Optimizing Gait Rehabilitation for Veterans With Non-traumatic Lower Limb Amputation (GEM)
Transtibial Amputation, Peripheral Artery Disease, Diabetes Mellitus
About this trial
This is an interventional treatment trial for Transtibial Amputation focused on measuring Amputation, Rehabilitation, Gait Training, Diabetes, Peripheral Artery Disease
Eligibility Criteria
Inclusion Criteria:
- Unilateral, non-traumatic, transtibial amputation
- Diabetes mellitus and/or peripheral artery disease
- Able to ambulate in the community without assistive device
- Step length asymmetry during walking (>1.0 asymmetry index.)
- 6 months to 10 years since amputation
Exclusion Criteria:
Unstable heart condition
- including unstable angina, uncontrolled cardiac dysrhythmia, acute myocarditis, hypertension, and acute pericarditis
- Acute systemic infection
- Active cancer treatment
- Traumatic or cancer related amputation etiology
Sites / Locations
- Rocky Mountain Regional VA Medical Center, Aurora, CORecruiting
- Hunter Holmes McGuire VA Medical Center, Richmond, VARecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
Error-augmentation training
Error-correction training
Supervised waking
A 4-week, 8 session, treadmill-based gait training program, with error-augmentation of step asymmetry delivered on a split-belt treadmill. Each training session will adhere to the same schedule. During the training blocks on the treadmill, the belt under the limb with the shorter step length will be set at 3/4 of the pre-intervention over-ground self-selected walking speed while the belt under the limb with the longer step length will be set to 1/2 of the fast belt speed (2:1 ratio between belts).
A 4-week, 8 session, treadmill-based gait training program, with error-correction of step asymmetry delivered with an auditory metronome signal while walking on a treadmill. During each training block, the metronome will be set to overcorrect stance time asymmetry through use of asymmetrical metronome tones, 2:1 ratio.
A 4-week, 8 session, treadmill-based supervised walking program. The active comparator group will participate in a supervised treadmill walking program of the same frequency and duration, to the two experimental groups.