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Ankle-foot Orthoses for Peripheral Artery Disease

University of Minnesota (UMN) logo

University of Minnesota (UMN)

Status

Completed

Conditions

Peripheral Artery Disease

Treatments

Device: AFO to improve outcomes

Study type

Interventional

Funder types

Other
NIH

Identifiers

NCT02280200
Mays-2
U54GM104944 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The primary aim of this study is to investigate the effect of an ankle foot orthoses (AFO) on the primary outcome of peak walking time (PWT) in patients with peripheral artery disease (PAD).

Full description

The investigators will test the hypothesis that PAD patients using an AFO during a graded exercise test will demonstrate a greater PWT compared to PWT assessed without the use of an AFO. Secondary hypotheses include evaluation of the effect of an AFO on: 1) calf muscle function, 2) claudication onset time, 3) functional ability, 4) peak oxygen consumption, and 5) patient-reported outcomes. We will also examine the effects of the AFO on outcomes following 12 weeks of community walking.

Enrollment

31 patients

Sex

All

Ages

40+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Men and women diagnosed with atherosclerotic peripheral arterial disease (PAD).
  • Patients who experience calf claudication
  • ≥40 years of age
  • An abnormal ankle-brachial index (ABI) of ≤.90.
  • For patients with an ABI >.90 and <1.00, a post-exercise ABI drop of 15% or more compared to the resting ABI

Exclusion criteria

  • Lower extremity amputation(s) which interfere(s) with walking.
  • Critical limb ischemia (i.e., ischemic rest pain, ulcers/gangrene on the lower extremities).
  • Non-atherosclerotic PAD (e.g., popliteal entrapment syndrome, Takayasu's arteritis)
  • Major surgical procedures that are contraindicated to an exercise program (e.g., recent organ transplant) or coronary artery bypass graft within 6 months prior to screening.
  • Primarily limitations to exercise due to chronic obstructive pulmonary disease, angina or heart failure.
  • Myocardial infarction within 3 months prior to screening.
  • Acute coronary syndrome symptoms diagnosed at time of screening.
  • Significant ischemic changes (documented on the 12-lead electrocardiogram) with horizontal or down-sloping ST-segment depression ≥ 0.5mm at rest and >1 mm with exercise in 3 beats for 2 contiguous leads, relative to the PR-segment (or ST-segment elevation ≥1mm).
  • Transient ischemic attack or stroke 3 months prior to screening.
  • New left bundle branch block or sustained ventricular tachycardia >30 seconds during screening.
  • Uncontrolled hypertension defined as ≥180 systolic or ≥100 diastolic resting blood pressure during screening.
  • Women who are pregnant (women of childbearing potential, a pregnancy test will be performed at screening.
  • Individuals currently incarcerated.
  • Evidence of acute impairment from alcohol or other illicit drugs.
  • Lack of diabetes control (glycated hemoglobin >12%)
  • Patients who are anemic (Hgb <11 g/dL for women and <10 g/dL for men).
  • Any other clinically significant diseases (e.g., pulmonary, renal, psychiatric, immunological) that are not stabilized or may otherwise confound the results of the study.

Trial design

Primary purpose

Treatment

Allocation

Non-Randomized

Interventional model

Single Group Assignment

Masking

None (Open label)

31 participants in 2 patient groups

AFO to improve outcomes
Experimental group
Description:
Patients completed graded treadmill testing, followed by 12 weeks of unstructured community-based walking using the AFO ad libitum
Treatment:
Device: AFO to improve outcomes
Historical Controls
No Intervention group
Description:
Historical PAD control group (n = 10) received upfront advice to walk at home with no intervention

Trial documents
1

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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