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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05520008
Other study ID # H-52182
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date November 3, 2022
Est. completion date October 6, 2023

Study information

Verified date November 2023
Source Baylor College of Medicine
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The present study aims to use a game-based tele-exercise program for patients using a compression garment to improve lower extremity edema. This tele-exercise gaming platform can work as an efficient exercise to improve patients' muscle strength. It also can be helpful in improving edema and venous return and can be used in addition to compression garments to increase efficacy. The sample size (n=30) is convenient and designed to explore acceptability and feasibility. Eligible participants will be screened at the Baylor college of Medicine Clinic based on the inclusion/exclusion criteria. Participants who satisfy the inclusion and exclusion criteria and sign the informed consent form will be randomly assigned with ratio of 1:1 into two groups. Both groups will receive a compression garment to use for 4 weeks, and in the intervention group, patients will receive a sensor and a tablet to play foot & ankle exercise games twice a day for 5 minutes. Study participation will be 4 weeks for all participants. Participants will be assessed in two visits: a baseline visit (BL) and a visit at the end of the 4 weeks (W4). The primary outcomes will be calf circumference, foot volume, and pitting edema grade. Secondary outcomes include limb strength, foot perfusion, gait assessment (gait speed, stride length, double stance, and gait steadiness), balance, and quality of life. The coordinator will monitor patients weekly to see their adherence to the compression garment and game-based exercise.


Description:

Lower extremity edema (LE) is an accumulation of interstitial fluid volume in the legs and feet and commonly occurs in patients with diabetes, hypertension, kidney disease, heart failure, cirrhosis, cancer, and obesity. LE can also result from deep vein thrombosis (DVT) in the lower leg. Compression socks or garments are often used to decrease this edema. Despite the efficacy of this treatment, there are some limitations including low patient compliance and contraindication of high compression levels for patients with high grades of peripheral arterial disease. Given that it is has previously been shown that exercise can be a positive way to reduce LE, the present study aims to use a game-based exercise program to help increase patient's movement and thus improve efficacy and adherence to the compression garments/socks. The investigators will recruit 30 participants and randomly divide them into two groups: Active Group (AG) and Control Group (CG). Both groups will receive a compression garment (CompreCares) developed by Medline Incorporated(Inc). (IL, USA). The AG will receive a tablet and foot sensor (TEXASSENSE INC, USA), and will be instructed to play with it daily for 5 minutes over the period of 4 weeks. During the two study visits (BL and W4), the investigators will assess the following outcomes: calf muscle activation (assessed by surface electromyography [sEMG]), foot perfusion (SNAPSHOT NIR, Kent Imaging System), calf and foot circumference, ankle-brachial index (ABI), pitting edema test, foot volume, gait, balance, and peripheral neuropathy (DPNCheck, Neurometrix Inc., Woburn, Massachusetts, USA). Acceptability and patient reported outcomes will be assessed via validated questionnaires collected at each study visit.


Recruitment information / eligibility

Status Completed
Enrollment 19
Est. completion date October 6, 2023
Est. primary completion date October 6, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Adult patients (18+ years old) who have lower extremity edema - Willing to attend clinic for assessments Exclusion Criteria: - Severe cognitive decline that reduces their ability to use tele-foot exercise device - Major visual problems that reduces their ability to use tele-foot exercise device - Inability to walk independently for a distance of 10 meters - Major foot problems such as active lower extremity wounds - Major foot deformity (e.g., Charcot Foot) - Previous major amputations, and claudication - Decompensated or advanced heart failure New York Heart Association (NYHA) Functional Class(FC) III-IV - Significant heart disease

Study Design


Intervention

Other:
Game-based exercise
Patients in the active group will put on a sensor connected to a tablet to play a game-based foot/ankle exercise twice a day for 5 minutes for four weeks.

Locations

Country Name City State
United States Baylor College of Medicine Houston Texas

Sponsors (2)

Lead Sponsor Collaborator
Baylor College of Medicine Medline Industries

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Change in peripheral neuropathy from baseline to 4 weeks Peripheral neuropathy will be assessed using DPNCheck (Neurometrix, Woburn, MA, USA). This is a noninvasive device which will measure conduction velocity and amplitude. 4 weeks from baseline
Other Patient acceptance at 4 weeks Participant acceptance of the tele-exergaming program will be assessed at the end of their participation using a validated technology acceptance model (TAM) questionnaire 4 weeks from baseline
Other Change in physical activity (step count and intensity minutes) from baseline to 4 weeks Physical activity metrics, such as step count and intensity minutes, will be measured over the course of the 4 weeks using a smart watch (Vivosmart 4, Garmin, US) 4 weeks from baseline
Primary Change in calf circumference from baseline to 4 weeks Calf circumference will be assessed with a soft measuring tape for each leg 4 weeks from baseline
Primary Change in foot circumference from baseline to 4 weeks Foot circumference will be assessed with a soft measuring tape for each leg 4 weeks from baseline
Primary Change in foot volume from baseline to 4 weeks Foot volume will be assessed with a standard foot volumeter 4 weeks from baseline
Primary Change in pitting edema grade from baseline to 4 weeks Coordinators will press on the affected area in the lower extremities and measure depth of indention. They will record the length of skin rebound time and grade the edema based on validated scales 4 weeks from baseline
Secondary Change in gastrocnemius muscle strength from baseline to 4 weeks Lower extremity strength will be assessed with an ankle dynamometer and surface electromyography (Delsys Trigno Wireless EMG System, MA, US). 4 weeks from baseline
Secondary Change in gait and balance from baseline to 4 weeks Gait speed will be measured with standard walking tests and wearable sensors (Legsys). 4 weeks from baseline
Secondary Change in balance from baseline to 4 weeks Static balance will be measured with standard balance tests and wearable sensors (Balansens). 4 weeks from baseline
Secondary Change in plantar tissue oxygen saturation/consumption from baseline to 4 weeks Percentage of tissue oxygen saturation (SatO2) and hemoglobin values will be measured using a validated near-infrared (NIR) camera (Snapshot NIR, KENT Imaging Inc., Calgary, AB, Can) that detects an approximate value of real-time SatO2 and level in superficial tissue. The area that will be captured is the metatarsus area 4 weeks from baseline
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