RR&D Research Career Scientist Award Application

项目摘要（当前研究和目标） 我的研究旨在改善下肢截肢的退伍军人的活动能力，降低他们受伤的风险， 并在佩戴假肢时提高其舒适度。我探索创新的想法， 国家的最先进的和使用随机临床试验，以确定疗效和效率，目前- 指导临床决策的干预措施。 对创新想法的探索提供了通过以下方式显著改变功能结果的机会： 高度想象力的新设备的发展。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下肢假肢，以解决移动，受伤， 下肢截肢老兵的舒适问题。为了提高活动性，其中两个假肢探索 在不平坦的地形上行走时平衡改善;两者都具有可控制的内翻和外翻脚踝 刚度和一个可以符合地形起伏一样的自然肢体。作为VA Merit审查支持， 研究最近结束，我计划在2018年12月提交一份资助申请，以延长这项工作。第三种流动性- 我正在开发的一种增强型假肢使用了一种生物学激励器，并结合了一种学习算法 可以使推进输出适应不断变化的需求（这是一个悬而未决的VA Merit Review的主题）。背着一个沉重 装箱或背背包会导致持续时间短，突然发生驱动和推进需求的变化， 而与怀孕有关的体重增加是一个缓慢但持久的变化的例子。我正在探索 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 施加在残肢上的扭转载荷。一个具有可变的扭转刚度，可以随着行走速度而改变， 转向方向和用户偏好。另一种是受自然肢体功能的启发， 和横向平面运动，是最近资助的VA Merit Review的主题。与知识产权 在适当的保护下，这种仿生假体可以在商业市场上提供高回报。最后， 为了提高舒适度，我正在开发的第六种假肢旨在将汗液从承窝悬挂中排出 系统在剧烈活动期间在不适和滑动发生之前。为了营造这种舒适感- 增强型假肢最近被国防部选中。这些新设备中的每一个都解决了临床上- 目前还没有解决方案的驱动问题。 我的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。 为下肢截肢患者提供服务的人面临的一项具有挑战性的任务是在200多个 市售的假脚。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 它测量影响假脚特征的步态。为了探索不同的效率 康复干预措施，我收集活动水平的数据，从地理上分散的人口， 一个基于云的系统超过90名参与者和近三年的观察，这一丰富的数据集将 提供基础知识。在这个人群的一个子集上，我用一个定制的仪器来分类 并对不同运动活动期间所走的步数进行计数（即，在平地上笔直行走， 上下楼梯、上下坡道、左右转弯），以提供设计的视角 下一代假肢的需求。 我相信，从我的研究传播的知识将提供证据，以指导商业 新产品开发和当前临床实践。我希望两者都能带来实质性的生活质量 为下肢截肢的退伍军人提供了改善。

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.