Measuring In-Socket Residual Limb Volume Fluctuation

描述(由申请人提供)：拟议研究的长期目标是对假体使用者有效地实施残肢容量管理策略，以提高他们的临床结果、健康和生活质量。这一应用的重点是S，以揭示实现这一目标所必需的知识。这项研究的具体目的是确定不同的活动和调节策略对残肢昼夜液体量变化的影响，以及它们与胫骨截肢患者的舒适性和功能之间的关系。另一个目标是为那些开了处方但选择不使用残肢容量管理策略的人创造和评估一种新的住宿解决方案，例如更换假体袜层。为了实现这些目标，在前一个资助周期中开发的一种新型多通道生物阻抗分析仪被用来评估一组经胫骨(即膝下)假体使用者的残肢每日体液量的变化。临床结果，包括插座舒适度、满意度和感觉到的活动度，使用自我报告测量，而时间负重百分比和调节策略的使用通过定制仪器测量。预计肢体容量变化与用户满意度、舒适性和灵活性呈负相关，而容量调节策略的使用，如增加袜子和间歇性脱毛(即取出插口)会增强这些结果。我们为需要但选择不使用容量管理策略的人介绍了一种新的管理方案，即在肢体关键位置及时释放插座压力，以增强肢体液体容量恢复。根据拟议研究的结果，这一战略预计将与袜子通融一样有效或更有效地改善成果。拟议中的应用与公共卫生的相关性在于更好地理解残肢液体量的变化如何影响使用者的假肢体验、与残肢健康相关的临床重要结果以及使用者在生活活动中的表现。目前，尚不清楚残肢液体容量的变化发生在哪里，也不知道在不影响假体适合性的情况下可以容忍多少变化。在资助期过后，预计拟议的研究将扩展到临床工具， 允许从业者将肢体液体容量变化问题与其他问题隔离，例如不正确的组件或对齐。潜在地，这里描述的努力可以扩展到其他需要设备与人体组织安全和亲密配合的领域，包括转位假肢、上肢假肢和矫形术。

DESCRIPTION (provided by applicant): The long-term goal of the proposed research is the effective implementation of residual limb volume management strategies on prosthesis users so as to enhance their clinical outcomes, health, and quality-of- life. The focus of this application s to uncover knowledge essential to accomplishing this goal. The specific aims of the proposed research are to determine the influence of different activities and accommodation strategies on residual limb diurnal fluid volume change, and how they relate to comfort and performance of individuals with trans-tibial amputation. An additional goal is to create and evaluate a novel accommodation solution for people who are prescribed, but choose not to use, residual limb volume management strategies, such as changing prosthetic sock ply. To accomplish the aims, a novel multi-channel bioimpedance analysis instrument developed in the previous funding cycle is used to assess diurnal fluid volume changes in the residual limbs of a group of trans-tibial (i.e., below-knee) prosthesis users. Clinical outcomes, including socket comfort, satisfaction, and perceived mobility are obtained using self-report measures, while percent time weight-bearing and use of accommodation strategies are measured with custom instrumentation. It is expected that limb volume change negatively correlates with user satisfaction, comfort, and mobility, and that use of volume accommodation strategies, such as sock addition and intermittent doffing (i.e., removing the socket) enhances these outcomes. A novel management alternative we introduce for people who require, but choose not to use volume management strategies, is a timely release of socket pressures at key locations on the limb so as to augment limb fluid volume recovery. This strategy, informed by the results of the proposed research, is expected to be equally or more effective than sock accommodation towards enhancing outcomes. The relevance of the proposed application to public health is better understanding of how residual limb fluid volume changes impact users' experience with a prosthesis, clinically-important outcomes related to residual limb health, and users' performance in life activities. Currently, it is unknown where within the residual limb fluid volume changes occur or how much change can be tolerated without negatively affecting prosthetic fit. Beyond the grant period, it is anticipated the proposed research will be extended into clinical tools that allow practitioners to isolate limb fluid volume change problems from other issues such as improper componentry or alignment. Potentially, the efforts described here can be extended to other areas where devices require a secure and intimate fit with human tissues, including trans-fermoral prosthetics, upper-limb prosthetics, and orthotics.