Peripheral Nerve Stimulation for Lower Limb Amputees
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores whether stimulating certain nerves can improve blood flow and responsiveness in people with lower limb amputations. The aim is to develop a test that checks nerve reflexes related to circulation. Participants will either have a chronically implanted neural and muscular interface or receive peripheral nerve stimulation (PNS). It suits veterans who speak English and have either a lower limb amputation or diabetes with nerve damage in the legs.
As an unphased trial, this study offers participants the chance to contribute to groundbreaking research that could lead to innovative solutions for nerve-related circulation issues.
What prior data suggests that peripheral nerve stimulation is safe for lower limb amputees?
Research shows that the treatments in this trial have been studied before and are generally well-tolerated.
For the Chronically Implanted Neural and Muscular Interface, studies have shown it is safe for humans. One study examined the stability of these implants in individuals with lower limb loss over 2–4 years, and most components remained stable. This suggests the implant is safe for long-term use.
For Peripheral Nerve Stimulation (PNS), research has found it to be safe and effective, particularly for reducing pain after amputation. Patients have reported significant pain relief, with studies showing up to 100% reduction in phantom limb pain and pain in the remaining limb. Several studies have confirmed this, with patients experiencing lasting pain relief and improved quality of life over 12 months.
These findings strongly suggest that both treatments are generally safe for humans.12345Why are researchers excited about this trial?
Researchers are excited about these treatments for lower limb amputees because they offer a fresh approach to managing nerve signals and muscle control. Unlike traditional prosthetics, which rely on mechanical designs, the chronically implanted neural and muscular interface directly stimulates nerves and muscles, potentially offering more natural movement and sensation. Meanwhile, peripheral nerve stimulation is unique in that it can be applied to both able-bodied individuals and those with limb loss, aiming to enhance nerve communication without invasive surgery. These innovations could lead to more intuitive and responsive prosthetic control, significantly improving quality of life.
What evidence suggests that this trial's treatments could be effective for lower limb amputees?
Research has shown that devices implanted in nerves and muscles, which participants in this trial may receive, can help individuals with lower limb loss regain natural movement and sensation. Studies have found that these devices improve walking balance and ease movement over uneven ground. Meanwhile, peripheral nerve stimulation (PNS), another treatment option in this trial, has evidence suggesting it can significantly reduce pain, such as phantom limb pain, after an amputation. Some studies also indicate that PNS can lessen the need for pain medications. Both treatments offer promising results for enhancing the quality of life in individuals who have lost a lower limb.12467
Who Is on the Research Team?
Hamid Charkhkar, PhD
Principal Investigator
Louis Stokes VA Medical Center, Cleveland, OH
Are You a Good Fit for This Trial?
This trial is for veterans with diabetes who have had a lower limb amputation. Participants should be adults and able to undergo procedures involving nerve stimulation devices.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive peripheral nerve stimulation and undergo various physiological tests including thermal axon reflex and pressure induced vasoconstriction
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- Chronically Implanted Neural and Muscular Interface
- Peripheral Nerve Stimulation (PNS)
Trial Overview
Researchers are testing if using implanted devices that stimulate nerves and muscles (peripheral nerve stimulation) can improve blood flow and overall limb health in people with diabetes-related amputations.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
30 able body participants and 12 participants with unilateral lower-limb loss with receive peripheral nerve stimulation
6 lower limb loss participants who have already been chronically implanted with neural and muscular interfaces to allow for direct stimulation
Find a Clinic Near You
Who Is Running the Clinical Trial?
VA Office of Research and Development
Lead Sponsor
Case Western Reserve University
Collaborator
Citations
Somatosensory restoration and neural control strategies in ...
This review provides an overview of the current state of neuroprosthetics for somatosensory restoration and prosthetic control in lower-limb ...
Continuous neural control of a bionic limb restores ...
Here we hypothesize that continuous neural control of a bionic limb can restore biomimetic gait after below-knee amputation when residual muscle ...
Neural Interface for Upper Limb Amputation (PSI Trial)
Research shows that using a Chronically Implanted Neural and Muscular Interface holds promise for safety in humans. This treatment employs Functional Electrical ...
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trialx.com
trialx.com/clinical-trials/listings/281880/feasibility-of-sensory-feedback-for-lower-limb-amputees/Feasibility of Neural Feedback for Lower Limb Amputees
The purpose of this study is to evaluate the effectiveness of providing sensation of the missing limb to individuals with lower limb loss, including above and ...
Individuals with Amputation - Rehab Neural Engineering Labs
The goal of this study is to record muscle activity while a person performs a variety of hand and arm movements in order to help develop advanced prosthetic ...
Long-term performance and stability of implanted neural ...
this study examines the chronic stability of implanted C-FINEs in four individuals with lower limb loss over 2–4 years, with most channels (152 out of 158) ...
Interfaces with the peripheral nervous system for the control of ...
The C-FINE was found successful in restoring sensation in individuals with a lower limb amputation [75]. The flexible neural clip contains two ...
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