REMOTE PRESSURE MONITORING IN BK DIABETIC AMPUTEES

这项研究将测量继续进行的机械加载条件 糖尿病截肢者装配后软组织的病理变化 带着他们第一个膝盖以下的永久性假体。我们的前期工作 已经建立了一种非侵入性方法来监测皮肤对 延长负荷，使用组织反射光谱(TRS)。我们有 广泛表征脊髓缺血后的反应 受伤和多发性硬化症的对象，并将在这项研究中扩展 对糖尿病截肢者的测量。我们目前的工作也是 展示了一种有效的方法来适应 皮肤色素沉着的主要测量参数.浅层 皮肤血液含量和氧合。这些参数现在可以 在黑人受试者和其他种族群体中准确测量。第一 两年时间将集中于收集缺血后的标准TRS 已知的糖尿病截肢者在残肢部位的反应数据 处于危险之中。重复负荷对延长负荷的影响，以及 加载的幅度也将进行对比。在此期间，TRS将 也可用于动态表征血液内容物和 本院BK截肢者的氧合状况 局部疼痛和/或持续性皮肤发红。调查人员已经 还对高级压力的开发和评估做出了贡献 临床座椅和定位应用的测绘技术。 在头两年，我们将进一步开发这项技术，以 在日常使用过程中短节插座接口压力的测量 假肢。与TekScan Inc.合作，修改为 现有技术将在第一年和第三年制造，以允许可移动 界面压力监测。在3-5年级，我们将研究组织 100多名BK糖尿病截肢者对负荷史的反应 社区，在紧接装置安装后的期间内 患者的第一个永久性假体。试衣四天后， TRS将用于评估正常情况下残肢的面积 表现出局部损伤、炎症或疼痛以及任何 将对不良反应进行评估。详细的加载历史记录 进行处理后，将从收集的数据中提取组织响应 在监测期内。表征加载历史的参数 将包括：加载重复次数；大小和持续时间 峰值负荷；步行的持续时间；挥杆时的峰值压力 分期和相关的临床数据。

This study will measure the mechanical loading conditions that proceed pathological changes in soft tissues of diabetic amputees being fitted with their first below knee, permanent prosthesis. Our preliminary work has established a non-invasive method for monitoring skin response to prolonged loading, using tissue reflectance spectrometry (TRS). We have extensively characterized the post ischemia responses of spinal cord injured and multiple sclerosis subjects and will extend in this study the measurements to diabetic amputees. Our current work has also demonstrated an effective method for accommodating for the effects of skin pigmentation on the primary measurement parameters - superficial skin blood content and oxygenation. These parameters can now be accurately measured in black subjects and other ethnic groups. The first two years will concentrate on collecting normative TRS post ischemia response data on diabetic amputees at sites on the residual limb known to be at risk. The effect of repetitive vs prolonged loading, and amplitude of loading will also be contrasted. During this time TRS will also be used to dynamically characterize the blood content and oxygenation status of BK amputees who present at our clinic with localized pain and/or persistent skin redness. The investigators have also contributed to the development and evaluation of advanced pressure mapping technology for clinical seating and positioning applications. In the first two years we will further develop this technology for measurement of stump-socket interface pressures during everyday use of the prosthesis. In collaboration with Tekscan Inc., modifications to existing technology will be made in Years 1 and 3 to permit ambulatory monitoring of interface pressures. In years 3-5 we will study tissue response to loading history for over 100 BK diabetic amputees in the community, during the period immediately after the fitting of the patient's first permanent prosthesis. Four days after the fitting, the TRS will be used to evaluate areas of the residual limb that normally exhibit localized damage, inflammation or pain and the extent of any adverse responses will be measured. The detailed loading history that proceeded the tissue response will be extracted from the data collected during the monitoring period. Parameters to characterize loading history will include: number of loading repetitions; magnitude and duration of peak loads; duration of walking sessions; peak pressures during swing phase and pertinent clinical data.