Auto Control of Volume Management for Limb Loss

NCT ID: NCT03550118

Last Updated: 2023-05-03

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-07

Study Completion Date

2022-01-31

Brief Summary

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The aim of this research is to create a prosthetic system that will automatically adjust the fit of the socket and create a well-fitting prosthesis for people with leg amputations who experience volume fluctuations when using their prosthesis.

Detailed Description

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People with lower limb amputations often experience daily changes in the size (volume) of their residual limb. These daily changes can cause a prosthesis to fit poorly. They can also cause limb health problems including skin breakdown and injury to deeper tissues. Prosthetic socket systems that accommodate limb volume changes can help address these issues, but they require users to make adjustments throughout the day.

The objective of this research is to develop and test an automatically-adjusting prosthetic socket system for prosthesis users. The system integrates with a range of adjustable socket technologies, including those that are commercially available. The system allows small size adjustments for both tightening and loosening the socket. In early aims of the study, the prosthesis will be adjusted manually, but can be controlled remotely, eliminating the need to remove the prosthesis or bend down to make adjustments. The system will later be enhanced to automatically change the fit of an adjustable socket at the appropriate times, without distracting the user. We hypothesize that this system will help to maintain consistent limb fluid volume while the prosthesis user is wearing the socket and that socket fit will be improved. The system functions by continuously collecting measurements from sensors within the socket and uses small motors to control adjustable panels in the socket wall.

Conditions

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Lower Limb Amputation Below Knee (Injury)

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Aim 2 - Adjustable Socket - Researcher Controls

An adjustable socket is tested where researchers control the adjustments. This arm focuses on socket size adjustments while walking.

Group Type EXPERIMENTAL

Adjustable socket

Intervention Type DEVICE

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Aim 3 - Adjustable Socket - Participant Controls

An adjustable socket is tested where the study participant controls the adjustments. This arm focuses on socket size adjustments while walking.

Group Type EXPERIMENTAL

Adjustable socket

Intervention Type DEVICE

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Aim 4 - Adjustable Socket - Automatic Controls

An adjustable socket is tested where a control system is used to automatically control the adjustments. This arm focuses on socket size adjustments while walking.

Group Type EXPERIMENTAL

Adjustable socket

Intervention Type DEVICE

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Aim 6A - Release/Recovery - Researcher Controls

An adjustable socket is tested where researchers control the adjustments. This arm focuses on a socket release and recovery mechanism that allows for full or partial doffing of the socket while seated.

Group Type EXPERIMENTAL

Adjustable socket

Intervention Type DEVICE

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Aim 6B - Release/Recovery - Participant Controls

An adjustable socket is tested where the study participant controls the adjustments. This arm focuses on a socket release and recovery mechanism that allows for full or partial doffing of the socket while seated.

Group Type EXPERIMENTAL

Adjustable socket

Intervention Type DEVICE

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Aim 8 - Panel Pull During Resting

The purpose of Aim #8 was to determine if vacuum-like action ("panel pull") during resting between periods of activity facilitated limb fluid volume recovery and retention in transtibial prosthesis users. Liner attached to panels.

Group Type EXPERIMENTAL

Adjustable socket

Intervention Type DEVICE

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Aim 9 - Panel Pull During Ambulation

Extending from the Aim #8 results, we sought to determine in Aim #9 if "vacuum-like" action during ambulation facilitated limb fluid volume recovery and retention. Vacuum-like action was achieved by quickly pulling the panels and liner (liner attached to panels) radially outward during late stance phase and then moving them back to their original position during early swing.

Group Type EXPERIMENTAL

Adjustable socket

Intervention Type DEVICE

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Aim 10 - Adjustable Socket Out of Lab Testing

Participants took the investigational device home in one of three test modes. In the first mode, the panels were in a "locked" flush position, similar to their traditional prosthesis. Participants were not able to adjust the panels in this first mode. The second mode allowed participants to manually make panel adjustments, incrementally enlarging or tightening the panels radially. Lastly, the third mode implemented the automated controller developed in the previous aims. Participants were still able to make manual adjustments to the panel positions but during walks adjustments would also occur automatically. Each mode was tested for a minimum of 1 week.

Group Type EXPERIMENTAL

Adjustable socket

Intervention Type DEVICE

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Interventions

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Adjustable socket

The adjustable prosthetic socket will be used to test the influence of socket size adjustments during sitting, standing, and walking activities to determine if these strategies can be used to improve socket fit and reduce fluctuations in limb volume.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* 18 years of age or older
* Unilateral transtibial amputee
* At least 6 months post-amputation
* Wear prosthesis at least 3 hours per day
* Use an elastomeric (i.e. gel) liner
* K3 or higher Medicare Functional Classification Level
* Able to walk continuously with prosthesis for at least 5 minutes at a time, sit, stand, and step up a height of 5.0 cm.
* Residual limb of 9.0 cm or longer
* Experience problems with volume fluctuations that affect their prosthetic socket fit

Exclusion Criteria

* Participants experiencing skin breakdown on enrollment will be excluded, but can enter after having been free of clinically visually-apparent skin breakdown for two weeks.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Joan Sanders

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Joan E Sanders, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

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University of Washington Bioengineering

Seattle, Washington, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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STUDY00001779

Identifier Type: -

Identifier Source: org_study_id

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