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Lower Limb AmputationPhantomWalkNCT07191795

Uses of Phantom Sensations Induced by Global and Local Modifications of the Prosthetic Socket as Somatosensory Feedback During Walking in Lower Limb Amputees

A study testing Gait analysis, Mapping of referred sensations. and Evaluation of the effects of socket modifications on phantom sensations and walking in people with Lower Limb Amputation, run by Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est at 1 site in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Following lower-limb amputation, the loss of somatosensory information from the missing limb renders walking less automatic, more cognitively demanding, and often asymmetric, which can lead to secondary pathologies. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Lower Limb Amputation
What is being tested?
Gait analysis, Mapping of referred sensations. and Evaluation of the effects of socket modifications on phantom sensations and walking
Could I receive a placebo?
No, everyone receives an active treatment
How many people
248 participants
Where
1 siteFrance
Study dates
16 Sep 2024to 30 Sep 2030
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Participants with amputations:
  • Major lower limb amputation
  • Understand and be able to express oneself in the French language (for semi-structured interviews)
  • Affiliated with a social security scheme
  • Asymptomatic volunteer participants:
  • No major surgery on the lower limbs for at least 3 years
Show all 9Show fewer
  • No minor injury to the trunk, lower or upper limbs that could influence walking for at least 1 year
  • Understand and be able to express oneself in the French language
  • Affiliated with a social security scheme

Who cannot join

  • History of psychiatric disorders
  • Pregnant or breastfeeding woman
  • Minor
  • Adult subject to a legal protection measure
  • Person under guardianship or conservatorship
  • Person under a judicial protection order
  • Pain affecting walking (trunk, residual limb, phantom limb, contralateral limb)
  • Medical treatment incompatible with walking

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

France1 site, 1 recruiting
  • Institut Régional de Médecine Physique et de Réadaptation

    Nancy, 54000

    Jonathan Pierret, PhD, +33382526761, jonathan.pierret@ugecam.assurance-maladie.fr

    Christelle Requena, christelle.requena@ugecam.assurance-maladie.fr

    Recruiting

Other trials in France

About this study

Following lower-limb amputation, the loss of somatosensory information from the missing limb renders walking less automatic, more cognitively demanding, and often asymmetric, which can lead to secondary pathologies.

Hypothesis: This study is based on the hypothesis that phantom limb sensations (PLS), when coherent with the prosthetic device's movements and the phases of the gait cycle, can compensate for the loss of somatosensory feedback and thereby improve locomotion for individuals with amputation. It is further hypothesized that it is possible to artificially induce these coherent and useful sensations, notably through "referred sensations" elicited by stimulation of the residual limb (e.g., via the prosthetic socket).

Read more

Objectives: The project aims to:

  • Determine whether the natural presence of phantom limb sensations during walking impacts gait parameters.
  • Confirm in a larger patient population that modifications to the prosthetic socket can induce or enhance phantom sensations that are perceived as useful for walking.
  • Investigate whether these perceptual changes (induced or enhanced) are associated with objective, measurable improvements in gait quality.
Being tested
Gait analysis, Mapping of referred sensations., Evaluation of the effects of socket modifications on phantom sensations and walking, Phantom limb interview
Keywords
Phantom Limb Sensation, Referred Sensation, Somatosensory Feedback, Lower Limb Prosthesis, Prosthetic Gait

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Gait analysisOther

    Participants with unilateral amputations and a control group will undergo a comprehensive walking analysis. In a lab setting (on a treadmill or floor), their gait will be recorded using inertial sensors, EMG, force plates, and motion capture, while an EEG cap and a NASA-TLX questionnaire will assess cognitive load. Capable participants will also perform a walking test on a real-world outdoor course with varied terrain. The data will be analyzed to compare walking patterns between groups (amputees vs. controls, and amputees with vs. without phantom limbs). Finally, participants will describe any interactions they perceived between their phantom sensations and walking during the tests.

  • Mapping of referred sensations.Other

    Participants reporting referred sensations in gait analysis phase will undergo further testing. The study will investigate whether prosthesis pressure or a specific socket interaction causes these sensations. A 3x3 cm grid will be drawn on the residual limb to systematically map referred sensations using various stimuli (brush, pressure tip, electrical stimulation). Participants will rate the intensity and describe the location of any resulting phantom sensations. This mapping will be repeated after 6 months to assess the stability of these sensations over time, with the ultimate goal of potentially using them to provide sensory feedback for prosthesis users. The session will last approximately 2 hours.

  • Evaluation of the effects of socket modifications on phantom sensations and walkingOther

    In 10 unilateral transfemoral amputees with stable induced phantom sensations, this phase evaluates how a personalized socket modification affects phantom sensations and walking. With the prosthetist, a localized thickness (e.g., silicone insert) is added inside the usual socket at the stable stimulation sites identified on the residual-limb map, after measuring socket pressure with a thin sensor array. Each participant is tested in two conditions in a fixed order: usual socket first, then modified socket. The order is not randomized because induced sensations may persist after the modification is removed. For each condition, gait is analyzed in the laboratory and on the ecological course (4 sessions; conditions no more than 4 weeks apart). Participants describe their sensations, rate cognitive load, effort and socket comfort, and indicate which condition is most helpful for walking.

  • Phantom limb interviewOther

    A semi-structured interview will be conducted to ask participants to describe their phantom limb sensations (type, location, intensity) under three conditions: without their prosthesis, while standing with it, and while walking with it. This aims to identify factors influencing these sensations. Additionally, a brief physical examination of the residual limb will be performed to see if touch in specific areas triggers any referred sensations.

Study groups in NCT07191795
Study groupRoleWhat they receive
Amputees w-o SFExperimentalPeople without fantom sensation during gait
Receives: Other: Gait analysis; Other: Mapping of referred sensations.; Other: Phantom limb interview
Amputees H-SFExperimentalPeople with phantom sensations who are caregivers
Receives: Other: Gait analysis; Other: Mapping of referred sensations.; Other: Evaluation of the effects of socket modifications on phantom sensations and walking; Other: Phantom limb interview
ControlExperimentalAsymptomatic people
Receives: Other: Gait analysis
Amputees B-SFExperimentalPeople with bothersome phantom sensations
Receives: Other: Gait analysis; Other: Mapping of referred sensations.; Other: Evaluation of the effects of socket modifications on phantom sensations and walking; Other: Phantom limb interview
Amputees N-SFExperimentalPeople with neutral phantom sensations
Receives: Other: Gait analysis; Other: Mapping of referred sensations.; Other: Evaluation of the effects of socket modifications on phantom sensations and walking; Other: Phantom limb interview

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Prevalence of non-painful phantom sensations during walking

    Proportion of amputee participants able to walk who report non-painful phantom sensations during walking, collected during a standardized semi-structured interview. Reported as a proportion with its exact (Clopper-Pearson) 95% confidence interval

    Measured: The first day of the study

  2. Double support time during level walking at self-selected speed

    Double support time, defined as the sum of the initial and terminal double support periods of the prosthetic-limb gait cycle, expressed as a percentage of gait cycle duration (%). Measured by 3D motion analysis and force plates during level overground walking at self-selected speed in the laboratory (spontaneous condition).

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  3. Within-participant difference in double support time between usual and modified socket

    Difference in double support time (% of gait cycle, same definition and walking condition as Phase 2) between walking with the usual socket and walking with the socket modified by a focal thickness addition designed to induce phantom sensations, in transfemoral amputees. Conditions assessed in a fixed order (usual socket first). Reported as mean difference with 95% confidence interval.

    Measured: Days 4 to 7 of the study

Secondary outcomes (23)
  1. Walking pace under laboratory conditions

    The number of steps per minute (steps/min) when walking at a comfortable speed. Measured using inertial measurement units or the Vicon system.

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  2. Analysis of brain activity related to cognitive load during walking

    Electroencephalographic (EEG) activity will be recorded via a headset. Cognitive load will be quantified by analyzing the power ratio in specific frequency bands at the frontal electrodes.

    Measured: The second day of the study for participants with amputation

  3. Gait speed in ecological situation

    The average walking speed (in m/s) measured using inertial measurement units and pressure soles (Loadsol) during a predefined outdoor route including various difficulties (stairs, slopes, etc.).

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  4. Qualitative description of the interaction between phantom sensations and walking

    Participants' verbal descriptions of the nature of the interaction (facilitating, hindering, neutral), the evolution and characteristics of phantom sensations during walking will be collected via a structured interview at the end of the session. The data will be analyzed thematically.

    Measured: The second day of the study for participants with amputation

  5. Effect of focal stimulation on phantom sensations

    For the subgroup of participants reporting interaction between sensations and focal stimulation after various stimulations using a rubber tip (pressure), a brush, and a needle. The change in sensation intensity (rated on a scale of 0 to 5). The result will be categorized as "increase," "decrease," or "no change."

    Measured: Day 3 of the study

  6. Change in perceived cognitive load (NASA-TLX score) during walking in an ecological setting

    Perceived mental workload will be assessed using the NASA-TLX questionnaire immediately after each walking session. The total score will be compared between the four socket conditions.

    Measured: Day 4 to 7 of the study

  7. Evaluation of socket comfort

    The overall comfort perceived for each condition will be assessed at the end of each session using a Numerical Rating Scale (NRS) ranging from 0 (very uncomfortable) to 10 (very comfortable). The average score will be compared between the four conditions.

    Measured: Day 4 to 7 of the study

  8. Assessment of mental workload during walking using the NASA-TLX questionnaire

    The cognitive load perceived by the participant will be assessed using the NASA Task Load Index (NASA-TLX) self-report questionnaire. The total score, ranging from 0 to 100, will be calculated. A higher score indicates a greater perceived cognitive load.

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  9. Qualitative description of the sensations reported for each socket condition

    For each condition, a structured description of the sensations reported (type, location, intensity, perceived usefulness for walking) will be collected through an interview. The data will be analyzed thematically to compare the sensory experience.

    Measured: Day 4 to 7 of the study

  10. Change in phantom limb sensation intensity at 6 months for recent amputees

    For the subgroup of participants with an amputation of less than 6 months at inclusion, the intensity of phantom sensations will be re-assessed using the 3-point ordinal scale.

    Measured: The first day of the study and during the 6-month follow-up visit.

  11. Walking speed under laboratory conditions

    The participant's average walking speed, measured in meters per second (m/s). The measurement will be collected using inertial measurement units (IMUs) and/or a Vicon motion capture system while the participant walks on hard ground or on a treadmill at their self-selected speed.

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  12. Step length symmetry index.

    Gait symmetry will be calculated based on the stride length of the affected (or corresponding) limb and the healthy limb. The symmetry index is a unitless ratio (or percentage) that quantifies the difference between the two limbs. A value of 1 (or 100%) indicates perfect symmetry. Measured using inertial measurement units or the Vicon system.

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  13. Surface area and intensity of induced phantom sensation maps

    For each type of stimulation, the number of 3×3 cm areas of the residual limb eliciting phantom sensations is counted and the total surface area (cm²) is calculated (number × 9). For each reactive area, the participant rates the intensity of the induced sensation on a three-level ordinal scale (weak, medium, strong).

    Measured: 2nd or 3rd day of the study depending on whether the participant with an amputation was included in phase 2 or not and during the 6-month follow-up visit.

  14. Preferred socket condition

    At the end of Phase 4, participants indicate which condition (usual socket or modified socket) they perceive as most facilitating for walking.

    Measured: Day 7 of the study

  15. Spatiotemporal gait parameters in ecological situation

    Walking speed (m/s), cadence (steps/min) and step symmetry index measured with inertial sensors and pressure insoles during the predefined indoor/outdoor course, compared between the usual socket and the modified socket.

    Measured: Days 4 to 7 to the study

  16. Characterization of phantom limb sensations

    Composite assessment of phantom limb sensations via a semi-structured interview: type of sensation, location, intensity (weak, medium, strong) and perceived influence on walking (helpful, neutral, disturbing).

    Measured: The first day of the study

  17. Step length

    Step length (m) of the prosthetic and intact limbs during level walking at self-selected speed.

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  18. stance and swing phase durations

    Stance and swing phase durations of each limb, expressed as % of gait cycle.

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  19. Functional Ambulation Performance Score (FAPS)

    Composite score computed from spatiotemporal parameters, ranging from 30 (highly pathological gait) to 100 (healthy gait).

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  20. Enhanced Gait Variability Index (EGVI)

    Composite gait variability score computed from step-to-step spatiotemporal parameters; values between 95 and 105 indicate healthy variability.

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  21. Raw NASA-TLX score (RTLX)

    Perceived cognitive workload during walking, computed as the mean of the six NASA-TLX dimensions, each rated 0-10 (higher = higher workload).

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  22. Perceived exertion (Borg CR10)

    Borg CR10 score (0-10; higher = greater exertion), collected after each walking condition.

    Measured: The first day of the study for the control group and the second day of the study for participants with amputation

  23. Perceived interaction between phantom sensations and walking

    Visual analog scale from -5 (very disturbing) to +5 (very helpful), completed by participants with phantom sensations after each walking condition; analyzed as a continuous variable

    Measured: the second day of the study for participants with amputation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Sep 2025
  2. Study start16 Sep 2024
  3. Primary completion30 Sep 2028 (estimated)
  4. Study completion30 Sep 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
248 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07191795
Sponsor's protocol ID
2022-A01647-36
Other IDs
ANR-23-CE17-0067-02
Acronym
PhantomWalk
Status last verified
Oct 2026
First submitted
21 Aug 2025
Last updated
3 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Gait analysis, Mapping of referred sensations. and Evaluation of the effects of socket modifications on phantom sensations and walking in people with Lower Limb Amputation, run by Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 3 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jonathan J Pierret, PhD (+33383526761, jonathan.pierret@ugecam.assurance-maladie.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prevalence of non-painful phantom sensations during walking (time frame: The first day of the study). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2026.

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