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OHI--Randomized Control Trial to Evaluate Efficacy, Acceptability, and Perception of Benefit of an Innovative Custom AFO

Primary Purpose

Accidental Falls, Fall Due to Loss of Equilibrium, High Risk of Falls Due to Mobility Limitation

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
MBB AFO
Control
Sponsored by
Bijan Najafi, PhD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Accidental Falls focused on measuring Ankle Foot Orthoses, falls, Fall Prevention, Frailty, Concern for falls, Footwear, Mobility

Eligibility Criteria

65 Years - undefined (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 65 or older
  • High concerns or high risk of fall
  • Ambulatory

Exclusion Criteria:

  • Presence of an active wound infection on either of the foot and ankle
  • Use of medication or a medical condition that may have unstable (fluctuate over time) or temporary (less than one month) impact on gait and balance
  • Acute fractures on the foot
  • Participant of an interventional study within the last 30 days
  • Non-ambulatory or unable to stand without help or walk a distance of at least 1.8 m (~six feet) without assistance
  • Major foot amputation
  • Unable or unwilling to participate in all procedures

Sites / Locations

  • Baylor College of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

MBB AFO Group

No MBB AFO Group

Arm Description

This group will be provided with a pair of New Balance 813 shoes plus a custom made MBB AFO for the duration of the study.

This group will be provided with a pair of New Balance 813 shoes for the duration of the study.

Outcomes

Primary Outcome Measures

Hip Sway Change From Baseline to 6 Months
Hip sway (motion of hip joints in three dimensions) measured by wearable sensors while wearing their own shoes compared to the orthopedic shoes and compared to orthopedic shoes plus Ankle-Foot Orthosis (AFO)
Ankle Sway Change From Baseline to 6 Months
Ankle sway (motion of ankle joint in three dimensions) measured by wearable inertial sensors while wearing their own shoes compared to the orthopedic shoes and compared to orthopedic shoes plus Ankle-Foot Orthosis (AFO)
Center of Mass (COM) Sway Change Baseline to 6 Months
Center of Mass (COM) sway measured by wearable inertial sensors while wearing their own shoes compared to the orthopedic shoes and compared to orthopedic shoes plus Ankle-Foot Orthosis (AFO)

Secondary Outcome Measures

Adherence (Hours Per Day to Wear Ankle-Foot Orthosis (AFO))
The adherence of participants to the prescribed Ankle-Foot Orthosis (AFO) plus walking shoes was quantified using the response to a self-reported question ("How many hours per day did you wear the prescribed footwear?").
Fall Incidents
Fall incidents during the study
Concern for Falling Change Form Baseline to 6 Months
Concern for falling is quantified by Falls Efficacy Scale - International (FES-I) questionnaire. Scores range from minimum 16 (no concern about falling) to maximum 64 (severe concern about falling). Higher score indicate worse performance.
Physical Activity Level
Physical activity level for 24 hours while wearing their own shoes compared to the walking shoes and compared to walking shoes plus Ankle-Foot Orthosis (AFO). To quantify physical activity, number of taken steps per day was monitored using a pendant wearable sensor called, PAMSys (Biosensics, MA, USA).
Number of Participants With Adverse Events
Number of participants with adverse events reported during the study. Adverse events was inquired at 1 months, 3 months, 6 months, 12 months after the baseline, and summed at 12 months. If the participant has at least one adverse event reported in any assessed time frame, the participant will be categorized as the participant with adverse event.
Percentage of Participants Who Found the Device Useful and Easy to Use
The participants perceived usefulness of ease of use of wearing Moore Balance Brace (MBB) Ankle-Foot Orthosis (AFO) based on questionnaires of A technology acceptance model (TAM). Perceived usefulness was assessed using two questions (i.e., "I feel more stable when standing," and "I feel more stable when walking"). Perceived ease of use was assessed using two questions (i.e., "Was easy to take on and off," and "Was comfortable to wear"). The Likert scale (6-point scale from 0-5) was used to quantify how much they disagreed with each statement, including "strongly disagree," "disagree," "somewhat disagree," "somewhat agree," "agree," and "strongly agree," respectively. In this paper, responses were only categorized as positive (3-5 points) or negative (0-2 points) attitudes towards the use of AFO plus walking shoes.
Stride Velocity
stride velocity measured in single-task walking with normal speed
Stride Time
stride time measured in single task walking with normal speed
Stride Length
stride length measured in single-task walking with normal speed

Full Information

First Posted
June 28, 2016
Last Updated
February 26, 2020
Sponsor
Bijan Najafi, PhD
Collaborators
Orthotic Holdings, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02819011
Brief Title
OHI--Randomized Control Trial to Evaluate Efficacy, Acceptability, and Perception of Benefit of an Innovative Custom AFO
Official Title
OHI--Randomized Control Trial to Evaluate Efficacy, Acceptability, and Perception of Benefit of an Innovative Custom AFO
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
May 2016 (undefined)
Primary Completion Date
December 2018 (Actual)
Study Completion Date
April 4, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Bijan Najafi, PhD
Collaborators
Orthotic Holdings, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The investigators propose a randomized control trial to evaluate long term effects and effectiveness of Moore Balance Brace (MBB) ankle foot orthoses (AFO) in reducing risk of falling in older adults. Primary Endpoints • Characterize the impact of MBB AFO on balance, gait, risk of falling, frailty status, and adverse events Secondary Endpoints • Characterize the Impact of MBB AFO on spontaneous daily physical activities • Characterize the feasibility of the MBB AFO device on patient adherence, acceptability, user-friendliness, and perception of benefit for daily usage

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Accidental Falls, Fall Due to Loss of Equilibrium, High Risk of Falls Due to Mobility Limitation, Diabetes, Arthritis, Cancer, Peripheral Arterial Disease, Parkinson's Disease, End Stage Renal Failure on Dialysis
Keywords
Ankle Foot Orthoses, falls, Fall Prevention, Frailty, Concern for falls, Footwear, Mobility

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MBB AFO Group
Arm Type
Experimental
Arm Description
This group will be provided with a pair of New Balance 813 shoes plus a custom made MBB AFO for the duration of the study.
Arm Title
No MBB AFO Group
Arm Type
Active Comparator
Arm Description
This group will be provided with a pair of New Balance 813 shoes for the duration of the study.
Intervention Type
Device
Intervention Name(s)
MBB AFO
Intervention Description
Subjects will be provided with a pair of New Balance 813 shoes plus a custom made MBB AFO
Intervention Type
Other
Intervention Name(s)
Control
Intervention Description
Subjects will be provided with a pair of New Balance 813 shoes
Primary Outcome Measure Information:
Title
Hip Sway Change From Baseline to 6 Months
Description
Hip sway (motion of hip joints in three dimensions) measured by wearable sensors while wearing their own shoes compared to the orthopedic shoes and compared to orthopedic shoes plus Ankle-Foot Orthosis (AFO)
Time Frame
baseline to 6 months
Title
Ankle Sway Change From Baseline to 6 Months
Description
Ankle sway (motion of ankle joint in three dimensions) measured by wearable inertial sensors while wearing their own shoes compared to the orthopedic shoes and compared to orthopedic shoes plus Ankle-Foot Orthosis (AFO)
Time Frame
baseline to 6 months
Title
Center of Mass (COM) Sway Change Baseline to 6 Months
Description
Center of Mass (COM) sway measured by wearable inertial sensors while wearing their own shoes compared to the orthopedic shoes and compared to orthopedic shoes plus Ankle-Foot Orthosis (AFO)
Time Frame
baseline to 6 months
Secondary Outcome Measure Information:
Title
Adherence (Hours Per Day to Wear Ankle-Foot Orthosis (AFO))
Description
The adherence of participants to the prescribed Ankle-Foot Orthosis (AFO) plus walking shoes was quantified using the response to a self-reported question ("How many hours per day did you wear the prescribed footwear?").
Time Frame
6 months
Title
Fall Incidents
Description
Fall incidents during the study
Time Frame
Baseline, 12 months
Title
Concern for Falling Change Form Baseline to 6 Months
Description
Concern for falling is quantified by Falls Efficacy Scale - International (FES-I) questionnaire. Scores range from minimum 16 (no concern about falling) to maximum 64 (severe concern about falling). Higher score indicate worse performance.
Time Frame
Baseline, 6 months
Title
Physical Activity Level
Description
Physical activity level for 24 hours while wearing their own shoes compared to the walking shoes and compared to walking shoes plus Ankle-Foot Orthosis (AFO). To quantify physical activity, number of taken steps per day was monitored using a pendant wearable sensor called, PAMSys (Biosensics, MA, USA).
Time Frame
baseline to 6 months
Title
Number of Participants With Adverse Events
Description
Number of participants with adverse events reported during the study. Adverse events was inquired at 1 months, 3 months, 6 months, 12 months after the baseline, and summed at 12 months. If the participant has at least one adverse event reported in any assessed time frame, the participant will be categorized as the participant with adverse event.
Time Frame
assessed at 1, 3, 6, and 12 months, month 12 reported
Title
Percentage of Participants Who Found the Device Useful and Easy to Use
Description
The participants perceived usefulness of ease of use of wearing Moore Balance Brace (MBB) Ankle-Foot Orthosis (AFO) based on questionnaires of A technology acceptance model (TAM). Perceived usefulness was assessed using two questions (i.e., "I feel more stable when standing," and "I feel more stable when walking"). Perceived ease of use was assessed using two questions (i.e., "Was easy to take on and off," and "Was comfortable to wear"). The Likert scale (6-point scale from 0-5) was used to quantify how much they disagreed with each statement, including "strongly disagree," "disagree," "somewhat disagree," "somewhat agree," "agree," and "strongly agree," respectively. In this paper, responses were only categorized as positive (3-5 points) or negative (0-2 points) attitudes towards the use of AFO plus walking shoes.
Time Frame
6 months
Title
Stride Velocity
Description
stride velocity measured in single-task walking with normal speed
Time Frame
baseline, 6 months
Title
Stride Time
Description
stride time measured in single task walking with normal speed
Time Frame
baseline, 6 months
Title
Stride Length
Description
stride length measured in single-task walking with normal speed
Time Frame
baseline, 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 65 or older High concerns or high risk of fall Ambulatory Exclusion Criteria: Presence of an active wound infection on either of the foot and ankle Use of medication or a medical condition that may have unstable (fluctuate over time) or temporary (less than one month) impact on gait and balance Acute fractures on the foot Participant of an interventional study within the last 30 days Non-ambulatory or unable to stand without help or walk a distance of at least 1.8 m (~six feet) without assistance Major foot amputation Unable or unwilling to participate in all procedures
Facility Information:
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Only de-identified data and associated results will be published in peer-reviewed papers or scientific abstracts
Citations:
PubMed Identifier
30504728
Citation
Wang C, Goel R, Rahemi H, Zhang Q, Lepow B, Najafi B. Effectiveness of Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses on Balance, Fear of Falling, and Physical Activity in Older Adults: A Randomized Controlled Trial. Gerontology. 2019;65(3):299-307. doi: 10.1159/000494114. Epub 2018 Nov 30.
Results Reference
result
PubMed Identifier
31018018
Citation
Wang C, Goel R, Zhang Q, Lepow B, Najafi B. Daily Use of Bilateral Custom-Made Ankle-Foot Orthoses for Fall Prevention in Older Adults: A Randomized Controlled Trial. J Am Geriatr Soc. 2019 Aug;67(8):1656-1661. doi: 10.1111/jgs.15929. Epub 2019 Apr 24.
Results Reference
result

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OHI--Randomized Control Trial to Evaluate Efficacy, Acceptability, and Perception of Benefit of an Innovative Custom AFO

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