MECHANICALLY INDUCED STOCHASTIC RESONANCE TO IMPROVE AMPUTEE GAIT AND BALANCE

机械诱导随机共振改善截肢者的步态和平衡

• 批准号: 7718684
• 负责人: NICOLAS Eugene WALSH
• 金额: $ 0.01万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7718684
• 关键词: Amputees; Clinical; Complications of Diabetes Mellitus; Computer Retrieval of Information on Scientific Projects Database; Daily; Effectiveness of Interventions; Enrollment; Equilibrium; Exhibits; Feedback; Funding; Gait; Grant; Injury; Institution; Intervention; Knee; Limb structure; Lower Extremity; Measures; Motor; Movement; Neuropathy; Numbness; Patients; Pattern; Persons; Placement; Proprioception; Prosthesis; Recruitment Activity; Relative (related person); Research; Research Personnel; Residual state; Resources; Risk; Sensory; Source; Stimulus; Surface; Testing; Time; United States National Institutes of Health; Walking; Work; base; clinically relevant; computerized; design; diabetic; falls; foot; gait examination; improved; instrument; novel; pressure; protocol development; receptor; research study; response; vibration

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVE: One of the many complications of diabetes is the loss of sensation in the feet. This sensory deficit can negatively impact the postural stability and mobility of non-amputees, since without feedback, it is simply more difficult to stand and walk. For lower limb amputees, the problem is compounded. These patients often have difficulty with prosthetic limb placement during maneuvering tasks, exhibit dramatic increases in the movement of their center of pressure during quiet standing, and both clinical and observational gait analysis reveal significant changes in their gait pattern relative to non-amputees. Our work proposes to explore the use of a novel prosthetic intervention for diabetic lower limb amputees. We hypothesize that our intervention will sufficiently enhance proprioception to result in measurably improved postural stability and locomotor function for these patients. The intervention is based on a phenomenon known as stochastic resonance, whereby the application of sub-threshold vibration enables mechano-receptors previously unable to respond to stimuli to become more susceptible to depolarization. For persons with neuropathic proprioceptive losses, stochastic resonance may facilitate a functional response from subtle stimuli where gross inputs were formerly required. The objective of the proposed research is to discover if machanical stochastic resonance of the surface of the residual limb will improve the postural stability and mobility of diabetic transtibial amputees. RESEARCH PLAN: We propose to recruit diabetic transtibial amputees to wear a study prosthetic socket which has been specially built to produce stochastic resonance using miniature vibratory motors. To measure the intervention effect on postural stability, we will conduct a quantitative computerized sway experiment and employ an additional test that measures balance during representative daily activities (Berg Balance Scale). To measure the effect on locomotor function, we will conduct a clinical instrumented gait analysis and a test that measures dynamic balance and function (Expanded Timed Get-up and Go). METHODS: The proposed study is a within-subject design where we will compare measures of balance and gait with and without the application of stochastic resonance through a study prosthetic socket worn by the below-knee amputee. A group of normal subjects will be enrolled as well to aid in protocol development. CLINICAL RELEVANCE: For lower limb amputees with neuropathic complications from diabetes, the proposed research is the first step toward developing a new and clinically feasible approach to improving their mobility and reduding their risk of fall-related injuries.

这个子项目是许多利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 中心，但不一定是研究者所在的机构。 目的：糖尿病的众多并发症之一是足部感觉丧失。 这种感觉缺陷会对非截肢者的姿势稳定性和活动性产生负面影响，因为没有反馈，站立和行走会更加困难。 对于下肢截肢者来说，问题更加复杂。 这些患者在操作任务期间通常难以放置假肢，在安静站立期间其压力中心的运动显著增加，并且临床和观察步态分析均显示其步态模式相对于非截肢者的显著变化。 我们的工作建议探索使用一种新的假肢干预糖尿病下肢截肢者。 我们假设，我们的干预将充分增强本体感觉，导致这些患者的姿势稳定性和运动功能明显改善。 这种干预是基于一种被称为随机共振的现象，由此应用阈下振动使以前无法对刺激作出反应的机械感受器变得更容易去极化。 对于神经性本体感受丧失的人，随机共振可能有助于从细微刺激中产生功能反应，而这些刺激以前需要总的输入。 该研究的目的是发现残肢表面的机械随机共振是否会改善糖尿病经胫骨截肢者的姿势稳定性和活动性。 研究报告：我们建议招募糖尿病经胫骨截肢者戴上研究假肢接受腔，它是专门建造的，使用微型振动电机产生随机共振。 为了测量干预对姿势稳定性的影响，我们将进行定量计算机化摇摆实验，并采用一项额外的测试来测量代表性日常活动期间的平衡（贝格平衡量表）。 为了测量对运动功能的影响，我们将进行临床仪器步态分析和测量动态平衡和功能的测试（扩展定时起床和行走）。 方法：拟议的研究是一个受试者内的设计，我们将比较的平衡和步态的措施，并没有通过研究假肢接受腔的膝下截肢者的应用随机共振。 还将入组一组正常受试者，以帮助制定方案。 临床相关性：对于患有糖尿病神经病变并发症的下肢截肢者来说，这项研究是朝着开发一种新的临床可行方法来改善他们的活动能力和降低跌倒相关损伤风险的第一步。