Please select the eligibility criteria that correspond to the clinical trial below.
Title: Personalized Mobility Interventions Using Smart Sensor Resources for Lower-Limb Prosthesis Users
Brief Summary: The goal of this research is to analyze data from smartphone-based and wearable sensors, using advanced machine-learning and data-mining techniques, and to combine this information with performance-based measures, participant-reported measures, and structured interviews to create a clinical toolbox to (i) identify individuals who exhibit reduced prosthesis use (compared to expected usage levels based on K-level designation and/or participant goals of community mobility and social interaction), (ii) identify prosthetic/physical and psychological factors that limit prosthesis use, and (iii) determine the effect of targeted interventions to increase prosthesis use and facilitate achievement of participant goals. Objective sensor-based measurement of home and community activities will allow for the correlation of real-world function to in-clinic assessments and to monitor changes resulting from rehabilitation interventions in real time. Machine-learning and data mining techniques will be used to identify a subset of measures from this toolbox that sensitively and accurately reflect real-world function, enabling clinicians to predict and assess activity and provide effective interventions to optimize prosthesis use. The goal of this project, to improve overall performance with respect to activities of daily living and other real-world activities, thus addresses the Fiscal Year 2017 (FY17) Orthotics and Prosthetics Outcomes Research Program (OPORP) Focus Area of Orthotic or Prosthetic Device Function.


Options:
A: Inclusion Criteria:

* Lower limb amputation 1-5 years prior to enrollment
* Type 2 Diabetes Mellitus and/or
* Peripheral Artery Disease
* Ambulatory using a lower limb prosthesis
* English speaking

Exclusion Criteria:

* Traumatic or cancer-related etiology of the lower limb amputation
* Unstable heart condition, including:

  * unstable angina
  * uncontrolled cardiac dysrhythmia
  * acute myocarditis
  * acute pericarditis
* Uncontrolled hypertension
* Acute systemic infection
* Prisoner
* Decisionally challenged volunteers
* Cancer
* Recent cerebral vascular accident (within two years)
* lower extremity wound or ulcer that limits ability to ambulate
B: Inclusion Criteria:

* People with unilateral transtibial amputations (TTA)
* At the lowest level of function candidates will have the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at a fixed cadence. Typical of the limited and unlimited household ambulator, the majority of candidates' ability or potential for ambulation with the ability to transverse low-level environmental barriers such as curbs, stairs, or uneven surfaces (the ceiling for candidacy) will be those TTAs who have the ability to vary cadence and can ambulate within the community.
* People with a diagnosis of diabetic mellitus and/or peripheral vascular disease leading to amputation
* Persons comfortably fitted with a prosthesis for a period of at least 6 months
* Candidates who have completed the "standard" course of rehabilitation and prosthetic training
* Candidates who score in the range of 10 to 36 on the Amputee Mobility Predictor which would indicate that subjects achieved the minimum required score to be fitted with a prosthesis but they did not attain a score that is considered to be at the highest level of functioning where additional therapy would not be of significant benefit.
* Able to tolerate a moderate intensity exercise program

Exclusion Criteria:

* Persons receiving renal dialysis
* Persons with severe cardiac or pulmonary disease limiting ability to exercise including angina or poorly controlled hypertension.
* Persons with neurological disorders such as Parkinson's disease or stroke that affect ability to ambulate
* Persons with severe lower extremity arthritis
* Persons with wound on non-amputated side
* Persons experiencing problems with prosthetic fit
* Persons with poor control of diabetes
C: 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
D: 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)

Answer: C