RR&D Research Career Scientist Award Application

RR

• 批准号: 10664827
• 负责人: Glenn Klute
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-10-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10664827
• 关键词: Address; Air; American; Ankle; Area; Award; Biomimetics; Bionics; Characteristics; Classification; Clinical; Communities; Complex; Couples; Custom; Data; Data Set; Development; Devices; Distal; Elements; Environment; Equilibrium; Etiology; Funding; Gait; Geography; Goals; Grant; Household; Incidence; Individual; Injury; Intellectual Property; Intervention; Intuition; Kinetics; Knowledge; Laboratories; Learning; Left; Life Experience; Limb Prosthesis; Limb structure; Locomotion; Lower Extremity; Marketing; Measures; Military Personnel; Modeling; Motion; Motor; Muscle; Output; Participant; Pattern Recognition; Persons; Population; Posture; Pregnancy; Process; Property; Prosthesis; Provider; Quality of life; Ramp; Rehabilitation therapy; Research; Research Support; Risk; Robotics; Scientist; Skin; Skin Temperature; Skin injury; Soft Tissue Injuries; Source; Surgeon; Suspensions; System; Temperature; Testing; Thermodynamics; Time; Torque; Torsion; Trauma; Ulcer; Vacuum; Veterans; Walking; Weight; Weight Gain; Work; career; clinical decision-making; clinical practice; clinically relevant; cloud based; design; diabetic; efficacy evaluation; experience; falls; foot; functional outcomes; graduate student; graphical user interface; improved; improved mobility; innovation; instrument; learning algorithm; limb amputation; limb loss; machine learning algorithm; new product development; new technology; next generation; novel; peer; power consumption; preference; prophylactic; prosthesis control; prosthesis fitting; prosthetic foot; randomized, clinical trials; rehabilitative care; residual limb; response; restoration; skills; soft tissue; stem; tool; walking speed; wearable device

Project Summary (current research and goals) My research aims to improve the mobility of veterans with lower limb amputation, reduce their risk of injury, and enhance their comfort while wearing a prosthesis. I explore innovative ideas that could dramatically advance the state-of-the-art and use randomized clinical trials to determine the efficacy and efficiency of currently- prescribed interventions to guide clinical decision-making. The exploration of innovative ideas offers the opportunity to dramatically alter functional outcomes through the development of highly imaginative, novel devices. With the help of veterans, graduate students, professional staff, and colleagues, I am currently developing six lower limb prostheses to address the mobility, injury, and comfort problems of veterans with lower limb amputation. To improve mobility, two of these prostheses explore balance improvement while walking on uneven terrain; both have inverting and everting ankles with controllable stiffness and one can conform to terrain undulations like the natural limb. As VA Merit Review support for this research recently ended, I plan a grant submission to extend this work in December 2018. A third mobility- enhancing prosthesis I am developing uses a biologically-inspired actuator and incorporates a learning algorithm that can adapt propulsive outputs to changing needs (the topic of a pending VA Merit Review). Carrying a heavy box or donning a backpack exemplify short duration, sudden onset changes to actuation and propulsive needs, while weight gains associated with pregnancy are an example of slow, but long-lasting changes. I am exploring how machine learning algorithms may enable intuitive prosthesis control in response to these changing conditions. To reduce soft tissue injury risk, the fourth and fifth prostheses I am developing aim to reduce the torsional loads applied the residual limb. One has variable torsional stiffness that can change with walking speed, turning direction, and user preference. The other, inspired by the function of the natural limb, couples sagittal and transverse plane motions and is the topic of a recently funded VA Merit Review. With intellectual property protections in place, this biomimetic prosthesis may offer a high payoff in the commercial market place. Finally, to enhance comfort, the sixth prosthesis I am developing aims to expel perspiration from the socket-suspension system during vigorous activities before discomfort and slippage occur. The work to develop this comfort- enhancing prosthesis was recently selected for DOD funding. Each of these novel devices tackles a clinically- driven problem for which there is currently no solution. A more immediate goal of my research is to provide clinicians with evidence to guide clinical decision-making. A challenging task faced by providers for individuals with lower limb amputation is choosing among the 200+ commercially available prosthetic feet. To help inform their decisions, I am making a graphical user interface tool available to aid with the prescription process. This tool uses experimental data from a robotic gait simulator that measures gait influencing characteristics of prosthetic feet. To explore the efficiency of different rehabilitation interventions, I am collecting activity level data from a geographically-dispersed population with a cloud-based system. With over ninety participants and nearly three years of observations, this rich data set will provide fundamental knowledge. On a subset of this population, I am using a custom-built instrument to classify and count the number of steps taken during different locomotion activities (i.e., walking straight on level ground, up and down stairs, up and down ramps, and turning left and right) to provide perspective on the design requirements of next generation prostheses. I believe the knowledge disseminated from my research will provide evidence to guide both commercial development of new products and current clinical practice. I expect both to lead to substantial quality of life improvements for veterans with lower limb amputation.

项目总结(当前研究和目标) 我的研究旨在提高下肢截肢退伍军人的行动能力，降低他们受伤的风险， 并提高他们佩戴假肢时的舒适性。我探索创新的想法，这些想法可以极大地推动 最先进的和使用随机临床试验来确定目前- 指导临床决策的处方干预。 对创新想法的探索提供了通过 开发极富想象力的新奇设备。在退伍军人、研究生、专业人士的帮助下 工作人员和同事们，我目前正在开发六个假肢，以解决移动性、损伤和 退伍军人下肢截肢后的舒适度问题。为了改善移动性，其中两个假体探索 在不平坦的地形上行走时改善平衡；两人都有内翻和外翻的脚踝，可控 僵硬，一个人可以像自然肢体一样适应地形起伏。作为退伍军人事务部对此的支持 研究刚刚结束，我计划在2018年12月提交一份拨款申请，以延长这项工作。第三种机动性- 我正在开发的增强假肢使用了一个受生物启发的致动器，并结合了一个学习算法 这可以使推进输出适应不断变化的需求(这是尚未完成的退伍军人事务部功绩评估的主题)。背着一件沉重的 箱子或背包是持续时间较短、突然发生的激励和推进需求变化的例证， 而与怀孕相关的体重增加是缓慢但长期变化的一个例子。我在探索 机器学习算法如何响应这些变化实现直观的假肢控制 条件。为了减少软组织损伤的风险，我正在开发的第四和第五种假体旨在减少 对残肢施加扭转载荷。一种具有可变的扭转刚度，可以随着行走速度的变化而变化， 转向方向和用户偏好。另一种是受自然肢体功能的启发，成对矢状面 和横向平面运动，这是最近资助的退伍军人事务部功绩评论的主题。拥有知识产权 保护措施到位，这种仿生假体在商业市场上可能会有很高的回报。最后， 为了增加舒适性，我正在开发的第六个假体旨在排出插座悬浮物中的汗液 系统在剧烈活动期间，在不适和滑脱发生之前。开发这种舒适性的工作- 增强假体最近被选为国防部的资助对象。这些新设备中的每一个都解决了临床上的- 当前没有解决方案的驱动问题。 我研究的一个更直接的目标是为临床医生提供指导临床决策的证据。 为下肢截肢患者提供服务的提供者面临的一项具有挑战性的任务是在200多个 市面上可以买到的假肢。为了帮助他们做出决定，我制作了一个图形用户界面 可用于帮助处方流程的工具。该工具使用来自机器人步态模拟器的实验数据 测量影响假肢特征的步态。要探索不同的效率 康复干预，我正在收集地理上分散的人群的活动水平数据， 一个基于云的系统。随着90多名参与者和近三年的观察，这个丰富的数据集将 提供基本知识。在这个群体的一个子集上，我正在使用一种定制的工具来分类 并统计在不同的移动活动(即，在平地上笔直行走， 上下楼梯、上下坡道和左转右转)，以提供设计视角 对下一代假体的要求。 我相信我的研究传播的知识将提供证据来指导商业 新产品的开发和当前的临床实践。我希望两者都能带来实质性的生活质量 为接受下肢截肢的退伍军人提供的改进。