Targeting Balance Confidence to Increase Community Integration in Users of Prostheses
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/20/2019 |
| Start Date: | April 5, 2018 |
| End Date: | November 2020 |
| Contact: | Noah J Rosenblatt, PhD |
| Email: | noah.rosenblatt@rosalindfranklin.edu |
| Phone: | 847-578-8425 |
Targeting Balance Confidence as a Strategy to Increase Integration and Improve Outcomes in Users of Lower-Limb Prostheses
Low balance confidence occurs when an individual perceives they have limited ability to
maintain their balance while performing a specific task of daily living. It is a prevalent
problem in lower limb prosthesis users and is a strong predictor of prosthesis use and
community participation. Balance confidence is not necessarily related to functional
abilities. It is possible to improve functional ability as a result of rehabilitation,
without concurrently improving balance confidence. Interventions to address low balance
confidence may need to target both functional abilities as well as beliefs regarding these
abilities. The purpose of this study is to test whether, for users of lower limb prostheses,
an intervention combining physical therapy exercise to improve function with cognitive
behavioral therapy to address fears and thoughts associated with low confidence can improve
balance confidence and promote community participation.
maintain their balance while performing a specific task of daily living. It is a prevalent
problem in lower limb prosthesis users and is a strong predictor of prosthesis use and
community participation. Balance confidence is not necessarily related to functional
abilities. It is possible to improve functional ability as a result of rehabilitation,
without concurrently improving balance confidence. Interventions to address low balance
confidence may need to target both functional abilities as well as beliefs regarding these
abilities. The purpose of this study is to test whether, for users of lower limb prostheses,
an intervention combining physical therapy exercise to improve function with cognitive
behavioral therapy to address fears and thoughts associated with low confidence can improve
balance confidence and promote community participation.
Lower limb prosthesis users, with self-reported low balance confidence complete baseline gait
analysis and balance testing, as well as a series of validated self-reported outcome scales
addressing balance confidence, quality of life, and community integration. Participants are
then provided a step activity monitor (SAM) and a global position sensing (GPS) tracker to be
worn for one week, the data from which is linked and used to objectively quantify baseline
community participation. At the conclusion of the one week, participants are randomized to
one of two groups, each of which will last for 8 weeks. At the conclusion of the eight weeks,
participants repeat baseline assessments and are again provided a SAM and GPS tracker to wear
for one week. Baseline measures and activity monitoring occur again 8 and 16 weeks
thereafter.
analysis and balance testing, as well as a series of validated self-reported outcome scales
addressing balance confidence, quality of life, and community integration. Participants are
then provided a step activity monitor (SAM) and a global position sensing (GPS) tracker to be
worn for one week, the data from which is linked and used to objectively quantify baseline
community participation. At the conclusion of the one week, participants are randomized to
one of two groups, each of which will last for 8 weeks. At the conclusion of the eight weeks,
participants repeat baseline assessments and are again provided a SAM and GPS tracker to wear
for one week. Baseline measures and activity monitoring occur again 8 and 16 weeks
thereafter.
Inclusion Criteria:
- age ≥18 years
- unilateral lower limb amputation without serious complications
- at least 6 months experience using a definitive lower limb prosthesis
- Activity Specific Balance Confidence (ABC) scale score≤80
- self-reported concern about balance that limit activities
Exclusion Criteria:
- active wounds on weight bearing surfaces
- inability to perform the protocol without an assistive device
- currently seeing a physical therapist for any reason
- history of neurodegenerative disease
- history of stroke
- ill-fitting or ill-functioning prosthesis (to be verified by research prosthetist
during screening)
- prohibited by primary care physician or research physician to participate in mild
exercise
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