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| ID | Type | Description | Link |
|---|---|---|---|
| R01NR018450 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute of Nursing Research (NINR) | NIH |
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The purpose of this study is to determine if walking biobehavioral intervention improves physical activity after dysvascular lower limb amputation.
Sedentary lifestyles and high levels of disability are relevant public and personal health issues resulting from the chronic comorbid condition of dysvascular lower limb amputation. This study examines the use of an evidence-based walking biobehavioral intervention to increase physical activity after dysvascular amputation. The proposed intervention leverages successes in conventional prosthetic rehabilitation, while addressing the complex health conditions and chronic sedentary behaviors that underlie dysvascular amputation, with the ultimate goal of improved physical activity self-management to minimize disability.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Walking Biobehavioral Intervention (EXP) | Experimental | The EXP group will receive biobehavioral training that is integrated into the conventional outpatient training component and is delivered over 5 months. There will be 10 biobehavioral sessions, 1 of which will be a combined biobehavioral/conventional outpatient session and the other 9 being telehealth sessions. |
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| Attention Control (CTL) | Active Comparator | The CTL group intervention will include the same conventional outpatient training (10 sessions) as the EXP group and receive the same computer tablets with telehealth software as the EXP group (week 3 of prosthetic training). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Walking Biobehavioral Intervention | Behavioral | Each walking biobehavioral training session includes self-monitoring, tailored feedback, identification of barriers and facilitators, problem solving, action planning and encouragement. Self-monitoring of walking behavior will occur with participant use of the FitBit sensor and software, reviewed with the interventionist at each session. Tailored feedback from the FitBit sensor, as well as feedback from the interventionist, will detail progress over time and be compared to baseline data. Barriers and facilitators of reaching activity goals will be discussed with emphasis on problem solving to take advantage of facilitators and minimize/remove participant-specific barriers. Action planning will be based on weekly step goals set collaboratively by the interventionist and participant, based the FitBit data. Finally, encouragement will be provided by the interventionist by putting progress or lack of progress in perspective of the efforts made by the participant. |
| Measure | Description | Time Frame |
|---|---|---|
| Physical Activity | Change in 10 day physical activity step count with ActivPAL activity monitor between the beginning of conventional prosthetic rehabilitation to the end of intervention. Maintenance will be observed at six months after the end of the intervention. | Day 0 (start of conventional prosthetic rehabilitation), prosthetic rehabilitation end (3 months), intervention end (6 months), and 6 months after intervention end (12 months) |
| Measure | Description | Time Frame |
|---|---|---|
| Patient Reported Outcomes Measurement Information System (PROMIS): Self-Efficacy for Managing Symptoms | Change in participant's confidence in managing symptoms of chronic disease. Final scores range from 4 points (not at all confident) to 20 points (very confident). | Day 0, 3 months, 6 months and 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Activities-specific Balance Confidence Scale | Change in self-reported balance confidence. Final scores range from 0% (no confidence in balance) to 100% (complete confidence in balance). | Day 0, 3 months, 6 months and 12 months |
| Two-Minute Walk Test |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Cory Christiansen, PT, PhD | University of Colorado, Denver | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Colorado Hospital | Aurora | Colorado | 80045 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37276273 | Derived | B Aledi L, Flumignan CD, Trevisani VF, Miranda F Jr. Interventions for motor rehabilitation in people with transtibial amputation due to peripheral arterial disease or diabetes. Cochrane Database Syst Rev. 2023 Jun 5;6(6):CD013711. doi: 10.1002/14651858.CD013711.pub2. |
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The investigators will publish the trial results data on the ClinicalTrials.gov website, on which the clinical trial will be registered. Sharing of data will include the potential of sharing raw data generated from all clinical assessments under a data-sharing agreement.
The investigators will publish the trial results within one year of testing the final participant.
User registration will be required to access/download any data and will require agreement to conditions of use in accordance with NIH Data Sharing Policy Guidelines.
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Apr 14, 2026 | |
| Reset | May 5, 2026 | |
| Release | Jun 10, 2026 | |
| Reset | Jul 7, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Apr 14, 2026 | May 5, 2026 | |||
| Jun 10, 2026 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D058729 | Peripheral Arterial Disease |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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Randomized controlled futility design
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| Attention Control | Other | Attention control sessions will include a brief review of the conventional home-exercises, a summary of all healthcare visits and falls, and interventionist-delivered education on safety topics (e.g., fall prevention, wound care, assistive device use). Outpatient therapists will provide home-based exercises to ensure that the participant receives adequate training and demonstrates safe performance prior to home use. The CTL interventionist will assess and discuss the safe performance of each home-based exercise with CTL group participants. Exercises in the CTL group will only be progressed by the outpatient physical therapist and not during the telehealth sessions. |
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| PROMIS: Self-Efficacy for Managing Daily Activities |
Change in participant's confidence in managing daily activities. Final scores range from 4 points (not at all confident) to 20 points (very confident). |
| Day 0, 3 months, 6 months and 12 months |
| PROMIS: Ability to participate in social roles and activities | Change in participant's ability to participate in social roles and activities. Final scores range from 8 points (never participates) to 40 points (always participates). | Day 0, 3 months, 6 months and 12 months |
| Prosthesis Evaluation Questionnaire - Mobility Score | Change in self-reported mobility. Final scores range from 0 (lowest mobility) to 4 (highest mobility) | Day 0, 3 months, 6 months and 12 months |
| Timed Up-and-Go test | Change in time required to rise from chair, walk 10 feet, turn around and return to sitting in same chair. | Day 0, 3 months, 6 months and 12 months |
| World Health Organization-Disability Assessment Schedule 2.0 | Change in self-reported disability. Final scores range from 0 (no disability) to 100 (full disability). | Day 0, 3 months, 6 months and 12 months |
| Self-Efficacy for Managing Chronic Disease | Change in self-reported confidence in managing different aspects of chronic disease. Final scores range from 1 (not at all confident in managing chronic disease) to 10 (totally confident in managing chronic disease). | Day 0, 3 months, 6 months and 12 months |
Change in the distance a participant can walk in two minutes. Use of assistive device is noted
| Day 0, 3 months, 6 months and 12 months |
| Five Meter Walk | Change in the length of time it takes a participant to walk 5 meters, at a comfortable walking pace. | Day 0, 3 months, 6 months and 12 months |
| Study Intervention Reach | Percentage of eligible participants enrolled | Day 0 |
| Outpatient Practitioner Intervention Fidelity | An individual practitioner's percent adherence to outpatient intervention protocol | Day 0 through 3 months |
| Biobehavioral Practitioner Intervention Fidelity | An individual interventionist's percent adherence to biobehavioral intervention protocol | Day 0 through 6 months |
| FitBit Use Adherence | Number of days participant uses FitBit during the no-contact phase of the study | Month 12 |
| Jul 7, 2026 |
| D050197 | Atherosclerosis |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016491 | Peripheral Vascular Diseases |
| D001519 | Behavior |