Even-Up to Minimize Secondary Site Pain For Ankle Fracture

NCT ID: NCT04164563

Last Updated: 2022-10-18

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

6 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-11-14

Study Completion Date

2020-09-10

Brief Summary

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Evaluating impact of use of Even-Up shoe wear device for patients treated in CAM boot walker for an ankle fracture. Randomized controlled trial, randomizing patients into control group with boot treatment only versus boot treatment with Even-Up device on contralateral extremity.

Detailed Description

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A variety of foot and ankle injuries can be treated effectively through the use of a controlled ankle movement (CAM) walker boot. CAM walker boots protect the injured area by restricting foot and ankle motion, providing a stable platform to distribute forces while bearing weight, and allowing the user to rollover the foot during ambulation because of a rocker bottom-shaped sole. Such qualities lend the CAM walker boot to provide ankle support that can be advantageous compared with other commonly used methods. Despite their utility, CAM walker boots create a simulated leg-length discrepancy (LLD), which can result in altered biomechanics during ambulation. Additionally, a LLD can be associated with lower back and joint pain.

We have previously conducted a study that suggests a relationship exists between CAM walker boot treatment and pain at sites other than the extremity being treated. There have been several randomized controlled trials (RCTs) examining a relationship between the correction of inherent LLD with insole inserts and lower back pain. Furthermore, there has been a past RCT and there is a current RCT examining a relationship between the use of the EVENup orthotic shoe lift to correct CAM walker boot simulated LLD and pain at sites other than the extremity being treated. However, these studies were not conducted with patient populations with uniform injuries. To the best of our knowledge, an RCT has not been conducted with the EVENup orthotic shoe lift to examine this relationship in a uniform patient population with nonoperative ankle fractures. This RCT aims to assess the efficacy of the EVENup orthotic shoe lift, towards reducing and even preventing such pain that may be associated with this common course of treatment.

Conditions

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Arthralgia Trouble Balancing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Both patients and providers are aware that patients are being assigned to either control or experimental group.

Study Groups

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Control

Standard CAM boot treatment without Even-Up device.

Group Type NO_INTERVENTION

No interventions assigned to this group

Study

CAM boot treatment with Even-Up for contralateral extremity.

Group Type EXPERIMENTAL

Even-Up

Intervention Type DEVICE

Orthotic shoe lift worn on contralateral foot to increase leg length

Interventions

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Even-Up

Orthotic shoe lift worn on contralateral foot to increase leg length

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Non-operative Treatment of Ankle Fracture
* CAM boot as treatment for injury
* Weight bearing ad lib

Exclusion Criteria

* Pregnancy
* Non-English speaking
* Recent surgery for lower extremity or back
* Recent other injury to lower extremity or back
* Restricted weight bearing
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Brigham and Women's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Jeremy Smith

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jeremy T Smith, MD

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Locations

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Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Countries

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United States

References

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Waverly BJ, Sorensen MD, Sorensen TK. Early Weightbearing Protocol in Operative Fixation of Acute Jones Fractures. J Foot Ankle Surg. 2018 May-Jun;57(3):489-493. doi: 10.1053/j.jfas.2017.11.005.

Reference Type BACKGROUND
PMID: 29685559 (View on PubMed)

DiGiovanni BF, Moore AM, Zlotnicki JP, Pinney SJ. Preferred management of recalcitrant plantar fasciitis among orthopaedic foot and ankle surgeons. Foot Ankle Int. 2012 Jun;33(6):507-12. doi: 10.3113/FAI.2012.0507.

Reference Type BACKGROUND
PMID: 22735325 (View on PubMed)

Mittal R, Harris IA, Adie S, Naylor JM; CROSSBAT Study Group. Surgery for Type B Ankle Fracture Treatment: a Combined Randomised and Observational Study (CROSSBAT). BMJ Open. 2017 Mar 27;7(3):e013298. doi: 10.1136/bmjopen-2016-013298.

Reference Type BACKGROUND
PMID: 28348185 (View on PubMed)

Simpson MR, Howard TM. Tendinopathies of the foot and ankle. Am Fam Physician. 2009 Nov 15;80(10):1107-14.

Reference Type BACKGROUND
PMID: 19904895 (View on PubMed)

Vulcano E, Deland JT, Ellis SJ. Approach and treatment of the adult acquired flatfoot deformity. Curr Rev Musculoskelet Med. 2013 Dec;6(4):294-303. doi: 10.1007/s12178-013-9173-z.

Reference Type BACKGROUND
PMID: 23765382 (View on PubMed)

Ready LV, Fisk EG, Ciurylo W, Chiodo CP, Bluman EM, Smith JT. Associated Joint Pain With Controlled Ankle Movement Walker Boot Wear. J Am Acad Orthop Surg Glob Res Rev. 2018 Nov 27;2(12):e044. doi: 10.5435/JAAOSGlobal-D-18-00044. eCollection 2018 Dec.

Reference Type BACKGROUND
PMID: 30680366 (View on PubMed)

Keene DJ, Willett K, Lamb SE. The Immediate Effects of Different Types of Ankle Support Introduced 6 Weeks After Surgical Internal Fixation for Ankle Fracture on Gait and Pain: A Randomized Crossover Trial. J Orthop Sports Phys Ther. 2016 Mar;46(3):157-67. doi: 10.2519/jospt.2016.6212. Epub 2016 Jan 26.

Reference Type BACKGROUND
PMID: 26813753 (View on PubMed)

White SC, Gilchrist LA, Wilk BE. Asymmetric limb loading with true or simulated leg-length differences. Clin Orthop Relat Res. 2004 Apr;(421):287-92. doi: 10.1097/01.blo.0000119460.33630.6d.

Reference Type BACKGROUND
PMID: 15123962 (View on PubMed)

O'Toole GC, Makwana NK, Lunn J, Harty J, Stephens MM. The effect of leg length discrepancy on foot loading patterns and contact times. Foot Ankle Int. 2003 Mar;24(3):256-9. doi: 10.1177/107110070302400310.

Reference Type BACKGROUND
PMID: 12793490 (View on PubMed)

Subotnick SI. Limb length discrepancies of the lower extremity (the short leg syndrome). J Orthop Sports Phys Ther. 1981;3(1):11-6. doi: 10.2519/jospt.1981.3.1.11.

Reference Type BACKGROUND
PMID: 18810144 (View on PubMed)

Rannisto S, Okuloff A, Uitti J, Paananen M, Rannisto PH, Malmivaara A, Karppinen J. Correction of leg-length discrepancy among meat cutters with low back pain: a randomized controlled trial. BMC Musculoskelet Disord. 2019 Mar 14;20(1):105. doi: 10.1186/s12891-019-2478-3.

Reference Type BACKGROUND
PMID: 30871549 (View on PubMed)

Defrin R, Ben Benyamin S, Aldubi RD, Pick CG. Conservative correction of leg-length discrepancies of 10mm or less for the relief of chronic low back pain. Arch Phys Med Rehabil. 2005 Nov;86(11):2075-80. doi: 10.1016/j.apmr.2005.06.012.

Reference Type BACKGROUND
PMID: 16271551 (View on PubMed)

Kipp D, Village D, Edwards KJ. Effectiveness of Evenup Shoe-Lift Use Among Individuals Prescribed a Walking Boot. J Allied Health. 2017 Summer;46(2):104-110.

Reference Type BACKGROUND
PMID: 28561867 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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http://clinicaltrials.gov/ct2/show/NCT03848949

Study of an Orthotic Designed to Equalize Leg Lengths for Patients with Injuries Managed in Walking Boots

Other Identifiers

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2019P002694

Identifier Type: -

Identifier Source: org_study_id

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