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Transtibial Amputation - UnilateralNCT07652619

Motor Imagery for Prosthetic Gait Training in Transtibial Amputees

A study testing Motor Imagery in people with Transtibial Amputation - Unilateral and Transtibial Amputation, run by Ariel University at 1 site in Israel.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study included the development of motor imagery (i.e., the cognitive process of mentally reheasing a motor task) protocol for improving prosthetic gait among acute transtibial amputees. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Motor Imagery
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteIsrael
Study dates
10 Jan 2023to 20 Oct 2023
Phase
Interventional
Are there results?
None posted in the registry

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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Unilateral transtibial amputation
  • No experience with VESSA training

Who cannot join

  • Vestibular and/or cerebellar disorders
  • Cognitive impairments (e.g., mental retardation)
  • Hearing and/or visual impairment
  • Bilateral amputation
  • Acute medical exacerbation in the past two weeks

Trial locations and contacts

1 site in 1 country.

Israel1 site
  • Loewenstein Rehabilitation Hospital

    Raanana

Other trials in Israel

About this study

Official title: Motor Imagery Prior to or Alongside Initial Prosthetic Gait Training in Acute Transtibial Amputees: A Feasibility Pilot Study

This study included the development of motor imagery (i.e., the cognitive process of mentally reheasing a motor task) protocol for improving prosthetic gait among acute transtibial amputees. Further, the researchers investigated whether praciticng motor imagery before or alongside initial temporary prosthetic training (aka VESSA) would affect measures of functional status, pain, prosthethis embodiement and motor imagery ability.

Read the detailed description

Background: People undergoing transtibial amputation (TTA) face impairments in gait, balance, confidence, pain, and prosthesis embodiment. Motor imagery (MI) is a cognitive approach for addressing motor and cognitive performance. The current study aimed to (1) explore the feasibility of MI for individuals with acute TTA and (2) investigate the preliminary effects of MI on participants' functional status, gait, pain, prosthesis embodiment and imagery ability.

Methods: Ten participants (age range: 46-68 years, eight males) with acute unilateral TTA were randomly allocated into two groups based on delivery timing of MI in relation to temporary prosthesis (Vessa) training: prior to (pre-Vessa) or alongside (w-Vessa), both concurrently with conventional physical therapy. Participants underwent eight individualized MI sessions over two weeks. Data were collected at four timepoints: before and after MI, first independent prosthesis gait, and discharge from the hospital. Outcome measures included intervention feasibility, functional status, pain, prosthesis embodiment and imagery ability.

Being tested
Motor Imagery
Keywords
transtibial amputation, prosthetic rehabilitation, motor imagery, cognition, gait retraining, rehabilitation

What participants receive

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

  • Motor ImageryBehavioural

    Also called Motor Imagery Practice, Mental Imagery

    The motor imagery intervention aimed to: (1) introduce rationale, mechanisms of action, and advantages of MI; (2) facilitate kinesthetic and functional familiarization with the prosthesis; and (3) enhance prosthetic gait, weight-bearing, balance and turning.

    The protocol followed MI paradigms and methodologies (e.g., combining visual and kinesthetic modalities), including the PETTLEP model that was previously used in amputees. The MI contents addressed movement range of motion, quality, timing, and lower extremity and whole-body intersegmental coordination with motor tasks serving as outcome measures not being explicitly practiced.

    The following components were included:

    1. Introduction to MI- definition, mechanisms of effect, advantages, modalities, and perspectives.
    2. Acquaintance with and embodiment of the stump, MI of the prosthesis and MI of the stump-prosthesis interaction (e.g., contact area, pressure).
    3. Weight bearing and shifting during sit-to-stand, standing and gait.
Study groups in NCT07652619
Study groupRoleWhat they receive
Pre VESSAExperimentalParticipants attended the motor imagery training prior to beginning actual temporary prosthetic (VESSA) training
Receives: Behavioral: Motor Imagery
With VESSAExperimentalParticipants attended the motor imagery training alongside actual temporary prosthetic (VESSA) training
Receives: Behavioral: Motor Imagery

What is being measured

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

  1. Feasibility: Participants' Recruitement

    The actual number of participants successfully recruited for each group

    Measured: Within 72 hours post-intervention

  2. Feasiblity: Safety

    The lack of adverse events or negative effects throughout the intervention.

    Measured: Within 72 hours post-intervention

  3. Feasibility: Compliance

    The percentage of MI sessions successfully complated by participants

    Measured: Within 72 hours post-intervention

  4. Feasibility: Participants' Feedback

    Opinions and insights expressed by the participants about the intervention.

    Measured: Within 72 hours post-intervention

  5. Amputee Mobility Predictor

    A functional assessment of mobility level for determining the appropriate prosthetic prescription. The test consists of 21 daily living functional motor tasks (e.g., turning, sitting down, and walking over an obstacle). Scores are "0" ('inability to perform the task'), "1" ('minimal level of achievement or that some assistance was required in completing the task'), or "2" ('complete independence or mastery of the task'). A higher score indicates a greater level of prosthesis function.

    Measured: Within 72 hours prior to initial VESSA training

  6. Daily Functioning Ability Test

    An 18-item test for assessing patients' daily functioning inside and outside the hospital ward. Each item is rated on a 7-point scale, with higher scores representing less assistance needed by the patient. Scoring categories are: fully independent (109-126), independent with assistance devices (91-108), requiring supervision (73-90), requiring assistance (37-72), and fully dependent (nursing care; 18-36). Higher scores mean a better outcome.

    Measured: Within 72 hours pre-intervention, within 72 hours post-intervention, once first independent gait is possible (up to 72 hours) and at discharge from the rehabilitation center (up to 72 hours)

  7. Timed Up and Go

    A functional test for quantifying functional mobility. The participants are asked to rise from a chair, walk 3 meters, turn around an obstacle, and return to take a seat as quickly and safely as possible. The average time (in seconds) of two trials was recorded using a stopwatch. Lower scores mean a better outcome.

    Measured: Once first independent gait is possible (up to 72 hours) and at discharge from the rehabilitation center (up to 72 hours)

  8. Ten-meter Walk Test

    A functional test for assessing early gait after amputation. The time (in seconds) for completing a ten-meter forward walk was recorded.

    Measured: Once first independent gait is possible (up to 72 hours), and at discharge from the rehabilitation center (up to 72 hours)

Secondary outcomes (3)
  1. Prosthesis Embodiment Scale of Lower Limb Amputees

    A 10-item questionnaire for assessing perceptual correlates of successful body-prosthesis interaction (i.e., acceptance). Scores for each item are on a 7-point Likert scale ranging from "-3" ('strongly disagree') to "+3" ('strongly agree'). Higher scores mean better outcome (i.e., higher prosthesis embodiment).

    Measured: Within 72 hours pre-internvetion, within 72 hours post-intervention, once first independent gait is possible (up to 72 hours), and at discharge from the rehabilitation center (up to 72 hours).

  2. McGill Pain Questionnaire-Short Form

    A 17-item self-administered questionnaire for assessing pain, including post amputation pain. The questionnaire includes three sections: pain visual analog scale (VAS; 0-10 scale), pain intensity index (PPI; 0-5 scale), and total McGill score (0-45 scale). Higher scores mean worse outcome (i.e., higher levels of pain).

    Measured: Within 72 hours pre-internvetion, within 72 hours post-intervention, once first independent gait is possible (up to 72 hours), and at discharge from the rehabilitation center (up to 72 hours).

  3. Kinesthetic Visual Imagery Questionnaire

    A 5-item questionnaire for assessing MI clarity (visual subscale) and intensity (kinesthetic subscale) of motor tasks, including the amputated ('affected') and intact ('unaffected') . Scores range between "1" ('no image at all') and "5" ('image as clear as seeing'). Higher scores mean a better outcome.

    Measured: Within 72 hours pre-internvetion, within 72 hours post-intervention, once first independent gait is possible (up to 72 hours), and at discharge from the rehabilitation center (up to 72 hours).

Timeline

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

  1. First posted17 Jun 2026
  2. Study start10 Jan 2023
  3. Primary completion20 Oct 2023
  4. Study completion20 Oct 2023

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
Other
Allocation
Randomised
Intervention model
Sequential
Model description
Participants were allocated into one of two groups: 'pre-Vessa' ('pVessa') or 'with-Vessa' ('wVessa'). Group allocation was based on a cutoff of 14 days (estimated by medical staff) remaining until initial Vessa training. Participants with more than 14 days left were alternately allocated to either group, whereas participants with less than 14 days were allocated to the wVessa group
Masking
None (open label)
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07652619
Sponsor's protocol ID
0017-22-LOE
Status last verified
Jun 2026
First submitted
1 Jun 2026
Last updated
17 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Collected data (without identifiers) will be shared upon request submitted by email to the researchers.

Publications

  • Bekrater-Bodmann R. Mind over matter: Perceived phantom/prosthesis co-location contributes to prosthesis embodiment in lower limb amputees. Conscious Cogn. 2022 Feb;98:103268. doi: 10.1016/j.concog.2021.103268. Epub 2022 Jan 6.

    PubMed 34999318
  • Abraham A, Hart A, Andrade I, Hackney ME. Dynamic Neuro-Cognitive Imagery Improves Mental Imagery Ability, Disease Severity, and Motor and Cognitive Functions in People with Parkinson's Disease. Neural Plast. 2018 Mar 14;2018:6168507. doi: 10.1155/2018/6168507. eCollection 2018.

    PubMed 29725348
  • Malouin F, Richards CL, Jackson PL, Lafleur MF, Durand A, Doyon J. The Kinesthetic and Visual Imagery Questionnaire (KVIQ) for assessing motor imagery in persons with physical disabilities: a reliability and construct validity study. J Neurol Phys Ther. 2007 Mar;31(1):20-9. doi: 10.1097/01.npt.0000260567.24122.64.

    PubMed 17419886
  • Saruco E, Guillot A, Saimpont A, Di Rienzo F, Durand A, Mercier C, Malouin F, Jackson P. Motor imagery ability of patients with lower-limb amputation: exploring the course of rehabilitation effects. Eur J Phys Rehabil Med. 2019 Oct;55(5):634-645. doi: 10.23736/S1973-9087.17.04776-1. Epub 2017 Nov 16.

    PubMed 29144105
  • Ladda AM, Lebon F, Lotze M. Using motor imagery practice for improving motor performance - A review. Brain Cogn. 2021 Jun;150:105705. doi: 10.1016/j.bandc.2021.105705. Epub 2021 Feb 27.

    PubMed 33652364
  • Jeannerod M. Mental imagery in the motor context. Neuropsychologia. 1995 Nov;33(11):1419-32. doi: 10.1016/0028-3932(95)00073-c.

    PubMed 8584178
  • Lotze M, Halsband U. Motor imagery. J Physiol Paris. 2006 Jun;99(4-6):386-95. doi: 10.1016/j.jphysparis.2006.03.012. Epub 2006 May 22.

    PubMed 16716573
  • Bekrater-Bodmann R. Factors Associated With Prosthesis Embodiment and Its Importance for Prosthetic Satisfaction in Lower Limb Amputees. Front Neurorobot. 2021 Jan 15;14:604376. doi: 10.3389/fnbot.2020.604376. eCollection 2020.

    PubMed 33519413
  • Isakov E, Burger H, Krajnik J, Gregoric M, Marincek C. Influence of speed on gait parameters and on symmetry in trans-tibial amputees. Prosthet Orthot Int. 1996 Dec;20(3):153-8. doi: 10.3109/03093649609164437.

    PubMed 8985994
  • Isakov E, Keren O, Benjuya N. Trans-tibial amputee gait: time-distance parameters and EMG activity. Prosthet Orthot Int. 2000 Dec;24(3):216-20. doi: 10.1080/03093640008726550.

    PubMed 11195356
  • Barr S, Howe TE. Prosthetic rehabilitation for older dysvascular people following a unilateral transfemoral amputation. Cochrane Database Syst Rev. 2018 Oct 23;10(10):CD005260. doi: 10.1002/14651858.CD005260.pub4.

    PubMed 30350430
  • Samuelsen BT, Andrews KL, Houdek MT, Terry M, Shives TC, Sim FH. The Impact of the Immediate Postoperative Prosthesis on Patient Mobility and Quality of Life after Transtibial Amputation. Am J Phys Med Rehabil. 2017 Feb;96(2):116-119. doi: 10.1097/PHM.0000000000000553.

    PubMed 27386805
  • Zidarov D, Swaine B, Gauthier-Gagnon C. Quality of life of persons with lower-limb amputation during rehabilitation and at 3-month follow-up. Arch Phys Med Rehabil. 2009 Apr;90(4):634-45. doi: 10.1016/j.apmr.2008.11.003.

    PubMed 19345780
  • Sarroca N, Valero J, Deus J, Casanova J, Luesma MJ, Lahoz M. Quality of life, body image and self-esteem in patients with unilateral transtibial amputations. Sci Rep. 2021 Jun 15;11(1):12559. doi: 10.1038/s41598-021-91954-1.

    PubMed 34131211
  • MacKenzie EJ, Jones AS, Bosse MJ, Castillo RC, Pollak AN, Webb LX, Swiontkowski MF, Kellam JF, Smith DG, Sanders RW, Jones AL, Starr AJ, McAndrew MP, Patterson BM, Burgess AR. Health-care costs associated with amputation or reconstruction of a limb-threatening injury. J Bone Joint Surg Am. 2007 Aug;89(8):1685-92. doi: 10.2106/JBJS.F.01350.

    PubMed 17671005

Questions about this trial

What is this clinical trial studying?

A study testing Motor Imagery in people with Transtibial Amputation - Unilateral and Transtibial Amputation, run by Ariel University at 1 site in Israel.

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 2 inclusion and 5 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: finished, as of the sponsor's last update on 17 Jun 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 Israel. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility: Participants' Recruitement (time frame: Within 72 hours post-intervention). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07652619, which also lists 19 linked publications.

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 17 Jun 2026.

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