Please select the eligibility criteria that correspond to the clinical trial below.
Title: Virtual Reality for Rehabilitation for Individuals With Lower Limb Amputation
Brief Summary: A custom designed Virtual Gait Retraining System (VGRS) is being adapted for balance and mobility rehabilitation in individuals with transtibial amputation. The system is composed of a treadmill that can simulate different environmental situations such as walking up stairs and hills and going around curves. The treadmill is synchronized with an immersive display and an avatar of the user. The combination of variable terrain and visual feedback is extremely promising as a means for amputee patients to achieve improved functional mobility after gait training. The proposed work is relevant to public health because it is the first step in developing a novel rehabilitation system that will use visual feedback for gait training in amputees and others with pathological gait disorders. The research is pertinent to the mission of the Department of Veterans Affairs which is committed to improve the quality of life of Veterans with disability.


Options:
A: Inclusion Criteria:

* Subjects must be unilateral transtibial amputees (TTA) between the ages of 18 and 65 who have consistently used a prosthesis for at least one year.
* Subjects must be community ambulators at a K3 level,

  * which dictates that they have the ability or potential to walk with variable cadence,
  * to traverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.

Exclusion Criteria:

* History of surgical procedures on their intact limb.
* Subjects will be excluded from the study if they present with

  * cardiovascular,
  * neurological,
  * or balance disorders that can affect gait.
  * Rheumatoid arthritis,
  * knee joint replacement,
  * and the use of ambulatory aids will also exclude participation.
* Subjects with considerable pain in their knee joints, as measured by a visual analog scale will also be excluded due to the confounding effects of pain on gait patterns.
* A medical history screening will be used to identify subjects with pre-existing conditions that would compromise their gait.
B: Inclusion Criteria:

* Unilateral transfemoral or transtibial amputee
* Fitted by a prosthetist at a Military Treatment Facility
* K2-K4 Medicare Functional Classification Levels
* DEERS-eligible.
* For providers: MHS provider

Exclusion Criteria:

* K0-K1 Medicare Functional Classification Levels
* Physically unstable or requires an ambulatory device
* Pregnant women
C: Inclusion Criteria:

* age ≥18 years
* unilateral lower limb amputation without serious complications
* at least 6 months experience using a definitive lower limb prosthesis
* Activity Specific Balance Confidence (ABC) scale score≤80
* self-reported concern about balance that limit activities

Exclusion Criteria:

* active wounds on weight bearing surfaces
* inability to perform the protocol without an assistive device
* currently seeing a physical therapist for any reason
* history of neurodegenerative disease
* history of stroke
* ill-fitting or ill-functioning prosthesis (to be verified by research prosthetist during screening)
* prohibited by primary care physician or research physician to participate in mild exercise
D: Inclusion Criteria:

* Patient over the age of majority, no age limit
* Amputation related to obliterative arteriopathy of the lower limbs
* Trans-tibial or trans-femoral amputation in an already amputated patient
* Patient with an indication of discharge to a rehabilitation and re-education service
* Patient with the ability to understand the protocol
* Patient who has agreed to participate in the study and has given express oral consent
* Patient receiving social security cover or entitled to it

Exclusion Criteria:

* Trauma related amputation
* Patient with no history of amputation
* Amputation of upper limb, trans-metatarsal or one or more toes
* Amputation of comfort in a palliative care setting
* Patient leaving home after surgery
* Patient undergoing psychological or psychiatric treatment
* Pregnant or breastfeeding woman, or a woman who is able to procreate without effective contraception
* Patient unable to follow the protocol as judged by the investigator
* Patient participating in another interventional research protocol involving a drug or medical device
* Patient under guardianship, curators or legal protection measure

Answer: A