Development of a Novel Device to Measure Socket Pistoning

 描述（由申请人提供）： 接受腔活塞运动，定义为残肢在接受腔内的轴向运动，导致截肢退伍军人的不适和皮肤损伤，如水泡、皮肤破裂和老茧。大多数以前的研究评估活塞静态，但这并不代表活塞，发生在日常生活中遇到的典型活动。先前的两项研究已经动态地评估了活塞运动，但需要昂贵的设备和插座的修改。开发一种廉价的工具，不需要插座修改，可以准确地测量插座活塞动态可以提高插座的舒适性和适合截肢退伍军人，使他们能够恢复最大可能水平的功能能力和活动。目的 该项目的目的是设计、开发、验证并在临床上实施一种新型的测量装置，该装置价格低廉，不需要对关节窝进行修改，可以准确定量地测量经胫骨和经股骨截肢的退伍军人的关节窝活塞运动。利用非接触式电位计和无线收发器等技术，开发出了一种精确、便携且廉价的原型。所提出的工作的第一个目的是进一步设计和开发这种动态插座活塞测量装置，使其可以在临床环境中使用。将组装和校准五台设备和一个用户界面。这些设备将是小的（7 cm x 4cm x 3cm），便宜的（成本<500美元），便携式（电池供电和无线），不需要修改插座。第二个目的是验证套筒活塞测量装置。为了评估动态接受腔活塞运动，将同时从接受腔活塞运动测量装置、动态立体放射摄影系统和Vicon运动捕捉系统收集数据，同时在定制的接受腔内以1-2 Hz的频率上下移动拟人代表性肢体，上下移动范围为40 mm，这是典型的行走轴向移动。当套筒活塞测量装置的结果与动态立体放射摄影和Vicon系统的结果相差小于2 mm，并且在5分钟内的信号漂移小于1%时，该装置将在临床中实施。最终目的是在VA Eastern科罗拉多Health Care System朱厄尔区域截肢诊所对截肢退伍军人临床实施插座活塞测量装置，以实际评估系统设计和功能。三名假肢专家将在他们定期安排的20名经胫骨或经股骨截肢的退伍军人的预约中实施插座活塞测量装置。患者和修复师都将评价该器械的易用性、舒适性和适用性。在临床环境中，接受腔活塞运动的动态准确量化将提供接受腔舒适度和适合度的客观测量;从而为修复师和研究人员提供有益的信息，以改进接受腔制造技术和接受腔舒适度评估。正确安装插座和减少插座活塞有可能减少残肢皮肤问题，使截肢更舒适，并鼓励截肢退伍军人更积极的生活方式。

 DESCRIPTION (provided by applicant): Project Summary/Abstract Socket pistoning, defined as the axial movement of the residual limb within a prosthetic socket, leads to discomfort and skin damage such as blisters, skin breakdown, and callouses in Veterans with an amputation. Most previous research has assessed pistoning statically, but this does not represent the pistoning that takes place during typical activities encountered in daily life. Two previous studies have assessed pistoning dynamically, but required expensive equipment and socket modification. Developing an inexpensive tool that does not require socket modification and can accurately measure socket pistoning dynamically could improve socket comfort and fit for Veterans with amputations, allowing them to regain the greatest possible level of functional ability and activity. The purpose of the proposed project is to design, develop, validate, and clinically implement a novel measurement device that is inexpensive, requires no socket modification, and accurately and quantitatively measures socket pistoning in Veterans with transtibial and transfemoral amputations. Using technology such as non-contact potentiometers and wireless transceivers, an accurate, portable, and inexpensive prototype has been developed. The first aim of the proposed work is to further design and develop this dynamic socket pistoning measurement device so that it can be used in a clinical setting. Five devices and a user interface will be assembled and calibrated. The devices will be small (7cm x 4cm x 3cm), inexpensive (cost <$500), portable (battery-powered and wireless), and require no socket modification. The second aim is to validate the socket pistoning measurement device. To assess dynamic socket pistoning, data will be collected simultaneously from the socket pistoning measurement device, dynamic stereo radiography system, and Vicon motion capture system, while an anthropomorphic representative limb is moved up and down at 1-2 Hz within a 40 mm range inside a custom-fabricated socket, an axial movement typical for walking. When the socket pistoning measurement device results are less than 2 mm different from the dynamic stereo radiography and Vicon systems, and have a signal drift of less than 1% over five minutes, the device will be implemented in the clinic. The final aim is to clinically implement the socket pistoning measurement device on Veterans with an amputation at the VA Eastern Colorado Health Care System Jewell Regional Amputation Clinic to practically assess system design and function. Three prosthetists will implement the socket pistoning measurement device during their regularly scheduled appointments on 20 Veterans with transtibial or transfemoral amputations. Both the patients and prosthetists will evaluate the device for ease of use, comfort and applicability. The accurate quantification of socket pistoning dynamically and in a clinical setting will provide an objective measure of socket comfort and fit; thus giving beneficial information to prosthetists and researchers that could improve socket fabrication techniques and assessment of socket comfort. Properly fitting sockets and the reduction of socket pistoning have the potential to reduce residual limb skin problems, make ambulation more comfortable, and encourage a more active lifestyle among Veterans with a leg amputation.