Torsional stiffness and user preference: lower limb amputee lab test

 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。二战结束后，由H·D·埃伯哈特领导的一个由知名临床科学家组成的团队研究了人体步态的生物力学，并向国家研究委员会假肢委员会、退伍军人事务部和美国陆军卫生局局长办公室提供咨询意见，报告称，横向平面运动及其摩擦效应是下肢截肢者感到不适的主要来源和皮肤溶解的主要原因。考虑到1947年假肢的最先进水平，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，假体横向平面上更大的自由度可能会改善活动截肢者的方向改变。正如我们自己的研究表明，转身动作约占日常步数的30%，因此，文献中有证据表明，商用扭转适配器的好处包括改善步行能力、降低新陈代谢成本、减少残肢软组织损伤以及改善平衡和稳定性，这并不令人惊讶。虽然这些设备可供处方使用，但 明显的问题依然存在。商业化的横向平面扭转适配器都不能由用户调整。当患者适合使用这些装置时，假肢医生设定僵硬，仅此而已。所选的僵硬程度应足以满足所有截肢者的要求 活动。为了解决这一不足，我们开发了一种新型假体，其横向平面刚度可以由使用者调整。建议研究的具体目标是确定：(1)较佳的横向平面刚度和(2)满足以下条件的横向平面刚度 在不同的步行活动中，以不同的速度，最大限度地减少应用于退伍军人下肢截肢者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天然肢体一样发挥作用，是退伍军人管理局应该做的事情：走在假肢技术和处方实践的前沿。

 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.