Please select the eligibility criteria that correspond to the clinical trial below.
Title: Targeting Balance Confidence as a Strategy to Increase Integration and Improve Outcomes in Users of Lower-Limb Prostheses
Brief Summary: Low balance confidence occurs when an individual perceives they have limited ability to maintain their balance while performing a specific task of daily living. It is a prevalent problem in lower limb prosthesis users and is a strong predictor of prosthesis use and community participation. Balance confidence is not necessarily related to functional abilities. It is possible to improve functional ability as a result of rehabilitation, without concurrently improving balance confidence. Interventions to address low balance confidence may need to target both functional abilities as well as beliefs regarding these abilities. The purpose of this study is to test whether, for users of lower limb prostheses, an intervention combining physical therapy exercise to improve function with cognitive behavioral therapy to address fears and thoughts associated with low confidence can improve balance confidence and promote community participation.


Options:
A: 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
B: Inclusion Criteria:

1. Diabetes and/or Peripheral Artery Disease
2. Unilateral transtibial amputation \< 6 months prior to screening
3. Household ambulation using definitive prosthesis prior to baseline testing
4. Participation in physical rehabilitation at time of baseline testing
5. Live within 45 minutes of a participating clinic

Exclusion Criteria:

1. Require wheelchair for mobility (use prosthesis for transfers only)
2. Ankle-level or above amputation on contralateral limb
3. Traumatic or cancer-related amputation
4. Uncontrolled heart condition
5. Acute systemic infection
6. Pregnancy
7. Decisionally challenged
8. Prisoners
C: Inclusion Criteria:

1. adults who are 19 years of age or older.
2. individuals who are post unilateral transtibial/transfemoral amputation and casted an initial prosthesis within the past year.
3. English speaking.
4. living in British Columbia or Ontario, Canada.
5. have access to an internet connectable device (e.g., computer or tablet)

Exclusion Criteria:

1) people who are unable to use SMART program (e.g., visual, auditory, cognitive, or physical impairments)
D: Inclusion Criteria:

* Unilateral or bilateral lower limb amputation at transtibial or transfemoral level
* Ability to wear and use a prosthesis
* Designated K-level 2 - 4, or equivalent
* Prescription of definitive prosthesis
* Veterans Affairs participants must receive care through the Veterans Affairs or related remote-site clinic
* Age: 18-89 years-to reflect the age range of eligible participants at Department of Defense and Veterans Affairs study sites, including young, combat-injured Service Members and healthy older Veterans, aged 70-80.

Exclusion Criteria:

* Co-morbidities that limit prosthesis use, independently of prosthetic function, training, or motivation, such as stroke, obesity, severe traumatic brain injury, and neuralgia, which require interventions outside the scope of this study. Suitability to participate in the study will be determined by the individual's physician.
* Unable or unwilling to learn to use the smartphone app or to allow transmission of study data
* Unable or unwilling to provide informed consent
* Residing in an area with poor cell phone coverage

Answer: A