Interface Materials for Patients with Limb Amputation

描述(申请人提供)：该项目的长期目标是改进用于肢体截肢患者的界面衬垫材料的处方和设计，以创造出机械稳定并在行走过程中抵抗软组织损伤的假体。其具体目标是开发一套测试系统，以评估商业上可用的界面衬垫，解释结果，并向从业者传达这些不同的衬垫如何影响皮肤力学、肢体插座稳定性和肢体温度。开发的套件应该允许从业者快速、轻松地评估用于患者的材料，并帮助他们根据最好的可用科学证据和机械测试数据做出明智的决定。主要特点包括新型假体衬垫的性能，以及随着时间的推移，衬垫的机械性能随时间的变化和典型使用的程度。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，开发这一套装将使这项服务能够在资金期限过后继续以低成本提供。为了实现这些目标，开发了专门用于肢体假肢应用的定制仪器来测试衬垫。这些材料被测试其提供以下功能的能力：缓冲；假体悬吊；皮肤粘附性；容量变化调节；透气性；导热性；以及耐用性。新的衬垫和患者使用长达九个月的衬垫都进行了测试。对传统衬垫和“智能”衬垫都进行了测试，这些衬垫会在施加电压或力的情况下改变其性能。生物力学模型被用来比较不同衬垫在患者使用过程中的肢体-窝界面力学、肢体-窝的稳定性以及残肢上的热应力。然后将数据合并为清晰且易于理解的格式演示文稿，供从业者、患者、研究人员和行业使用。这一应用程序的健康相关性是一种评估和传播策略，在康复治疗中有广泛的使用。量化的材料数据以临床相关的形式呈现，以改善截肢者的患者护理和与健康相关的生活质量。应加强衬垫的选择和处方，减少截肢患者皮肤破裂和受伤的发生。此外，这项研究将有助于明确未来衬里的量化工程需求。潜在地，拟议申请中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、鞋垫和矫形器。

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.