Torsional stiffness and user preference: lower limb amputee lab test

扭转刚度和用户偏好：下肢截肢者实验室测试

• 批准号: 9033047
• 负责人: Glenn Klute
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-01-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9033047
• 关键词: Address; Adoption; Aging; American; Amputees; Articular Range of Motion; Behavior; Biomechanics; Clinic; Clinical; Clinical Trials; Conflict (Psychology); Crowding; Data; Development; Devices; Diabetes Mellitus; Equilibrium; Etiology; Exhibits; Fall injury; Feedback; Freedom; Future; Gait; Glare; Goals; Growth; Height; Home environment; Housing; Human; Incidence; Individual; Laboratories; Life; Limb Prosthesis; Limb structure; Literature; Lower Extremity; Mechanics; Metabolic; Middle East; Motion; Motor; National Research Council; One-Step dentin bonding system; Operative Surgical Procedures; Overweight; Patients; Performance; Play; Population; Process; Property; Prosthesis; Quality of life; Reporting; Research; Research Support; Role; Sampling; Scientist; Skin; Soft Tissue Injuries; Source; Speed; Surgeon; System; Technology; Testing; Toes; Torque; Torsion; United States; Veterans; Violence; Walking; War; Weight; World War II; abstracting; arm; clinically relevant; clinically significant; cooking; cost; design; disability; falls; human subject; improved; improved functioning; improved mobility; innovation; limb amputation; meetings; new technology; novel; preference; public health relevance; research study; residual limb; sensor; walking speed

 DESCRIPTION (provided by applicant): Project Summary (Public Abstract) The violent conflict of war always results in amputees. After World War II, a team of well-known clinician scientists led by H. D. Eberhart examined the biomechanics of human gait and reported to the National Research Council Committee on Artificial Limbs, advisory to the Veterans Affairs and the Office of the Surgeon General of the United States Army, that transverse plane motions and their frictional effects "are a major source of discomfort and the chief cause of dissolution of the skin" in lower limb amputees. This was quite remarkable given the state-of-the-art of prosthetic limbs in 1947. Identifying a problem is one thing, solving it is another. Thirty years went by before Lamoureux and Radcliffe reported in 1977 that a greater degree of freedom in the transverse plane of the prosthesis might improve the changing of direction of ambulatory amputees. As our own research suggests that turning maneuvers comprise about 30% of daily steps, it is not too surprising that evidence in the literature reports the benefits of commercially-available torsion adapters to include improved walking performance, reduced metabolic costs, the potential to reduce residual limb soft tissue injuries, and improved balance and stability. While these devices are available for prescription, a glaring problem remains. None of the commercially-available transverse plane torsion adapters can be adjusted by the user. When patients are fit with these devices, the prosthetist sets the stiffness and that is it. The selected stiffness is expected to be adequate for all of an amputee's activities. To address this deficiency, we developed a novel prosthesis whose transverse plane stiffness can be adjusted by the user. The specific aims of the proposed research are to determine: (1) the preferred transverse plane stiffness and (2) the transverse plane stiffness that minimizes the transverse plane moment applied to the residual limb of Veteran lower limb amputees during different ambulatory activities at different speeds. We believe this research will significantly improve the function and quality of life of Veteran lower limb amputees. Developing new technology that allows the prosthetic limbs of Veteran amputees perform like a natural limb is where the VA should be: at the forefront of prosthetic technology and prescription practice.

 描述（由申请人提供）： 项目摘要（公开摘要）战争的暴力冲突总是导致截肢者。第二次世界大战后，由H。D.埃伯哈特研究了人类步态的生物力学，并向美国国家假肢研究理事会委员会报告说，横向平面运动及其摩擦效应是下肢截肢者“不适的主要来源，也是皮肤溶解的主要原因”。考虑到1947年最先进的假肢，这是相当了不起的。发现问题是一回事，解决问题是另一回事。30年后，Lamoureux和Radcliffe在1977年报告说，假体横向平面的更大自由度可能会改善行走截肢者的方向改变。正如我们自己的研究表明，转动动作约占日常步数的30%，文献中的证据报告了市售扭转适配器的益处，包括改善行走性能，降低代谢成本，减少残肢软组织损伤的潜力，以及改善平衡和稳定性，这并不奇怪。虽然这些设备可用于处方， 仍然存在一个突出的问题。市售的横向平面扭转适配器都不能由用户调节。当患者适合这些装置时，修复师设置刚度，就是这样。 活动为了解决这一缺陷，我们开发了一种新型假体，其横向平面刚度可以由用户调整。所提出的研究的具体目的是确定：（1）优选的横向平面刚度和（2） 最小化在不同速度下的不同步行活动期间施加于退伍军人下肢截肢者的残肢的横向平面力矩。我们相信这项研究将显著改善退伍军人下肢截肢者的功能和生活质量。开发新技术，使退伍军人截肢者的假肢像自然肢体一样工作，是退伍军人事务部应该做的：在假肢技术和处方实践的最前沿。