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RecruitingNCT03409133Updated Mar 6, 2026

Feasibility of Neural Feedback for Lower Limb Amputees

An interventional study of Stimulating nerve electrodes and intramuscular recording electrodes in Amputation, sponsored by Louis Stokes VA Medical Center. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-06.

Sponsored by Louis Stokes VA Medical Center · Not applicable, Interventional, and Device feasibility

Phase
Not applicable
Study type
Interventional
Enrollment
15
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

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 below knee amputees. The approach involves delivering small electrical currents directly to remaining nerves via implanted stimulating electrodes. These small electrical currents cause the nerves to generate signals that are then transferred to your brain similar to how information about the foot and lower limb used to be transferred to your brain prior to the amputation.

Individuals also have the option to have recording electrodes implanted within muscles of the lower limb(s) in an attempt to develop a motor controller that would enable the user to have intuitive control of a robotic prosthetic leg.

Read the detailed description

Electrodes are surgically implanted on one to four nerves of the residual limb. An external wearable device controls the delivery of electrical pulses to the implanted system. The participant will be asked to verbally describe the perceived sensations and highlight their locations on a drawing of a foot presented to them on an electronic screen. An instrumented prosthesis will be developed such that perceived sensations would correspond to prosthesis interactions with the floor. This instrumented prosthesis, also known as a sensory neuroprosthesis, will be worn while the participant is engaging in various functional tasks, such as standing, walking, or climbing stairs, or with visual or mental distractions.

Intramuscular recording electrodes can be implanted in the lower limb(s) and/or hip muscles in order to obtain electromyography (EMG) signals. The EMG recordings from the residual muscles will be used to develop an algorithm which can operate an advanced robotic prosthesis in which the movement of the joint(s) could be controlled.

02

Conditions studied

  • Amputation

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Keywords

  • prosthesis user
  • phantom sensation
  • sensory feedback
  • prosthesis
  • amputee
  • amputation
  • limb loss
  • robotic prosthesis
  • neuroprosthesis
  • sensory restoration
  • robotic
  • electromyography
  • EMG
  • sensation
  • myoelectric
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adults age 18 or greater
  • Chronic, medically stable ( > 3 months) trans-tibial or trans-femoral amputation at the time of implant surgery.
  • Potential user of trans-tibial or trans-femoral prostheses for standing or walking
  • Viable target nerves in the lower extremity as determined by standard-of-care clinical tests of nerve conduction, response to stimulation, sensory evoked potentials and the like
  • Good skin integrity and personal hygiene
  • Absence of autoimmune deficiencies, seizure disorders or cardiac abnormalities contraindicating stimulation
  • Sufficient social support and personal ability to tolerate study procedures and comply with follow-up schedule

Exclusion criteria

Exclusion Criteria:

  • Uncontrolled diabetes to a degree that would preclude surgery
  • Significant vascular disease
  • Chronic skin ulcerations
  • Significant history of poor wound healing
  • Significant history of uncontrolled infections
  • Active infection
  • Significant pain in the residual or phantom limb
  • Pregnancy
  • Inability to speak English
  • Expectation that MRI will be required at any point for the duration of study or while percutaneous leads are in place
  • Severe neurological conditions that significantly impair balance or mobility to an extent that independent ambulation is impossible without assistance ( as determined by a healthcare provider)
  • Appropriate body habitus (height and weight within acceptable limits as determined by study physician)
  • Poor surgical candidate
  • Psychiatric or cognitive conditions that could affect cooperation or understanding of instructions and willingness to undergo psychological evaluation, if recommended by study surgeons or investigators.
04

Study design

Phase
Not applicable
Primary purpose
Device feasibility
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
15 participants (estimated)

Study arms

  • Experimental
    Stimulating nerve electrodes & intramuscular recording electrodes

    Fifteen subjects with lower limb amputation will have multi-contact stimulating nerve cuff electrodes implanted around the nerves in their residual limb. These electrodes will be connected to temporary percutaneous leads. During experimental testing, a small amount of electrical current will be delivered to the nerves through multi-contact nerve cuff electrodes. Participants also have the option to have recording electrodes implanted within muscles in their lower limb(s). These muscles are associated with prosthetic movement, and recordings from these muscles will be used to develop a controller for a robotic myoelectric prosthesis.

    Device: Stimulating nerve electrodes and intramuscular recording electrodes

Interventions

  • DeviceStimulating nerve electrodes and intramuscular recording electrodes

    See Arm Description

05

What researchers measure

Primary outcomes

  1. Stimulation Thresholds

    Quantify the minimum stimulation required to evoke electrically induced sensations on the phantom limb.

    Time frame: 9 months post implant

  2. Functional Gait Assessment (FGA)

    The Functional Gait Assessment is a 10 task test that measures postural stability. Each task is scored from 0 -3 with 0 indicating severe impairment in the task and 3 indicating normal ambulation. The scores are combined to give a total score. The maximum score is 30. A higher score indicates a better outcome.

    Time frame: 1 year post implant

06

Study locations

1 of 1 sites recruiting
  • Louis Stokes VA Medical Center
    Cleveland, Ohio 44106, United States
    • Aarika Sheehan, PT, DPT · Contact · Aarika.Sheehan@va.gov · 216-791-3800
    • Ronald Triolo, PhD · Principal investigator
    Recruiting
07

References and documents

Publications

  • Sheehan A, Siu R, Schmitt M, Vala J, Wright J, Kim D, Li S, Graczyk E, Triolo RJ, Charkhkar H. Impact of Long-Term Home and Community Use of a Lower Limb Sensory Neuroprosthesis. Res Sq [Preprint]. 2025 Sep 19:rs.3.rs-7412528. doi: 10.21203/rs.3.rs-7412528/v1. PubMed 41001531 ↗

Individual participant data

Plan to share: Yes — Data obtained through this study may be provided to qualified researchers with academic interest in neuroprostheses and amputee research. The shared data will be coded, with no PHI included. Approval of the request by local IRB and review of the PI(s) are prerequisites to the sharing of data with the requesting party.

Supporting information: Sap, Analytic code

08

Registry details

Key details

Study ID
NCT03409133
Lead sponsor
Louis Stokes VA Medical Center
Collaborators
Case Western Reserve University, United States Department of Defense
Responsible party
Ronald Triolo (Senior Research Career Scientist, US Department of Veterans Affairs,, Louis Stokes VA Medical Center) — Principal investigator
First posted
Jan 24, 2018
Start date
Nov 5, 2015
Primary completion
Sep 1, 2027 (estimated)
Completion
Sep 1, 2027 (estimated)
Last update
Mar 6, 2026

Study contacts

Aarika Sheehan, PT, DPT
Contact
Aarika.Sheehan@va.gov
216-791-3800 ext. 65832
jessica jarvela, MS
Contact
jessica.jarvela@va.gov
216-769-0531
Ronald Triolo, PhD
principal investigator · Louis Stokes VA Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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