ASCENT K2: Assessing Outcomes With Microprocessor Knee Utilization in a K2 Population
Study Details
Study Description
Brief Summary
Two-phased randomized controlled trial comparing the impact of microprocessor controlled knee prostheses (MPK) with the impact of non-microprocessor controlled knee prostheses (NPMK) in patients with a transfemoral/knee disarticulation level amputation categorized as K2 ambulators.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
N/A |
Detailed Description
Randomized controlled trial investigating the benefits of microprocessor controlled knee prostheses (MPK) in patients with a transfemoral or knee disarticulation level amputation categorized by Medicare Functional Classification Level (MFCL) as a Limited Community Ambulator (K-Level 2). There are two aims for the study. Aim 1 is to understand the effect of MPK technology for the K2 ambulator on reducing fear and anxiety of falling, improving health-related quality of life, and participation in society and activities. Aim 2 is to understand the long-term effect of MPK technology the aspects from Aim 1 as well as reducing morbidity. The trial will be conducted in two phases. Phase 1 will cover the initial 12-month period to address Aim 1, and phase 2 will monitor from 12 months to 5 years to address Aim 2.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: MPK Microprocessor controlled knee |
Device: Kenevo or C-Leg 4
Kenevo fitted to subjects walking slower than 0.8 m/s as measured by the 2-minute Walk Test. C-Leg 4 fitted to subjects walking faster than 0.8 m/s.
|
Active Comparator: NMPK Non-microprocessor controlled knee |
Device: Non microprocessor controlled knee (NMPK)
NMPK consistent with current standards of care
|
Outcome Measures
Primary Outcome Measures
- Fear of Falling Avoidance Behavior Questionnaire (FFABQ) [12 months]
This is a 14 item survey assessment originally developed with community-dwelling older adults which measures the degree to which respondents avoid activities due to their fear of falling. Responses are on a 5-point scale with 0 = completely disagree and 4 = completely agree. The total possible score is 56 points. A higher score indicates a greater activity limitation and participation restriction as a result of the fear of falling.
- Fear of Falling Avoidance Behavior Questionnaire (FFABQ) [5 years]
This is a 14 item survey assessment originally developed with community-dwelling older adults which measures the degree to which respondents avoid activities due to their fear of falling. Responses are on a 5-point scale with 0 = completely disagree and 4 = completely agree. The total possible score is 56 points. A higher score indicates a greater activity limitation and participation restriction as a result of the fear of falling.
Secondary Outcome Measures
- Patient-Reported Outcomes Measurement Information System (PROMIS) - 29 [12 months]
The survey assessment comprises from 7 health domains (physical function, anxiety, depression, fatigue, sleep disturbance, satisfaction with social roles, and pain interference). The combined constructs serve to provide a measure of patient's quality of life. Raw scores are converted to T-scores which standardizes the scores with a mean of 50 and standard deviation of 10. Being above or below the standard deviation could be desirable or undesirable based on the domain being measured. Higher scores means more of the concept being measured (e.g. more fatigue).
- Patient-Reported Outcomes Measurement Information System (PROMIS) - Ability to Participate in Social Roles and Activities (APSRA) [12 months]
Within the PROMIS system, this specific set of question is aimed at assessing the person's ability to perform usual social roles and activities, a construct noted to be of great significance to well-being within the World Health Organization International Classification of Function model. Four of the PROMIS-APSRA questions are included on the PROMIS-29 within the domain of 'satisfaction with social roles'. The addition of four more questions helps with the responsiveness within this specific domain. Thus the additional four questions of the PROMIS-APSRA will be administered to assess the domain of participation and activity.
- 12-month fall count from bi-weekly fall journal [12 months]
On a bi-weekly cadence, individuals will be asked to complete the Lower Limb Amputation Fall Survey. This survey was developed for the purpose of documenting number of falls and near-falls over a given period, as well as insight into the causality.
- Average daily step counts [12 months]
Difference in average daily step activity count from 1 week after initial assessment compared to average daily step activity count for 1 week prior to 12-month assessment. Modern activity monitors provide the ability to translate movement from triaxial inertial measurement units into corresponding step activity with great precision.
- Fear of Falling Avoidance Behavior Questionnaire (FFABQ) [3 years]
This is a 14 item survey assessment originally developed with community-dwelling older adults which measures the degree to which respondents avoid activities due to their fear of falling. Responses are on a 5-point scale with 0 = completely disagree and 4 = completely agree. The total possible score is 56 points. A higher score indicates a greater activity limitation and participation restriction as a result of the fear of falling.
- Patient-Reported Outcomes Measurement Information System (PROMIS) - 29 [5 years]
The survey assessment comprises from 7 health domains (physical function, anxiety, depression, fatigue, sleep disturbance, satisfaction with social roles, and pain interference). The combined constructs serve to provide a measure of patient's quality of life. Raw scores are converted to T-scores which standardizes the scores with a mean of 50 and standard deviation of 10. Being above or below the standard deviation could be desirable or undesirable based on the domain being measured. Higher scores means more of the concept being measured (e.g. more fatigue).
- Patient-Reported Outcomes Measurement Information System (PROMIS) - Ability to Participate in Social Roles and Activities (APSRA) [5 years]
Within the PROMIS system, this specific set of question is aimed at assessing the person's ability to perform usual social roles and activities, a construct noted to be of great significance to well-being within the World Health Organization International Classification of Function model. Four of the PROMIS-APSRA questions are included on the PROMIS-29 within the domain of 'satisfaction with social roles'. The addition of four more questions helps with the responsiveness within this specific domain. Thus the additional four questions of the PROMIS-APSRA will be administered to assess the domain of participation and activity.
- 10-meter Walk Test (10mWT) [5 years]
The 10mWT is a standardized test of self-selected walking speed in which patients are timed over the middle 6 meters (19.7 feet) of a 10-meter (32.8 feet) flat walkway. The self-selected walking speed is calculated in meters per second and has been discussed as a potential vital sign given its strong relationship with survival. It will serve as a marker of morbidity.
- Timed Up and Go (TUG) [5 years]
The Timed Up-and-Go test is a standard basic mobility test that includes a sit-to-stand, gait initiation, walking, turning, and stand-to-sit. The test measures, in seconds, the time to stand up from an arm chair, walk a distance of 3 meters (approximately 10 feet), turn, walk back to the chair and sit down. It is a measure of function, has been used to assess the risk of falling, and will serve as a marker of morbidity.
- Patient-Reported Outcomes Measurement Information System (PROMIS) - 29 [3 years]
Difference in average daily step activity count from 1 week after initial assessment compared to average daily step activity count for 1 week prior to 5-year assessment. Modern activity monitors provide the ability to translate movement from triaxial inertial measurement units into corresponding step activity with great precision.
- Patient-Reported Outcomes Measurement Information System (PROMIS) - Ability to Participate in Social Roles and Activities (APSRA) [3 years]
Within the PROMIS system, this specific set of question is aimed at assessing the person's ability to perform usual social roles and activities, a construct noted to be of great significance to well-being within the World Health Organization International Classification of Function model. Four of the PROMIS-APSRA questions are included on the PROMIS-29 within the domain of 'satisfaction with social roles'. The addition of four more questions helps with the responsiveness within this specific domain. Thus the additional four questions of the PROMIS-APSRA will be administered to assess the domain of participation and activity.
- 10-meter Walk Test (10mWT) [3 years]
The 10mWT is a standardized test of self-selected walking speed in which patients are timed over the middle 6 meters (19.7 feet) of a 10-meter (32.8 feet) flat walkway. The self-selected walking speed is calculated in meters per second and has been discussed as a potential vital sign given its strong relationship with survival. It will serve as a marker of morbidity.
- Timed Up and Go (TUG) [3 years]
The Timed Up-and-Go test is a standard basic mobility test that includes a sit-to-stand, gait initiation, walking, turning, and stand-to-sit. The test measures, in seconds, the time to stand up from an arm chair, walk a distance of 3 meters (approximately 10 feet), turn, walk back to the chair and sit down. It is a measure of function, has been used to assess the risk of falling, and will serve as a marker of morbidity.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Unilateral transfemoral or knee disarticulation amputation
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Received prosthesis between 4 - 24 months prior
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Currently uses prosthesis
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K2 ambulator status
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Able to speak English or Spanish language
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Age ≥ 65 years at Baseline Assessment (one month after enrollment)
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Minimum Socket Comfort Score (SCS) of 6/10
Exclusion Criteria:
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Upper limb involvement
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Individuals ≥ 275 lbs
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Unable to provide informed consent
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History of acute or chronic residual limb breakdown
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History of 2 or more socket adjustments or replacements in the past 6 months
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Amputation of the contralateral limb
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Active malignancy
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Rapidly declining health status resulting in reduced activity in the past 6 months, as determined by patient's clinician and confirmed by Clinical & Scientific Affairs personnel
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Patient unable or unwilling to follow study procedures
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Pregnant women, institutionalized persons, and children
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Hanger Clinic - Dothan, Alabama - 321 Westgate Parkway, Ste 2 | Dothan | Alabama | United States | 36303 |
2 | Hanger Clinic - Mobile, Alabama - 2700 Grant Street | Mobile | Alabama | United States | 36606 |
3 | Hanger Clinic - Arizona - 1515 East Florence Blvd Units 7,8,9 | Casa Grande | Arizona | United States | 85122 |
4 | Hanger Clinic - Arizona - 2175 N Alma School Rd., Suite 101 | Chandler | Arizona | United States | 85224 |
5 | Hanger Clinic - Gilbert, Arizona - 3501 S Mercy road Ste 103 | Gilbert | Arizona | United States | 85297 |
6 | Hanger Clinic - Arizona - 3816 N. 7th St., | Phoenix | Arizona | United States | 85014 |
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34 | Hanger Clinic - Florida - 3230 Commerce Place, Suite C | West Palm Beach | Florida | United States | 33407 |
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65 | Hanger Clinic - Meridian, Mississippi - 1903 23rd Ave | Meridian | Mississippi | United States | 39301 |
66 | Hanger Clinic - Cape Girardeau - 3065 William Street, Suite 205 | Cape Girardeau | Missouri | United States | 63703 |
67 | Hanger Clinic - Saint Peters, Missouri - 150 St Peters Centre Blvd | Saint Peters | Missouri | United States | 63376 |
68 | Hanger Clinic - Helena, Montana - 65 Medical Park Drive, Suite 3 | Helena | Montana | United States | 59601 |
69 | Hanger Clinic - Lincoln, Nebraska - 1001 S 70th St Ste 110 | Lincoln | Nebraska | United States | 68510 |
70 | Hanger Clinic - Nebraska - 7820 Wakeley Plaza | Omaha | Nebraska | United States | 68114 |
71 | Hanger Clinic - Omaha, Nebraska - 9109 Blondo Street | Omaha | Nebraska | United States | 68134 |
72 | Hanger Clinic - Las Vegas, Nevada - 7250 Peak Drive STE 120 | Las Vegas | Nevada | United States | 89128 |
73 | Hanger Clinic - New Hampshire - 7 Marsh Brook Dr Ste 201 | Somersworth | New Hampshire | United States | 03878 |
74 | Hanger Clinic - New Mexico - 715 Dr Martin Luther King Jr. Ave NE | Albuquerque | New Mexico | United States | 87102 |
75 | Hanger Clinic - New Mexico - 313 W. Country Club Rd., Ste 14 | Roswell | New Mexico | United States | 88201 |
76 | Hanger Clinic - New York - 21 Railroad Ave, | Cooperstown | New York | United States | 13326 |
77 | Hanger Clinic - New York - 6620 Fly Rd | East Syracuse | New York | United States | 13057 |
78 | Hanger Clinic - New York - 1300 College Ave Ste 1 | Elmira | New York | United States | 14901 |
79 | Hanger Clinic - New York - 787 State Route 5 And 20 | Geneva | New York | United States | 14456 |
80 | Hanger Clinic - New York - 635 Main Street | Johnson City | New York | United States | 13790 |
81 | Hanger Clinic - New York - 210 East 86th Street | New York | New York | United States | 10028 |
82 | Hanger Clinic - New York - 1882 Winton Rd S, Ste 6 | Rochester | New York | United States | 14618 |
83 | Hanger Clinic - North Carolina - 123 Professional Park Dr Ste 100 | Mooresville | North Carolina | United States | 28117 |
84 | Hanger Clinic - Winston-Salem, North Carolina - 1399 Westgate Center Dr | Winston-Salem | North Carolina | United States | 27103 |
85 | Hanger Clinic - Dayton, Ohio - One Elizabeth Place Suite 300 | Dayton | Ohio | United States | 45417 |
86 | Hanger Clinic - Fairfield, Ohio - 660 Wessel Drive | Fairfield | Ohio | United States | 45014 |
87 | Hanger Clinic - Ohio - 29101 Health Campus Dr Bld 2 St 104 | Westlake | Ohio | United States | 44145 |
88 | Hanger Clinic - Ohio - 930 Orchard Hill Rd | Zanesville | Ohio | United States | 43701 |
89 | Hanger Clinic - Oklahoma - 1904 SE Washington Blvd, | Bartlesville | Oklahoma | United States | 74006 |
90 | Hanger Clinic - Oregon - 3220 N Williams Ave | Portland | Oregon | United States | 97227 |
91 | Hanger Clinic - East Stroudsburg, Pennsylvania - Normal St | East Stroudsburg | Pennsylvania | United States | 18301 |
92 | Hanger Clinic - Pennsylvania - 2108 Harrisburg Pike, Suite 308 | Lancaster | Pennsylvania | United States | 17604 |
93 | Hanger Clinic - Wyomissing, Pennsylvania - 40 Berkshire Ct STE 2 | Wyomissing | Pennsylvania | United States | 19610 |
94 | Hanger Clinic - South Dakota - 3930 Cambell St | Rapid City | South Dakota | United States | 57701 |
95 | Hanger Clinic - Jackson, Tennessee - 779 W. Forest Ave. | Jackson | Tennessee | United States | 38301 |
96 | Hanger Clinic - Johnson City, Tennessee - 502 Princeton Rd. | Johnson City | Tennessee | United States | 37601 |
97 | Hanger Clinic - Memphis, Tennesse - 7 North Bellevue Blvd. | Memphis | Tennessee | United States | 38104 |
98 | Hanger Clinic - Tennessee - 1814 State Street | Nashville | Tennessee | United States | 37203 |
99 | Hanger Clinic - Tennessee - 129 E Division Rd., | Oak Ridge | Tennessee | United States | 37830 |
100 | Hanger Clinic - Texas - 2901 Medical Arts St Suite 500 | Austin | Texas | United States | 78705 |
101 | Hanger Clinic - Texas - 1301 Barbara Jordan Blvd Suite 306 | Austin | Texas | United States | 78723 |
102 | Hanger Clinic - Texas - Westgate Blvd, Suite 114, | Austin | Texas | United States | 78745 |
103 | Hanger Clinic - Texas - 8000 Anderson Square Suite 301A | Austin | Texas | United States | 78757 |
104 | Hanger Clinic - Texas - 1301 Medical Pkwy Suite 120 | Cedar Park | Texas | United States | 78613 |
105 | Hanger Clinic - Dallas, Texas -3910 Gaston Ave STE 150 | Dallas | Texas | United States | 75246 |
106 | Hanger Clinic - Texas - 1401 West Magnolia, | Fort Worth | Texas | United States | 76104 |
107 | Hanger Clinic - Texas - 11155 South Main St. | Houston | Texas | United States | 77025 |
108 | Hanger Clinic - Round Rock, Texas - 4001 N Mays St. Ste 1200 | Round Rock | Texas | United States | 78665 |
109 | Hanger Clinic - Webster, Texas -17490 Hwy 3 Unit 100A | Webster | Texas | United States | 77598 |
110 | Hanger Clinic - Utah - 5316 South Woodrow Street | Murray | Utah | United States | 84107 |
111 | Hanger Clinic - Salt Lake City, Utah - 2785 East 3300 South | Salt Lake City | Utah | United States | 84109 |
112 | Hanger Clinic - Newport News, VA - Thimble Shoals Blvd | Newport News | Virginia | United States | 23606 |
113 | Hanger Clinic - Virginia - 3333 South Crater Rd Suite 3-D | Petersburg | Virginia | United States | 23805 |
114 | Hanger Clinic - Virginia - 10710 Midlothian Tpke | Richmond | Virginia | United States | 23235 |
115 | Hanger Clinic - Renton, Washington - 401 SW 41st St | Renton | Washington | United States | 98057 |
116 | Hanger Clinic - Washington - 1101 Madison St., Ste 550 | Seattle | Washington | United States | 98104 |
117 | Hanger Clinic - Vancouver, Washington - 505 NE 87th Ave Suite LL10 | Vancouver | Washington | United States | 98664 |
118 | Hanger Clinic - Charleston, West Virginia - 4407 MacCorkle Ave SE | Charleston | West Virginia | United States | 25304 |
119 | Hanger Clinic - Wisconsin - 221 W Madison Street, Ste 7 | Eau Claire | Wisconsin | United States | 54703 |
120 | Hanger Clinic - Kenosha, Wisconsin - 5027 Green Bay Rd, Suite 124 | Kenosha | Wisconsin | United States | 53144 |
121 | Hanger Clinic - La Crosse, Wisconsin - 3440 Losey Blvd S | La Crosse | Wisconsin | United States | 54636 |
Sponsors and Collaborators
- Otto Bock Healthcare Products GmbH
- Hanger Clinic: Prosthetics & Orthotics
Investigators
- Principal Investigator: Andreas Kannenberg, MD, PhD, Otto Bock Healthcare Products GmbH
- Principal Investigator: Shane Wurdeman, PhD, Hanger Clinic: Prosthetics & Orthotics
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- OB113