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Amputation causes somatic and psychological damage. Prognostic factors for postoperative gait recovery include the need for proprioceptive re-education for dynamic balance. Improved gait patterns and use of the prosthesis contribute to an overall improvement in the amputee's autonomy. Virtual reality coupled with movement analysis allows personalization of treatment with objective assessment of progress.
The study authors hypothesize that a virtual reality protocol for the dynamic balance of a unilateral transtibial amputee in initial rehabilitation will improve the dynamic balance assessment criteria compared with a conventional rehabilitation protocol.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Virtual Reality group | Experimental |
| |
| Control group | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual Reality | Other | A progressive rehabilitation protocol (different levels according to success scores) consisting of several exercises using virtual and augmented reality with mechanical perturbations (pitching of the treadmill), interaction with the virtual environment, interaction with the virtual environment and augmented reality (projection of obstacles on the treadmill), and modification of the gait pattern with visual and/or audio biofeedback |
| Measure | Description | Time Frame |
|---|---|---|
| Mediolateral instability during mediolateral external perturbation between groups | The number of gait cycles required to regain center of mass displacement (number of cycles * cycle time), measured with the GRAIL rehabilitation and movement analysis platform | Before rehabilitation (Day 1) |
| Mediolateral instability during mediolateral external perturbation between groups | The number of gait cycles required to regain center of mass displacement (number of cycles * cycle time), measured with the GRAIL rehabilitation and movement analysis platform | End of rehabilitation sessions (Day 45) |
| Measure | Description | Time Frame |
|---|---|---|
| Step length variability between groups | Meters, measured with the GRAIL rehabilitation and movement analysis platform | Before rehabilitation (Day 1) |
| Step length variability between groups | Meters, measured with the GRAIL rehabilitation and movement analysis platform |
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Inclusion Criteria:
Exclusion Criteria:
The subject is participating in an interventional study or one involving a drug or medical device, or is in a period of exclusion determined by a previous study
Patient already included in the present study.
The subject refuses to or is unable to sign the consent
It is impossible to give the subject informed information
The patient is under safeguard of justice or state guardianship
Patients with uncorrected or untreated visual disorders.
Patients with major cognitive disorders (MOCA>23).
Patients with vestibular disorders.
Patient with uncontrolled epilepsy.
Patient with an unhealed amputation stump.
Patients weighing > 135kg or < 20kg.
Patients with a functional ambulation category of 1 (i.e. patients requiring the firm, continuous assistance of another person to carry their weight and maintain their balance) or less.
Patients with medication affecting exercise tolerance,
Patients with sensory impairments
Patients with significantly reduced bone density
Patients for whom it is impossible to correctly adjust the harness to the corresponding body part due to:
Pregnant, parturient or breast-feeding patients.
Appearance of a stump wound during the study requiring discharge.
Patient with more than 50% absenteeism from rehabilitation sessions.
Patient requiring a new prosthesis insert.
Patient with a serious adverse event affecting dynamic balance rehabilitation.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Eric Pantera | Contact | 04 66 02 25 36 | eric.pantera@chu-nimes.fr |
| Name | Affiliation | Role |
|---|---|---|
| Eric Pantera | CHU de Nimes | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Nîmes, Hôpital du Grau du Roi | Recruiting | Le Grau-du-Roi | 30240 | France |
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| Standard rehabilitation | Other | A treadmill walking protocol with virtual reality to immerse the patient in a 3 x 5-minute walking session, without visual, mechanical or auditory disturbances, and without prompting the patient to modify their walking pattern. |
|
| End of rehabilitation sessions (Day 45) |
| Step width variability between groups | Meters, measured with the GRAIL rehabilitation and movement analysis platform | Before rehabilitation (Day 1) |
| Step width variability between groups | Meters, measured with the GRAIL rehabilitation and movement analysis platform | End of rehabilitation sessions (Day 45) |
| Cadence variability between groups | Steps/minute, measured with the GRAIL rehabilitation and movement analysis platform | Before rehabilitation (Day 1) |
| Cadence variability between groups | Steps/minute, measured with the GRAIL rehabilitation and movement analysis platform | End of rehabilitation sessions (Day 45) |
| Center of mass variability between groups | Meters, measured with the GRAIL rehabilitation and movement analysis platform | Before rehabilitation (Day 1) |
| Center of mass variability between groups | Meters, measured with the GRAIL rehabilitation and movement analysis platform | End of rehabilitation sessions (Day 45) |
| Mobility and balance between groups | Time Up and Go test, seconds | Before rehabilitation (Day 1) |
| Mobility and balance between groups | Time Up and Go test, seconds | End of rehabilitation sessions (Day 45) |
| Aerobic endurance and functional capacity between groups | 2-minute walk test, meters | Before rehabilitation (Day 1) |
| Aerobic endurance and functional capacity between groups | 2-minute walk test, meters | End of rehabilitation sessions (Day 45) |
| Fall risk between groups | Berg scale, score between 0 and 56 (no fall risk) | Before rehabilitation (Day 1) |
| Fall risk between groups | Berg scale, score between 0 and 56 (no fall risk) | End of rehabilitation sessions (Day 45) |
| CHU de Nimes | Not yet recruiting | Nîmes | France |
|