.

Reference Type BACKGROUND
PMID: 22773260 (View on PubMed)

Legro MW, Reiber G, del Aguila M, Ajax MJ, Boone DA, Larsen JA, Smith DG, Sangeorzan B. Issues of importance reported by persons with lower limb amputations and prostheses. J Rehabil Res Dev. 1999 Jul;36(3):155-63.

Reference Type BACKGROUND
PMID: 10659798 (View on PubMed)

Kavounoudias A, Tremblay C, Gravel D, Iancu A, Forget R. Bilateral changes in somatosensory sensibility after unilateral below-knee amputation. Arch Phys Med Rehabil. 2005 Apr;86(4):633-40. doi: 10.1016/j.apmr.2004.10.030.

Reference Type BACKGROUND
PMID: 15827911 (View on PubMed)

Sanders JE, Cagle JC, Allyn KJ, Harrison DS, Ciol MA. How do walking, standing, and resting influence transtibial amputee residual limb fluid volume? J Rehabil Res Dev. 2014;51(2):201-12. doi: 10.1682/JRRD.2013.04.0085.

Reference Type BACKGROUND
PMID: 24933719 (View on PubMed)

Sanders JE, Harrison DS, Allyn KJ, Myers TR, Ciol MA, Tsai EC. How do sock ply changes affect residual-limb fluid volume in people with transtibial amputation? J Rehabil Res Dev. 2012;49(2):241-56. doi: 10.1682/jrrd.2011.02.0022.

Reference Type BACKGROUND
PMID: 22773526 (View on PubMed)

Sanders JE, Fatone S. Residual limb volume change: systematic review of measurement and management. J Rehabil Res Dev. 2011;48(8):949-86. doi: 10.1682/jrrd.2010.09.0189.

Reference Type BACKGROUND
PMID: 22068373 (View on PubMed)

Van Loan MD, Withers P, Matthie J, Mayclin PL. Use of bioimpedance spectroscopy to determine extracellular fluid, intracellular fluid, total body water, and fat-free mass. Basic Life Sci. 1993;60:67-70. doi: 10.1007/978-1-4899-1268-8_13. No abstract available.

Reference Type BACKGROUND
PMID: 8110166 (View on PubMed)

Organ LW, Bradham GB, Gore DT, Lozier SL. Segmental bioelectrical impedance analysis: theory and application of a new technique. J Appl Physiol (1985). 1994 Jul;77(1):98-112. doi: 10.1152/jappl.1994.77.1.98.

Reference Type BACKGROUND
PMID: 7961281 (View on PubMed)

Fuller NJ, Hardingham CR, Graves M, Screaton N, Dixon AK, Ward LC, Elia M. Predicting composition of leg sections with anthropometry and bioelectrical impedance analysis, using magnetic resonance imaging as reference. Clin Sci (Lond). 1999 Jun;96(6):647-57.

Reference Type BACKGROUND
PMID: 10334971 (View on PubMed)

Salinari S, Bertuzzi A, Mingrone G, Capristo E, Scarfone A, Greco AV, Heymsfield SB. Bioimpedance analysis: a useful technique for assessing appendicular lean soft tissue mass and distribution. J Appl Physiol (1985). 2003 Apr;94(4):1552-6. doi: 10.1152/japplphysiol.00571.2002.

Reference Type BACKGROUND
PMID: 12626475 (View on PubMed)

Dittmar M. Reliability and variability of bioimpedance measures in normal adults: effects of age, gender, and body mass. Am J Phys Anthropol. 2003 Dec;122(4):361-70. doi: 10.1002/ajpa.10301.

Reference Type BACKGROUND
PMID: 14614757 (View on PubMed)

Andreoli A, Melchiorri G, De Lorenzo A, Caruso I, Sinibaldi Salimei P, Guerrisi M. Bioelectrical impedance measures in different position and vs dual-energy X-ray absorptiometry (DXA). J Sports Med Phys Fitness. 2002 Jun;42(2):186-9.

Reference Type BACKGROUND
PMID: 12032414 (View on PubMed)

Donadio C, Consani C, Ardini M, Bernabini G, Caprio F, Grassi G, Lucchesi A, Nerucci B. Estimate of body water compartments and of body composition in maintenance hemodialysis patients: comparison of single and multifrequency bioimpedance analysis. J Ren Nutr. 2005 Jul;15(3):332-44. doi: 10.1016/j.jrn.2005.04.001.

Reference Type BACKGROUND
PMID: 16007563 (View on PubMed)

Segal KR, Burastero S, Chun A, Coronel P, Pierson RN Jr, Wang J. Estimation of extracellular and total body water by multiple-frequency bioelectrical-impedance measurement. Am J Clin Nutr. 1991 Jul;54(1):26-9. doi: 10.1093/ajcn/54.1.26.

Reference Type BACKGROUND
PMID: 2058583 (View on PubMed)

Wotton MJ, Thomas BJ, Cornish BH, Ward LC. Comparison of whole body and segmental bioimpedance methodologies for estimating total body water. Ann N Y Acad Sci. 2000 May;904:181-6. doi: 10.1111/j.1749-6632.2000.tb06444.x.

Reference Type BACKGROUND
PMID: 10865733 (View on PubMed)

Armstrong LE, Kenefick RW, Castellani JW, Riebe D, Kavouras SA, Kuznicki JT, Maresh CM. Bioimpedance spectroscopy technique: intra-, extracellular, and total body water. Med Sci Sports Exerc. 1997 Dec;29(12):1657-63. doi: 10.1097/00005768-199712000-00017.

Reference Type BACKGROUND
PMID: 9432101 (View on PubMed)

Siconolfi SF, Gretebeck RJ, Wong WW, Pietrzyk RA, Suire SS. Assessing total body and extracellular water from bioelectrical response spectroscopy. J Appl Physiol (1985). 1997 Feb;82(2):704-10. doi: 10.1152/jappl.1997.82.2.704.

Reference Type BACKGROUND
PMID: 9049756 (View on PubMed)

Sanders JE, Rogers EL, Abrahamson DC. Assessment of residual-limb volume change using bioimpedence. J Rehabil Res Dev. 2007;44(4):525-35. doi: 10.1682/jrrd.2006.08.0096.

Reference Type BACKGROUND
PMID: 18247249 (View on PubMed)

Sanders JE, Allyn KJ, Harrison DS, Myers TR, Ciol MA, Tsai EC. Preliminary investigation of residual-limb fluid volume changes within one day. J Rehabil Res Dev. 2012;49(10):1467-78. doi: 10.1682/jrrd.2011.12.0236.

Reference Type BACKGROUND
PMID: 23516051 (View on PubMed)

Sanders JE, Cagle JC, Harrison DS, Myers TR, Allyn KJ. How does adding and removing liquid from socket bladders affect residual-limb fluid volume? J Rehabil Res Dev. 2013;50(6):845-60. doi: 10.1682/JRRD.2012.06.0121.

Reference Type BACKGROUND
PMID: 24203546 (View on PubMed)

Sanders JE, Harrison DS, Cagle JC, Myers TR, Ciol MA, Allyn KJ. Post-doffing residual limb fluid volume change in people with trans-tibial amputation. Prosthet Orthot Int. 2012 Dec;36(4):443-9. doi: 10.1177/0309364612444752. Epub 2012 May 15.

Reference Type BACKGROUND
PMID: 22588848 (View on PubMed)

Sanders JE, Hartley TL, Phillips RH, Ciol MA, Hafner BJ, Allyn KJ, Harrison DS. Does temporary socket removal affect residual limb fluid volume of trans-tibial amputees? Prosthet Orthot Int. 2016 Jun;40(3):320-8. doi: 10.1177/0309364614568413. Epub 2015 Feb 20.

Reference Type BACKGROUND
PMID: 25710944 (View on PubMed)

Hanspal RS, Fisher K, Nieveen R. Prosthetic socket fit comfort score. Disabil Rehabil. 2003 Nov 18;25(22):1278-80. doi: 10.1080/09638280310001603983.

Reference Type BACKGROUND
PMID: 14617445 (View on PubMed)

Legro MW, Reiber GD, Smith DG, del Aguila M, Larsen J, Boone D. Prosthesis evaluation questionnaire for persons with lower limb amputations: assessing prosthesis-related quality of life. Arch Phys Med Rehabil. 1998 Aug;79(8):931-8. doi: 10.1016/s0003-9993(98)90090-9.

Reference Type BACKGROUND
PMID: 9710165 (View on PubMed)

Redfield MT, Cagle JC, Hafner BJ, Sanders JE. Classifying prosthetic use via accelerometry in persons with transtibial amputations. J Rehabil Res Dev. 2013;50(9):1201-12. doi: 10.1682/JRRD.2012.12.0233.

Reference Type BACKGROUND
PMID: 24458961 (View on PubMed)

Adragao T, Pires A, Branco P, Castro R, Oliveira A, Nogueira C, Bordalo J, Curto JD, Prata MM. Ankle--brachial index, vascular calcifications and mortality in dialysis patients. Nephrol Dial Transplant. 2012 Jan;27(1):318-25. doi: 10.1093/ndt/gfr233. Epub 2011 May 6.

Reference Type BACKGROUND
PMID: 21551082 (View on PubMed)

Potier L, Abi Khalil C, Mohammedi K, Roussel R. Use and utility of ankle brachial index in patients with diabetes. Eur J Vasc Endovasc Surg. 2011 Jan;41(1):110-6. doi: 10.1016/j.ejvs.2010.09.020. Epub 2010 Nov 20.

Reference Type BACKGROUND
PMID: 21095144 (View on PubMed)

Owings MF, Kozak LJ. Ambulatory and inpatient procedures in the United States, 1996. Vital Health Stat 13. 1998 Nov;(139):1-119.

Reference Type BACKGROUND
PMID: 9866429 (View on PubMed)

Pezzin LE, Dillingham TR, Mackenzie EJ, Ephraim P, Rossbach P. Use and satisfaction with prosthetic limb devices and related services. Arch Phys Med Rehabil. 2004 May;85(5):723-9. doi: 10.1016/j.apmr.2003.06.002.

Reference Type BACKGROUND
PMID: 15129395 (View on PubMed)

Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil. 2008 Mar;89(3):422-9. doi: 10.1016/j.apmr.2007.11.005.

Reference Type BACKGROUND
PMID: 18295618 (View on PubMed)

Berke GM, Fergason J, Milani JR, Hattingh J, McDowell M, Nguyen V, Reiber GE. Comparison of satisfaction with current prosthetic care in veterans and servicemembers from Vietnam and OIF/OEF conflicts with major traumatic limb loss. J Rehabil Res Dev. 2010;47(4):361-71. doi: 10.1682/jrrd.2009.12.0193.

Reference Type BACKGROUND
PMID: 20803404 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

Access external resources that provide additional context or updates about the study.

https://www.sandia.gov/research/dynamic-socket/

Sandia National Laboratories, Dynamic socket

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

STUDY00000969

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.