Amputees / Rehabilitation, Postural Balance, Virtual Reality
Conditions
Brief summary
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.
Interventions
OTHERVirtual Reality
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
OTHERStandard rehabilitation
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.
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Unilateral transtibial amputees in hospitalized in the rehabilitation of the musculoskeletal system service * All etiologies: vascular, traumatic and septic. * Adapted vascular equipment validated by physician. * Able to walk for 5 minutes on a treadmill without technical assistance. * The patient must have given their free and informed consent and signed the consent form * The patient must be a member or beneficiary of a health insurance plan
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: * Body shape * Colostomy bags * Skin lesions that cannot be adequately protected. * Any other reason that prevents proper, pain-free adjustment of the sling. * 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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mediolateral instability during mediolateral external perturbation between groups | Before rehabilitation (Day 1) | 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 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Step length variability between groups | Before rehabilitation (Day 1) | Meters, measured with the GRAIL rehabilitation and movement analysis platform |
| Step width variability between groups | Before rehabilitation (Day 1) | Meters, measured with the GRAIL rehabilitation and movement analysis platform |
| Cadence variability between groups | Before rehabilitation (Day 1) | Steps/minute, measured with the GRAIL rehabilitation and movement analysis platform |
| Center of mass variability between groups | Before rehabilitation (Day 1) | Meters, measured with the GRAIL rehabilitation and movement analysis platform |
| Mobility and balance between groups | Before rehabilitation (Day 1) | Time Up and Go test, seconds |
| Aerobic endurance and functional capacity between groups | Before rehabilitation (Day 1) | 2-minute walk test, meters |
| Fall risk between groups | Before rehabilitation (Day 1) | Berg scale, score between 0 and 56 (no fall risk) |
Countries
France
Contacts
CONTACTEric Pantera
PRINCIPAL_INVESTIGATOREric Pantera
CHU de Nimes
Outcome results
None listed