Lower Limb Amputation Below Knee (Injury)ENABLENCT05425810
R21: An Easy-to-use, iNtelligent, Affordable LinEr (ENABLE) System for Socket Fit Assessment
A study testing Apply ENABLE sensing pad and Insert small pads at pressure tolerant locations in people with Lower Limb Amputation Below Knee (Injury), run by North Carolina State University at 1 site in United States.
Trial summary
Lower limb amputees (LLA) rely on their prosthetic legs to remain active and lead an independent life. For most LLAs, a well-fitted prosthetic socket is the only option to interface with their prosthetic leg, however, it is a real challenge to make a prosthetic socket to interface with residual limbs accurately. Read more about this study
- Who is it for?
- Ages 18 to 99 years
- Conditions the study is for
- Lower Limb Amputation Below Knee (Injury)
- What is being tested?
- Apply ENABLE sensing pad and Insert small pads at pressure tolerant locations
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3 participants
- Where
- 1 siteUnited States
- Study dates
- 20 Apr 2021to 27 Feb 2026
- 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 to 99 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Unilateral transtibial amputees
- At least 1 year of experience using his/her prosthetic leg
- Has used the current socket for at least 6 months without a significant skin issue or major modification
- Can comfortably walk 3 mins without pausing to rest
- The fibula length on the residual limb must be greater than half of the length of the fibula on the unaffected side
Who cannot join
- Cognitive or visual impairment that affects the participant's ability to provide informed consent or to follow simple instructions during the experiments
- neuropathy observed on the residual limb
- regnant female
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
NC State University
Raleigh, North Carolina, 27695
Ming Liu, 919-515-8541, mliu10@ncsu.edu
He Huang, 9195158541, hhuang11@ncsu.edu
About this study
Lower limb amputees (LLA) rely on their prosthetic legs to remain active and lead an independent life. For most LLAs, a well-fitted prosthetic socket is the only option to interface with their prosthetic leg, however, it is a real challenge to make a prosthetic socket to interface with residual limbs accurately. One of the reasons is that there lack of accurate approaches to evaluate the pressure distribution on the residual limb accurately and effectively. To overcome this issue, the research team will develop an innovative sensing system, which permits the prosthetists to track the pressure distribution on the residual limb visually. The capability of the new sensing system will be demonstrated on lower limb amputees.
Read the detailed description
A novel pressure sensing pad will be tested in the project. The purpose of these tests is to collect the safety and efficacy of the sensing pad. The research team would like to seek a Non-significant Risk claim from Institutional Review Board (IRB).
The pad will be made of materials similar to the normal liner with embedded nanotubes. The nanotubes are filled with gallium alloys, of which resistance will change based on loaded pressure. When constant current passes these tubes, the change of pressure leads to a change in temperatures around, which will excite thermal-sensitive dyes to change color. So the research team could estimate the pressure at a given area based on the color around it.
The experimental procedure includes three sets and requires 3-4 visits from each subject.
Set I procedure includes a standard socket construction, which requires 2-3 visits for the subjects to the office of a local prosthetic company. Then, a certified prosthetist will build a test socket and a customized liner to maximize the socket fit and comfort and conduct the needed alignment of the prosthetic leg. Unless it is necessary, all testing sockets will be duplications of amputees' everyday sockets.
Set II will test the accuracy of the constructed prototype on amputee subjects compared to a commercially available sensor pad, which serves as a reference. First, the research team will mount both sensing systems on the subjects. The reference sensor grid will be mounted on the residual limb directly using medical tape. After the subject dons the ENABLE sensing pad, the research team will register two sensing systems. In the end, the subjects are required to don the testing socket and walk continuously, so the measurement of the developed prototype could be stabilized. Pictures of the ENABLE will be taken and compared with the recorded pressure signals from the reference grid.
Although the reference grid and ENABLE system are designed to be put on easily, brief assistance from experimenters will be needed to ensure that the mounting procedure can be conducted appropriately.
Set III will test whether information from the ENABLE leads to appropriated socket-fit-assessments based on the response of experienced prosthetists when the prosthetists are shown the pressure distribution measured by the ENABLE under different fit conditions. All subjects will be exposed to five socket fit conditions: good and additional foam pads at four different areas shown in a random sequence. The size of the pad at each location is selected by the prosthetists based on the shape and size of the residual limbs.
Under each fitting condition, each subject will go through three trials. In each trial, the subject will walk continuously until the color of the sensing pad is stabilized. After taking high-resolution digital pictures, which cover most of the sensing area of the ENABLE, the research team will let the subject rest until the optical pattern of the ENABLE fades completely before starting a new trial.
After the experiments are finished, the subject will need to fill out a survey about the comfort of the ENABLE system. The survey will be conducted just after the experimental procedure on paper. During Set II and III, a fall prevention harness is available for the participants if it is needed. The participants are requested to self-monitor the pressure and thermal conditions on their residual limbs and encouraged to request the early termination of the experimental procedure.
- Being tested
- Apply ENABLE sensing pad, Insert small pads at pressure tolerant locations
- Keywords
- amputee, prosthetic socket, residual skin, pressure ulcer
- Medical subject headings
- Wounds and Injuries, Pressure Ulcer
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Apply ENABLE sensing padDevice
The developed ENABLE system is integrated into the standard prosthetic liner and measures the pressure distribution during locomotion. Using the ENABLE system may lead temporary increase in the temperature inside the prosthetic socket and it is expected that the total exposition during the experimental procedure will be less than 10 min.
Insert small pads at pressure tolerant locationsDevice
To change the pressure distribution inside the socket, four fitting conditions are introduced by adding small pads at patella tendon (PT), lateral tibial crest (LTC), medial tibial crest (MTC), and popliteal fossa (PF) respectively. Including the no pads scenario, totally of five fitting conditions are simulated.
| Study group | Role | What they receive |
|---|---|---|
| Transtibial patient | Experimental | All the recruited participants will be included in this arm and will go through the socket manufacturing, fitting, and testing procedure. Receives: Device: Apply ENABLE sensing pad; Device: Insert small pads at pressure tolerant locations |
What is being measured
The primary outcome is the main question the study is designed to answer.
Discomfort chart
Subjects are requested to fill a Wong-Baker Faces Pain Rating Scale to describe any discomfort experienced when the ENABLE system is used. This data will be used to validate that the ENABLE system is safe to use.
Measured: The outcome is to evaluate the comfort of the final visit for the project (4 hours).
Secondary outcomes (1)
Pressure distribution on the residual limb
This outcome is measured by the developed ENABLE system and recorded by cameras after each walking trial. In three of these trials a commercially available pressure sensing pad, is also used to record the pressure distribution in the form of analog readings.
Measured: The outcome is to evaluate the real pressure on the residual limb in ten 60-second walking trials.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Jun 2022
- Study start20 Apr 2021
- Primary completion30 Jan 2026 (estimated)
- Study completion27 Feb 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Lower Limb Amputation Below Knee (Injury)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Device feasibility
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- All the participants will go through the same testing procedure. Both the experimenters and the participants know very well about the change in the experimental setup.
- Masking
- None (open label)
- Enrolment
- 3 participants (estimated)
Sponsor and investigators
- Lead sponsor
- North Carolina State University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ming Liu, North Carolina State University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05425810
- Sponsor's protocol ID
- 23949
- Acronym
- ENABLE
- Status last verified
- May 2025
- First submitted
- 9 May 2022
- Last updated
- 20 May 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- Yes: all individual participant data (IPD) that underlie results in the manuscript, which is planned to report the effectiveness of the ENABLE system.
Study at a glance
From the registry record, last updated by the sponsor on 20 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- R21: An Easy-to-use, iNtelligent, Affordable LinEr (ENABLE) System for Socket Fit Assessment
- ClinicalTrials.gov ID
- NCT05425810
- Acronym / sponsor ID
- ENABLE / 23949
- Keywords
- amputee, prosthetic socket, residual skin, pressure ulcer
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 3 participants (estimated)
- Lead sponsor
- North Carolina State UniversityUniversity, hospital or other
- Study start
- 20 Apr 2021 (actual)
- Primary completion
- 30 Jan 2026 (estimated)
- Study completion
- 27 Feb 2026 (estimated)
- First posted
- 21 Jun 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Lower limb amputees (LLA) rely on their prosthetic legs to remain active and lead an independent life. For most LLAs, a well-fitted prosthetic socket is the only option to interface with their prosthetic leg, however, it is a real challenge to make a prosthetic socket to interface with residual limbs accurately. One of the reasons is that there lack of accurate approaches to evaluate the pressure distribution on the residual limb accurately and effectively. To overcome this issue, the research team will develop an innovative sensing system, which permits the prosthetists to track the pressure distribution on the residual limb visually. The capability of the new sensing system will be demonstrated on lower limb amputees.
Detailed description
A novel pressure sensing pad will be tested in the project. The purpose of these tests is to collect the safety and efficacy of the sensing pad. The research team would like to seek a Non-significant Risk claim from Institutional Review Board (IRB).
The pad will be made of materials similar to the normal liner with embedded nanotubes. The nanotubes are filled with gallium alloys, of which resistance will change based on loaded pressure. When constant current passes these tubes, the change of pressure leads to a change in temperatures around, which will excite thermal-sensitive dyes to change color. So the research team could estimate the pressure at a given area based on the color around it.
The experimental procedure includes three sets and requires 3-4 visits from each subject.
Set I procedure includes a standard socket construction, which requires 2-3 visits for the subjects to the office of a local prosthetic company. Then, a certified prosthetist will build a test socket and a customized liner to maximize the socket fit and comfort and conduct the needed alignment of the prosthetic leg. Unless it is necessary, all testing sockets will be duplications of amputees' everyday sockets.
Set II will test the accuracy of the constructed prototype on amputee subjects compared to a commercially available sensor pad, which serves as a reference. First, the research team will mount both sensing systems on the subjects. The reference sensor grid will be mounted on the residual limb directly using medical tape. After the subject dons the ENABLE sensing pad, the research team will register two sensing systems. In the end, the subjects are required to don the testing socket and walk continuously, so the measurement of the developed prototype could be stabilized. Pictures of the ENABLE will be taken and compared with the recorded pressure signals from the reference grid.
Although the reference grid and ENABLE system are designed to be put on easily, brief assistance from experimenters will be needed to ensure that the mounting procedure can be conducted appropriately.
Set III will test whether information from the ENABLE leads to appropriated socket-fit-assessments based on the response of experienced prosthetists when the prosthetists are shown the pressure distribution measured by the ENABLE under different fit conditions. All subjects will be exposed to five socket fit conditions: good and additional foam pads at four different areas shown in a random sequence. The size of the pad at each location is selected by the prosthetists based on the shape and size of the residual limbs.
Under each fitting condition, each subject will go through three trials. In each trial, the subject will walk continuously until the color of the sensing pad is stabilized. After taking high-resolution digital pictures, which cover most of the sensing area of the ENABLE, the research team will let the subject rest until the optical pattern of the ENABLE fades completely before starting a new trial.
After the experiments are finished, the subject will need to fill out a survey about the comfort of the ENABLE system. The survey will be conducted just after the experimental procedure on paper. During Set II and III, a fall prevention harness is available for the participants if it is needed. The participants are requested to self-monitor the pressure and thermal conditions on their residual limbs and encouraged to request the early termination of the experimental procedure.
Study design
- Primary purpose
- Device feasibility
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- All the participants will go through the same testing procedure. Both the experimenters and the participants know very well about the change in the experimental setup.
| Arm | Type | Receives |
|---|---|---|
| Transtibial patient | Experimental | Device: Apply ENABLE sensing pad, Device: Insert small pads at pressure tolerant locationsAll the recruited participants will be included in this arm and will go through the socket manufacturing, fitting, and testing procedure. |
Who may qualify
- Ages
- 18 to 99 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Unilateral transtibial amputees
- At least 1 year of experience using his/her prosthetic leg
- Has used the current socket for at least 6 months without a significant skin issue or major modification
- Can comfortably walk 3 mins without pausing to rest
- The fibula length on the residual limb must be greater than half of the length of the fibula on the unaffected side
Key exclusion criteria (3 listed)
- Cognitive or visual impairment that affects the participant's ability to provide informed consent or to follow simple instructions during the experiments
- neuropathy observed on the residual limb
- regnant female
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Apply ENABLE sensing padThe developed ENABLE system is integrated into the standard prosthetic liner and measures the pressure distribution during locomotion. Using the ENABLE system may lead temporary increase in the temperature inside the prosthetic socket and it is expected that the total exposition during the experimental procedure will be less than 10 min. | Device | Transtibial patient |
| Insert small pads at pressure tolerant locationsTo change the pressure distribution inside the socket, four fitting conditions are introduced by adding small pads at patella tendon (PT), lateral tibial crest (LTC), medial tibial crest (MTC), and popliteal fossa (PF) respectively. Including the no pads scenario, totally of five fitting conditions are simulated. | Device | Transtibial patient |
Primary outcome
Discomfort chart
Time frame: The outcome is to evaluate the comfort of the final visit for the project (4 hours).
Subjects are requested to fill a Wong-Baker Faces Pain Rating Scale to describe any discomfort experienced when the ENABLE system is used. This data will be used to validate that the ENABLE system is safe to use.
1 secondary outcome
Pressure distribution on the residual limb
Time frame: The outcome is to evaluate the real pressure on the residual limb in ten 60-second walking trials.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 May 2025.
- Individual participant dataSharing planned: Yes. all individual participant data (IPD) that underlie results in the manuscript, which is planned to report the effectiveness of the ENABLE system.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Apply ENABLE sensing pad and Insert small pads at pressure tolerant locations in people with Lower Limb Amputation Below Knee (Injury), run by North Carolina State University at 1 site in United States.
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 5 inclusion and 3 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 20 May 2025. 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 United States. 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 Ming Liu, PhD (9195158541, mliu10@ncsu.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Discomfort chart (time frame: The outcome is to evaluate the comfort of the final visit for the project (4 hours).). 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 20 May 2025.