~8 spots leftby Apr 2026

Caregiver-Assisted Limb Scanning for Amputees

GK
Overseen byGlenn K Klute, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
Disqualifiers: Improper fit, Skin irritation, Osteoarthritis, others
No Placebo Group

Trial Summary

What is the purpose of this trial?

When the prosthetic socket of a Veteran with a lower limb amputation no longer fits or is damaged beyond repair, a new prosthetic socket is warranted. The provision of a new socket requires multiple clinical visits which can place a high travel burden and potential pandemic exposure stress on Veterans who live in rural communities far from VA Medical Centers or alternative prosthetic clinics. This research seeks to determine if one of the in-person visits traditionally needed to obtain a well-fitting prosthesis can be performed remotely with the assistance of a helper. The investigators seek to discover if an untrained individual (a helper) can wield inexpensive, easy to use, digital technology to capture the shape of a residual limb to see if it can be used to fabricate a prosthetic socket that fits at least as well as one fabricated by a prosthetist using traditional, hand casting methods in the clinic. The expected result of this research is an evidence-based prosthetic fabrication process that reduces Veteran travel burden while providing a prosthesis that fits at least as well as the current standard-of-care. The upshot is a clear improvement in prosthetic provision for Veterans, particularly for those who live in rural communities. To make this determination, the investigators will perform a between-subject experiment with two specific aims. To determine differences in goodness of fit between the two study sockets, the investigators will use both patient reported outcomes, and measurements of the pressure applied to the distal end of the residual limb. Specific Aim 1: Determine if patient reported outcomes, by subjects wearing a prosthetic socket whose shape was captured with study helper assistance, are at least as good as those reported by subjects wearing a socket whose shape was captured by a prosthetist. The investigators propose to recruit Veterans with a below knee amputation and their study helpers to participate in a human subject experiment. Participants will be randomly assigned and fit with either a prosthesis made with study helper assistance and digital methods, or one made wholly by a prosthetist using traditional methods. Patient reported outcome metrics will be collected while the subject is still wearing their as-prescribed socket at the beginning of the study (baseline), and again after wearing the study prosthesis for two weeks. Specific Aim 2: Determine if distal end residual limb pressure, measured from a group of individuals fit with a prosthetic socket whose shape was captured with study helper assistance using digital methods, are no worse than those measured from a group of individuals fit with a prosthetic socket whose shape was captured by a prosthetist using traditional methods. Concurrent with the human subject procedures briefly described above, the investigators propose to fabricate duplicates (copies) of the two prosthetic sockets used by each subject in Specific Aim 1. A novel sensor will be embedded in these duplicate sockets which can measure the pressure applied to the distal end of the residual limb. Measurements of distal end residual limb pressure while standing and walking for both the as-prescribed and study sockets will be collected at the beginning of the study (baseline), and again after two weeks. The data from the investigators' experiments will be used to determine if residual limb shape capture by a helper using digital technologies can be used to make prosthetic sockets that fit at least as well as those made by a prosthetist using traditional, hand casting techniques. One third of all Veterans live in rural communities far from VA Medical Centers. When Veterans with a lower limb amputation need a new prosthetic socket, attending in-person clinical visits can be a challenge. If the hypotheses are supported, this research will provide evidence to support the use of digital technology as part of clinical practice, enabling a remote, study helper enabled alternative to one of the in-person clinical visits needed to fabricate a well-fitting prosthesis.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Caregiver socket, Prosthetic Socket, Artificial Limb Socket, Prosthetist socket, Prosthetic socket, Artificial limb socket, Residual limb socket?

Research shows that vacuum-assisted socket systems can improve balance and walking ability in elderly amputees by reducing movement within the socket and increasing comfort. Adjustable sockets can also enhance fit and comfort by accommodating changes in the limb's size, which is crucial for prosthesis satisfaction and continued use.12345

Is the Caregiver-Assisted Limb Scanning for Amputees treatment generally safe for humans?

Research indicates that prosthetic sockets can cause discomfort, cysts, and sores, suggesting potential safety concerns related to skin issues. However, advancements in materials and fitting techniques aim to improve comfort and reduce these risks.678910

How is the Caregiver-Assisted Limb Scanning treatment for amputees different from other treatments?

The Caregiver-Assisted Limb Scanning treatment is unique because it involves caregivers in the process of scanning the residual limb, potentially improving the fit and comfort of the prosthetic socket. This approach contrasts with traditional methods that rely heavily on subjective assessments by prosthetists and often require multiple visits to achieve a proper fit.56111213

Research Team

GK

Glenn K Klute, PhD

Principal Investigator

VA Puget Sound Health Care System Seattle Division, Seattle, WA

Eligibility Criteria

This trial is for Veterans with a below-knee amputation who've used a prosthesis for at least 6 months, wear it over 4 hours daily, and can walk on a treadmill. They must be one-year post-amputation and have someone to help them with the study.

Inclusion Criteria

It has been over a year since my amputation.
Have an eligible and available study helper
I have been using a prosthesis for at least 6 months.
See 4 more

Exclusion Criteria

I have skin issues on my amputated limb.
My current prosthesis does not fit well and cannot be adjusted.
I have joint pain or an injury that affects my ability to walk.
See 3 more

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants' baseline data is collected while wearing their as-prescribed socket

1 week
1 visit (in-person)

Treatment

Participants are fitted with either a prosthesis made with study helper assistance using digital methods or one made by a prosthetist using traditional methods

2 weeks
1 visit (in-person or remote)

Follow-up

Participants are monitored for socket comfort, stability, suspension, and distal end residual limb pressure

2 weeks
1 visit (in-person)

Treatment Details

Interventions

  • Caregiver socket (Prosthetic Socket)
  • Prosthetist socket (Prosthetic Socket)
Trial OverviewThe study compares two ways of making prosthetic sockets: one using digital technology by an untrained helper, and the other by a professional prosthetist using traditional methods. The fit and comfort reported by patients as well as pressure measurements will determine if the new method is effective.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: Prosthetist socketExperimental Treatment1 Intervention
Participants will wear a prosthetic socket whose shape was captured by a prosthetist using traditional, hand casting methods.
Group II: Caregiver socketExperimental Treatment1 Intervention
Participants will wear a prosthetic socket whose shape was captured by a study helper using digital methods (i.e., a 3D scanner).

Caregiver socket is already approved in Canada for the following indications:

🇨🇦
Approved in Canada as Prosthetic Socket for:
  • Lower limb amputation
  • Upper limb amputation

Find a Clinic Near You

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials
1,691
Recruited
3,759,000+
Dr. Grant Huang profile image

Dr. Grant Huang

VA Office of Research and Development

Acting Chief Research and Development Officer

PhD in Medical Psychology and Master of Public Health from the Uniformed Services University of Health Sciences

Dr. Erica M. Scavella profile image

Dr. Erica M. Scavella

VA Office of Research and Development

Chief Medical Officer since 2022

MD from University of Massachusetts School of Medicine

Findings from Research

In a case series involving six subjects with transtibial amputation, the use of vacuum-assisted suspension sockets allowed for continued prosthetic use while healing residual limb wounds, with an average wound closure time of 177.6 days.
The initial average wound size was 2.17 cm², and the findings indicate that these well-fitting sockets did not hinder the healing process, suggesting a potential new approach to managing residual limb wounds.
Using vacuum-assisted suspension to manage residual limb wounds in persons with transtibial amputation: a case series.Hoskins, RD., Sutton, EE., Kinor, D., et al.[2022]
In a study of 16 unilateral transtibial dysvascular amputees aged around 65, the use of vacuum-assisted socket systems significantly improved balance, gait, and transfer abilities after just 4 weeks, as evidenced by various performance tests.
The vacuum-assisted socket system led to measurable improvements, such as a 7.5-point increase in the Berg Balance Scale score and a 32.85-meter increase in the 6-Min Walk Test, highlighting its effectiveness in enhancing mobility and reducing fall risk in older amputees.
The benefits of using a vacuum-assisted socket system to improve balance and gait in elderly transtibial amputees.Samitier, CB., Guirao, L., Costea, M., et al.[2022]
Adjustable prosthetic sockets have the potential to significantly improve fit and comfort for users, which is crucial for preventing prosthesis abandonment and enhancing community participation, as evidenced by a review of 50 literature articles and 63 patents.
Despite the promise of adjustable sockets, many designs lack adequate safety features and the rationale for their comfort improvements is often unclear, highlighting a need for better collaboration between researchers and industry to address these gaps.
Adjustable prosthetic sockets: a systematic review of industrial and research design characteristics and their justifications.Baldock, M., Pickard, N., Prince, M., et al.[2023]

References

Using vacuum-assisted suspension to manage residual limb wounds in persons with transtibial amputation: a case series. [2022]
The benefits of using a vacuum-assisted socket system to improve balance and gait in elderly transtibial amputees. [2022]
Adjustable prosthetic sockets: a systematic review of industrial and research design characteristics and their justifications. [2023]
Socket size adjustments in people with transtibial amputation: Effects on residual limb fluid volume and limb-socket distance. [2022]
A Framework for Measuring the Time-Varying Shape and Full-Field Deformation of Residual Limbs Using 3-D Digital Image Correlation. [2021]
A device to facilitate donning and cleaning of a roll-on socket in a trans-tibial amputee with a non-functional arm. [2022]
The comprehensive lower limb amputee socket survey: Reliability and validity of the persian version. [2021]
Mapping Lower-Limb Prosthesis Load Distributions Using a Low-Cost Pressure Measurement System. [2022]
Measuring discomfort-An objective method for quantifying peak pressure discomfort and improved fit in adults with transtibial amputation. [2023]
10.United Statespubmed.ncbi.nlm.nih.gov
Advanced prosthetic techniques for below knee amputations. [2022]
The preformed socket and modular assembly for primary amputees. [2022]
12.United Statespubmed.ncbi.nlm.nih.gov
Registering methodology for imaging and analysis of residual-limb shape after transtibial amputation. [2022]
A qualitative study on stakeholder perceptions of digital prosthetic socket fabrication for transtibial amputations. [2022]