Interface Materials for Patients with Limb Amputation

项目描述（申请人提供）：该项目的长期目标是改进肢体截肢患者界面衬垫材料的处方和设计，从而制造出在行走过程中机械稳定并抵抗软组织损伤的假肢。具体目标是开发一套测试系统来评估市售的界面衬垫，解释结果，并与从业者沟通这些不同的衬垫如何影响皮肤力学，四肢-窝稳定性和肢体温度。开发的套件应该能够快速方便地让从业者评估患者使用的材料，并帮助他们根据现有的最佳科学证据和机械测试数据做出明智的决定。关键特征包括新假肢衬垫的性能，以及衬垫随着时间的推移在持续和典型使用中改变其机械性能的程度。这些材料性能数据被放置在临床相关的评估和处方框架内。此外，该套件的开发将允许在资助期之后以低成本继续提供该服务。为了实现这一目标，开发了定制仪器来测试专门用于肢体修复应用的衬垫。测试了这些材料提供的能力：缓冲；假体悬挂;皮肤依从性;容积变化调节；透气性;热导率;和耐久性。对新药物和患者使用长达9个月的药物都进行了测试。测试了传统衬垫和“智能”衬垫，它们在施加电压或力的情况下改变其性能。采用生物力学模型比较不同衬垫在患者使用过程中的肢体-窝界面力学、肢体-窝稳定性和残肢热应力。然后将数据合并成清晰易懂的格式，供从业人员、患者、研究人员和行业使用。该应用程序的健康相关性是一种评估和传播策略，在康复治疗中广泛使用。定量材料数据以临床相关的格式呈现，以改善截肢患者的护理和健康相关的生活质量。应加强衬垫的选择和处方，减少截肢者皮肤破裂和损伤的发生。进一步的，本研究将有助于明确未来衬垫的定量工程需求。潜在地，在提议的申请中所描述的努力可以扩展到皮肤界面的选择具有临床重要性的其他领域，包括轮椅座椅、鞋类、鞋垫和矫形装置。

DESCRIPTION (provided by applicant): The long-term goal of this project is the improved prescription and design of interface liner materials for patients with limb amputation so as to create prostheses that are mechanically stable and resist soft tissue injury during ambulation. The specific aims are to develop a suite of testing systems to evaluate commercially available interface liners, interpret the results, and communicate to practitioners how these different liners affect skin mechanics, limb- socket stability, and limb temperature. The developed suite should quickly and easily allow practitioners to evaluate materials for use with their patients and assist them in making informed decisions based upon the best available scientific evidence and mechanical testing data. Key features include properties of new prosthetic liners and to what degree the liners change their mechanical performance over time with continual and typical use. These material performance data are placed within a clinically relevant framework for evaluation and prescription. Further, development of this suite will allow continued provision of this service at a low cost well beyond the funding period. To achieve the aims, custom instrumentation is developed to test liners specifically for limb prosthetics application. The materials are tested for their abilities to provide: cushioning; prosthetic suspension; skin adherence; volume change accommodation; breathability; thermal conductivity; and durability. Both new liners and those used by patients for up to nine months are tested. Both conventional liners and "smart" liners, which change their properties upon an applied voltage or force, are tested. Biomechanical models are implemented to compare limb-socket interface mechanics, limb-socket stability, and thermal stresses on the residual limb for different liners during patient use. The data are then incorporated into a clear and easy-to- understand format presentation for use by practitioners, patients, researchers, and industry. The health relatedness of this application is an evaluation and dissemination strategy that has widespread use in rehabilitation treatment. Quantitative material data are presented in a clinically relevant format to improve amputee patient care and health-related quality of life. Liner selection and prescription should be enhanced, reducing the occurrence of skin breakdown and injury to persons with limb amputation. Further, this research will help to specify quantitative engineering needs of future liners. Potentially, the efforts described in the proposed application can be extended to other areas where the selection of the skin interface is of clinical importance, including wheelchair seating, footwear, insoles and orthotic devices.