Skin Temperature Perception and Prosthetic Thermoregulation

NCT ID: NCT07215442

Last Updated: 2025-10-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

56 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-04-28

Study Completion Date

2013-08-09

Brief Summary

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To protect against excessive body temperatures, local thermoregulatory mechanisms include temperature sensory nerves (responsive to warm or cool stimuli) and vasomotors (muscles that constrict or dilate blood vessels). When the temperature changes occur, the temperature sensory nerves will detect "warm" or "cool" and communicate this sensation to the brain. This is called perceiving a sensation and will often elicit a behavioral change, such as donning additional clothes or moving to a different environment. Simultaneously, vasomotors will dilate or constrict to promote or prevent heat dissipation to the environment, respectively. As skin temperatures increase, perspiration may provide some thermal relief through evaporative cooling. However, the prostheses worn by individuals with lower limb amputations are impermeable to moisture and prevent evaporative cooling. Prosthetic materials are also excellent thermal insulators, contributing to skin temperature increases. Thermoregulation problems are compounded by diabetes, a common co-morbidity of many who experience lower limb amputation. For those who wear lower limb prostheses, many endure thermal discomfort.

This research explores the relationship between skin temperature, perception, and thermoregulation. The investigators aim to discover the temperature at which individuals with lower limb amputation perceive warm and cool stimuli. The investigators also aim to discover the vascular response that occurs when temperature changes are perceived. The goals are to determine temperature sensation thresholds of the lower limb, vascular reactivity, and the effect of diabetes and amputation.

Detailed Description

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This study will include four groups of participants including individuals with diabetes, individuals without a diagnosis of diabetes, individuals with lower limb amputations of diabetic etiology, and individuals with lower limb amputations of non-diabetic etiologies.

To measure temperature perception, a thermode (a temperature changing device about the size of a coffee cup) will be placed on the lower leg of each participant. The thermode also included a laser Doppler flow meter, embedded in the center of the thermode, to measure blood flow in response to changes in skin temperature. The experimental protocol begins with the thermode set for 3 minutes at 30 °C, 32 °C, 34 °C, and 35 °C (random order). The temperature will then be either increased or decreased at a slow rate of 0.2 °C/sec until the participant perceives either a warming or cooling sensation. The analysis plan includes determining the threshold at which a temperature change was perceived relative to each initial temperature, whether there are differences in blood flow (vascular reactivity) when thermal stimuli are detected, and these measurements are altered by diabetes or amputation.

The general hypotheses are that these populations will have (1) different warm and cool temperature perception thresholds depending on the initial skin temperature and (2) different changes in skin blood flow as a function of their temperature perception thresholds.

Conditions

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Lower Limb Amputation Below Knee Diabetes (DM) Skin Temperature Change Vascular Reactivity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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Individuals without a diagnosis of diabetes

Group Type OTHER

Warming stimulus starting at 30 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 32 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 34 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 35 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Cooling stimulus starting at 30 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 32 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 34 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 35 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Individuals with diabetes

Group Type OTHER

Warming stimulus starting at 30 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 32 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 34 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 35 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Cooling stimulus starting at 30 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 32 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 34 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 35 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Individuals with lower limb amputations of diabetic etiology

Group Type OTHER

Warming stimulus starting at 30 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 32 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 34 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 35 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Cooling stimulus starting at 30 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 32 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 34 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 35 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Individuals with lower limb amputations of non-diabetic etiologies

Group Type OTHER

Warming stimulus starting at 30 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 32 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 34 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Warming stimulus starting at 35 C initial temperature

Intervention Type OTHER

A warming stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Cooling stimulus starting at 30 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 32 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 34 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Cooling stimulus starting at 35 C initial temperature

Intervention Type OTHER

A cooling stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Interventions

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Warming stimulus starting at 30 C initial temperature

A warming stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Intervention Type OTHER

Warming stimulus starting at 32 C initial temperature

A warming stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Intervention Type OTHER

Warming stimulus starting at 34 C initial temperature

A warming stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Intervention Type OTHER

Warming stimulus starting at 35 C initial temperature

A warming stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 42 C was reached.

Intervention Type OTHER

Cooling stimulus starting at 30 C initial temperature

A cooling stimulus starting at 30 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Intervention Type OTHER

Cooling stimulus starting at 32 C initial temperature

A cooling stimulus starting at 32 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Intervention Type OTHER

Cooling stimulus starting at 34 C initial temperature

A cooling stimulus starting at 34 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Intervention Type OTHER

Cooling stimulus starting at 35 C initial temperature

A cooling stimulus starting at 35 C initial temperature was applied at a rate of 0.2 C/second until the participant perceived the stimulus or the termination temperature of 18 C was reached.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Able to ambulate without upper extremity aids
* Able to attend study visits
* Able to sense a Semmes-Weinstein 5.07 monofilament applied to proximal lateral aspect of test limb calf
* Have been fit with a prosthesis
* Have used a prosthesis for at least six months
* Wear the prosthesis for at least four hours per day by self-report

Exclusion Criteria

\- Have no residual limb ulcers
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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VA Puget Sound Health Care System

FED

Sponsor Role lead

Responsible Party

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Glenn K. Klute, PhD

Director, CLiMB

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Glenn K Klute, PhD

Role: PRINCIPAL_INVESTIGATOR

VA Puget Sound Health Care System

Locations

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VA Puget Sound Health Care System Seattle Division

Seattle, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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1587700

Identifier Type: -

Identifier Source: org_study_id

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