Design of a Smart Prosthetic Liner Controlled by Muscle Activation Feedback

肌肉激活反馈控制的智能假肢衬垫设计

• 批准号: 9333115
• 负责人: Steven A. Gard
• 金额: --
• 依托单位: JESSE BROWN VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9333115
• 关键词: Address; Affect; Air; Algorithms; American; Amputees; Area; Bladder; Bulla; Characteristics; Contracts; Data; Development; Devices; Electrodes; Electromyography; Extensor; Feedback; Flexor; Future; Gait; Gastrocnemius Muscle; Goals; Hip region structure; Intelligence; Investigation; Joints; Kinetics; Limb structure; Liquid substance; Literature; Location; Locomotion; Logic; Lower Extremity; Measures; Methods; Mission; Monitor; Movement; Muscle; Muscle Contraction; Names; Patient Care; Patients; Pattern; Performance; Physiology; Production; Prosthesis; Quality of life; Regression Analysis; Regulation; Role; Shapes; Signal Transduction; Skin; Speed; Surface; Suspensions; System; Time; Tissues; Vacuum; Variant; Veterans; Walking; Work; base; design; health administration; health related quality of life; improved; instrument; kinematics; light weight; limb amputation; negative affect; novel; pressure; prosthetic socket; prototype; public health relevance; residual limb; residual limb health; response; soft tissue; tibialis anterior muscle; walking speed

 DESCRIPTION (provided by applicant): Prosthetic comfort is rated as one of the most important issues faced by lower-limb amputees and is primarily dictated by fit and pressure at the residual limb/prosthetic socket interface. It s well established that socket fit and pressure can fluctuate throughout the day due to redistribution of fluids and associated volumetric changes within the residual limb. While these changes can be managed by donning or doffing socks, doing so will globally add or remove volume to the entire limb, which could negatively affect local interface pressures. Additionally, though, the pressure characteristics between the socket interface and the soft tissue of the residual limb may be dynamically affected by muscle activity during gait. While muscle activity of lower limb amputees is entrained to the gait cycle, the functional roles of this activity are not entirely clear. For example, while hip extensor and flexors muscles aid in moment production, prolonged activity during stance may be needed to stabilize the joint and maintain socket fit. Muscle activation patterns could also reflect control of dynamic socket pressures as muscle contractions alter the shape of the residual limb and socket pressure. However, the functional relationship between electromyography (EMG) signals of the residual limb in lower limb amputees and socket pressure is currently unknown. This proposed study is the initial step in a line of investigations to create an intelligent socket interface (liner) that can modulate intrasocet pressure dynamically based on EMG and pressure. The long-term goal is to design a prosthesis that maximizes patient comfort and in turn movement performance and other associated aspects of health-related quality of life. After completion of the proposed work we expect to demonstrate that: 1) across a variety of walking speeds and across the duration of walking for multiple minutes a relationship exists between EMG and intrasocket pressure; 2) the relationship is affected by socket fit; 3) the relationship is independent of gait kinematics and kinetics, and 4) EMG provides unique information regarding comfort and it is possible to use this information to manipulate intrasocket pressure and maximize comfort during gait. The overall design concept is an instrumented prosthetic socket/residual limb interface (liner) that monitors intrasocket EMG and pressures to appropriately modulate pressures during ambulation so as to optimize comfort and function. We will monitor pressures along the surface of muscles within the prosthetic socket at locations neighboring EMG electrode placement. When the muscle contracts the volume of the nearby muscle and residuum tissue will also change leading to local variations in pressures between the socket and limb. The prototypical device is intended to respond to these changes. In response to EMG, we will inflate/deflate pockets of air that have been retrofit to the socket and aligned with the muscles. Pockets will inflate or deflate using small, lightweight compressors which will be controlled using simple on-board real-time logic. The prototype will demonstrate the ability to manipulate intrasocket pressure based on residual limb EMG. The proposed study is intended to lay the groundwork for a more complete understanding of the relationship between EMG, socket pressure and comfort. Creating a dynamic interface that improves socket comfort and reduces interface pressure would improve overall health of the residual limb by limiting daily limb volume fluctuation, tissue breakdown, blistering and reddening of the skin.

 描述（由申请人提供）： 假肢舒适度被认为是下肢截肢者面临的最重要的问题之一，主要取决于残肢/假肢接受腔界面的配合和压力。众所周知，由于残肢内液体的重新分布和相关的体积变化，承窝配合和压力可以在一天中波动。虽然这些变化可以通过穿或脱袜子来管理，但这样做会在全局上增加或减少整个肢体的体积，这可能会对局部界面压力产生负面影响。另外，虽然，在步态期间，接受腔界面和残肢的软组织之间的压力特性可能受到肌肉活动的动态影响。虽然下肢截肢者的肌肉活动是夹带到步态周期，这种活动的功能作用并不完全清楚。例如，虽然髋关节伸肌和屈肌肌肉有助于产生力矩，但可能需要在站立期间延长活动以稳定关节并保持关节窝配合。肌肉激活模式也可以反映动态插座压力的控制，肌肉收缩改变残肢的形状和插座压力。然而，在下肢截肢者的残肢肌电图（EMG）信号和插座压力之间的功能关系是目前未知的。这项拟议的研究是一系列调查的第一步，以创建一个智能插座接口（内衬），可以动态地调制intrasocet压力的基础上，肌电图和压力。长期目标是设计一种假体，最大限度地提高患者的舒适度，进而提高运动性能和其他与健康相关的生活质量。在完成所提出的工作后，我们希望证明：1）在不同的步行速度和步行持续数分钟的时间内，EMG和椎间孔内压力之间存在关系; 2）该关系受椎间孔配合的影响; 3）该关系独立于步态运动学和动力学，和4）EMG提供关于舒适性的独特信息，并且可以使用该信息来操纵囊内压力并使步态期间的舒适性最大化。整体设计理念是一个仪表化的假肢接受腔/残肢接口（衬垫），用于监测接受腔内EMG和压力，以在截肢过程中适当调节压力，从而优化舒适度和功能。我们将监测压力沿着表面的肌肉内的假肢接受腔的位置附近的EMG电极放置。当肌肉收缩时，附近肌肉和残余组织的体积也将改变，导致接受腔和肢体之间的压力的局部变化。原型器械旨在响应这些变化。为了响应EMG，我们将对已经改装到插座并与肌肉对齐的气囊进行充气/放气。口袋将充气或放气使用小型，轻便的压缩机，这将是控制使用简单的板载实时逻辑。该样机将展示基于残肢EMG操纵火箭内压力的能力。这项研究旨在为更全面地了解EMG、插座压力和舒适度之间的关系奠定基础。创建改善承窝舒适度并降低界面压力的动态界面将通过限制日常肢体体积波动、组织破裂、皮肤起泡和发红来改善残肢的整体健康。