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: 9143249
• 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 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9143249
• 关键词: Accounting; Address; Affect; Air; Algorithms; American; Amputees; Area; Bladder; Bulla; Characteristics; Contracts; Data; Development; Devices; Electrodes; Electromyography; 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; Patient Care; Patients; Pattern; Performance; Physiology; Production; Prosthesis; Quality of life; Regression Analysis; Regulation; Role; Shapes; Shipping; Ships; Signal Transduction; Skin; Speed; Surface; Suspension substance; 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; 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）： 假体舒适度被评为下limb amuputees面临的最重要问题之一，主要由残留的肢体/假肢插座界面处的拟合和压力决定。可以很好地确定，由于液体的重新分布以及残留肢体内的相关容量变化，插座拟合和压力会在一天中波动。虽然可以通过戴或脱落袜子来管理这些更改，但是这样做会在全球范围内增加或删除整个肢体的音量，这可能会对本地接口压力产生负面影响。但是，但是，在步态过程中，插座界面和残留肢体软组织之间的压力特性可能会受到肌肉活性的动态影响。虽然下肢截肢者的肌肉活性充满了步态周期，但该活动的功能作用尚不完全清楚。例如，虽然髋关节扩展器和屈肌有助于瞬间生产，但可能需要长时间的活动来稳定关节并保持插座拟合度。肌肉激活模式还可以反映动态插座压力的控制，因为肌肉收缩会改变残留肢体和插座压力的形状。然而，目前尚不清楚下肢截肢和插座压力中残留肢体的肌电图（EMG）信号之间的功能关系。这项拟议的研究是一系列研究的第一步，以创建一个智能插座界面（衬里），该插座界面（衬里）可以根据EMG和压力动态调节肌内压力。长期目标是设计一个假体，以最大程度地提高患者的舒适性和运动性能以及与健康相关的生活质量的其他相关方面。拟议的工作完成后，我们希望证明：1）跨越各种步行速度，并且在步行持续时间内持续了数分钟，EMG和板内压力之间存在关系； 2）关系受插座拟合的影响； 3）这种关系独立于步态运动学和动力学，4）EMG提供了有关舒适性的独特信息，并且可以使用此信息来操纵内股内压力并在步态过程中最大化舒适性。总体设计概念是一种仪器的假肢/残留肢体界面（衬里），可监视耗时EMG和压力以适当调节卧床期间的压力，以优化舒适性和功能。我们将在附近EMG电极放置位置的假体插座内的肌肉表面监测压力。当肌肉收缩近肌肉和残留组织的体积时，也会改变插座和肢体之间压力的局部变化。原型设备旨在响应这些变化。为了响应EMG，我们将膨胀/放气的空气口袋，这些空气已改装到插座上并与肌肉对齐。口袋将使用小型轻巧的压缩机充气或放气，这些压缩机将使用简单的板载实时逻辑来控制。该原型将证明基于残留肢体EMG操纵内压力的能力。拟议的研究旨在为对EMG，插座压力和舒适性之间的关系提供基础。创建一个动态界面，以改善插座舒适度并降低界面压力，可以通过限制每日肢体体积波动，组织崩溃，泡沫和皮肤变红来改善残留肢体的整体健康状况。