Enhancing the prosthetic interface: 1/f vibrotactile socket stimulation to improve the adaptability of trans-tibial amputees

 描述（由申请人提供）：下肢截肢的个体由于失去自然结构（如足部和踝关节）而感觉受损。这些结构在运动过程中身体与地面的相互作用中起着非常重要的作用。虽然假肢可以解决肢体丧失的功能缺陷，但感觉缺陷尚未得到解决。这种感觉缺陷在周围神经病患者中更为明显，是独立运动的重要障碍。本研究的目的是调查一种有针对性的干预措施，以解决这一持续存在的问题，在假肢康复，结合生物医学科学的两个新兴概念。首先，当经由鞋垫施加到足部的足底表面时，亚阈值（不可感知的）振动刺激已被证明通过增强来自神经病性肢体的弱传入感觉信号而有效地改善患有周围神经病的人的平衡。其次，粉红噪声（一种具有幂律标度1/f结构的信号，使得振荡频率f越小，振幅越大）已被证明在健康运动系统的生理输出中无处不在。该项目建议通过假肢接受腔（假肢和残肢之间的界面）提供亚阈值振动刺激，特别是以粉红噪音的形式。这种结构的刺激可能更容易B身体接受，因为它模仿了缺席的脚和脚踝的“自然”信号。因此，本项目将确定通过经胫骨截肢者的假肢接受腔施加振动触觉刺激引起的功能性能变化。在研究的第一部分中，将在安静站立和水平行走期间将随机和粉红噪声刺激条件与无刺激条件进行比较，以隔离粉红噪声结构对随机结构的影响。研究的第二部分将通过检查在扰动站立和在不平坦的地形上行走的性能来调查干预对适应性的影响;在每个刺激条件下量化由增加的平衡挑战引起的性能恶化。假设经胫骨截肢者的表现和适应性将在阈值下粉红噪声刺激的存在下改善。这种简单而廉价的干预措施在未来可能很容易被纳入假体技术，以增强感觉并促进功能的普遍获得，提高个人在较低的运动后保持活跃和维持健康和生活质量的能力。 截肢

 DESCRIPTION (provided by applicant): Individuals with lower limb amputation have impaired sensation due to the loss of natural structures such as the foot and the ankle. These structures play a very important role in the body's interaction with the ground during movement. Although prostheses may address the functional deficits of limb loss, the sensory deficit is yet to be addressed. This sensory deficit is more pronounced in individuals with peripheral neuropathy and is an important barrier to independent locomotion. The purpose of this study is to investigate a targeted intervention developed to address this ongoing issue in prosthetic rehabilitation that combines two emerging concepts in biomedical science. Firstly, sub-threshold (imperceptible) vibratory stimulation when applied via insoles to the plantar surface of the feet has been shown to be effective in improving the balance of people with peripheral neuropathy, by enhancing the weak afferent sensory signals from the neuropathic extremity. Secondly, pink noise (a signal with a structure that exhibits a power-law scaling, 1/f, such that the smaller the frequency of oscillation, f, the larger the amplitude) has been shown to be ubiquitous in the physiological outputs of the healthy locomotor system. This project proposes to deliver sub-threshold vibratory stimulation via the prosthetic socket - the interface between the prosthetic limb and residual limb - specifically in the form of pink noise. A stimulus of this structure may b more readily accepted by the body as it emulates the 'natural' signal of the absent foot and ankle. As such this project will determine the changes in functional performance induced by vibrotactile stimulation applied via the prosthetic socket in trans-tibial amputees. In the first prt of the study stochastic and pink noise stimulation conditions will be compared to the no stimulation condition during quiet standing and level walking, to isolate the effect of the pink noise structure over a random one. The second part of the study will investigate the effect of the intervention on adaptability by examining performance in perturbed standing and in walking on uneven terrain; quantifying in each stimulation condition the deterioration in performance induced by increased challenges to balance. It is hypothesised that performance and adaptability of trans-tibial amputees will improve in the presence of sub- threshold pink noise stimulation. This simple and inexpensive intervention may in future be readily incorporated into prosthetic technology to enhance sensation and promote universal gains in function, improving the ability of individuals to remain active and maintain health and quality of life following lower limb amputation.