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.

项目摘要（当前研究和目标） 我的研究旨在提高下肢截肢退伍军人的活动能力，降低他们受伤的风险， 并提高佩戴假肢时的舒适度。我探索可以极大推进的创新想法 最先进的并使用随机临床试验来确定当前的功效和效率 制定干预措施以指导临床决策。 对创新理念的探索提供了通过以下方式显着改变功能结果的机会： 开发极具想象力的新颖设备。在退伍军人、研究生、专业人士的帮助下 工作人员和同事们，我目前正在开发六种下肢假肢，以解决行动不便、受伤和 下肢截肢退伍军人的舒适度问题。为了提高活动能力，其中两个假肢探索 在不平坦的地形上行走时改善平衡；两者都有可控制的内翻和外翻脚踝 刚度，并且可以像自然肢体一样顺应地形起伏。作为 VA 绩效审查对此的支持 研究最近结束，我计划在 2018 年 12 月提交赠款以扩展这项工作。第三种流动性 - 我正在开发的增强假肢使用仿生执行器并结合了学习算法 可以使推进输出适应不断变化的需求（即将进行的 VA 绩效审查的主题）。背负着沉重的 盒子或背上背包体现了持续时间短、突然发生的驱动和推进需求变化， 与怀孕相关的体重增加是缓慢但持久的变化的一个例子。我正在探索 机器学习算法如何实现直观的假肢控制以响应这些变化 状况。为了降低软组织损伤风险，我正在开发的第四和第五假肢旨在减少 扭转载荷施加于残肢。具有可变的扭转刚度，可以随行走速度而变化， 转动方向和用户偏好。另一种受自然肢体功能的启发，将矢状面结合起来 和横向平面运动，这是最近资助的 VA 优异评审的主题。拥有知识产权 如果保护到位，这种仿生假肢可能会在商业市场上带来高回报。最后， 为了提高舒适度，我正在开发的第六个假肢旨在排出接受腔悬挂中的汗水 在发生不适和打滑之前进行剧烈活动期间的系统。开发这种舒适感的工作- 增强假肢最近被选择获得国防部资助。这些新颖的设备中的每一个都解决了临床上的问题 目前尚无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证据来指导临床决策。 下肢截肢患者的提供者面临的一项具有挑战性的任务是在 200 多个患者中进行选择 市售假脚。为了帮助他们做出决定，我正在制作一个图形用户界面 可用于帮助处方过程的工具。该工具使用来自机器人步态模拟器的实验数据 测量影响假脚步态的特征。探索不同的效率 康复干预措施，我正在从地理上分散的人群中收集活动水平数据 基于云的系统。这个丰富的数据集有超过 90 名参与者和近三年的观察，将 提供基础知识。对于这个人群的一个子集，我使用定制的工具来分类 并计算不同运动活动期间所采取的步数（即在水平地面上直走， 上下楼梯、上下坡道以及左转和右转）以提供设计视角 下一代假肢的要求。 我相信我的研究传播的知识将为指导商业 新产品的开发和当前的临床实践。我希望两者都能提高生活质量 下肢截肢退伍军人的改善。