Interface Materials for Patients with Limb Amputation

描述（由申请人提供）：本项目的长期目标是改进截肢患者界面内衬材料的处方和设计，以创建机械稳定并在截肢过程中抵抗软组织损伤的假体。具体目标是开发一套测试系统，以评估市售界面内衬，解释结果，并向从业者传达这些不同内衬如何影响皮肤力学、肢体-关节窝稳定性和肢体温度。开发的套件应快速，轻松地允许从业者评估材料用于他们的病人，并帮助他们作出明智的决定的基础上，最好的科学证据和机械测试数据。关键特征包括新假体内衬的性能以及内衬在持续和典型使用中随时间推移机械性能的变化程度。将这些材料性能数据置于临床相关框架内进行评价和处方。此外，开发这套软件将使人们能够在供资期结束后继续以低成本提供这一服务。为了实现这些目标，开发了定制仪器来测试专门用于肢体修复应用的内衬。测试材料的能力，以提供：缓冲;假肢悬挂;皮肤粘附;体积变化调节;透气性;导热性;和耐久性。对新内衬和患者使用长达9个月的内衬进行测试。测试了传统衬垫和“智能”衬垫，它们在施加电压或力时改变其特性。实施生物力学模型，以比较患者使用过程中不同内衬的肢体-关节窝界面力学、肢体-关节窝稳定性和残肢上的热应力。然后，这些数据被合并到一个清晰，易于理解的格式演示文稿中，供从业人员，患者，研究人员和行业使用。该应用程序的健康相关性是一种评估和传播策略，在康复治疗中得到广泛使用。定量材料数据以临床相关的格式呈现，以改善截肢患者的护理和健康相关的生活质量。应加强衬垫的选择和处方，减少皮肤破裂和截肢者受伤的发生。此外，这项研究将有助于指定未来班轮的定量工程需求。潜在地，在所提出的申请中描述的努力可以扩展到皮肤界面的选择具有临床重要性的其他领域，包括轮椅座椅、鞋类、鞋垫和矫正装置。 公共卫生相关性：该项目的长期目标是为截肢患者提供界面内衬材料处方的有用工具，以便创建在截肢期间机械稳定且不会造成软组织损伤的假体。

DESCRIPTION (provided by applicant): The long-term goal of this project is the improved prescription and design of interface liner materials for patients with limb amputation so as to create prostheses that are mechanically stable and resist soft tissue injury during ambulation. The specific aims are to develop a suite of testing systems to evaluate commercially available interface liners, interpret the results, and communicate to practitioners how these different liners affect skin mechanics, limb- socket stability, and limb temperature. The developed suite should quickly and easily allow practitioners to evaluate materials for use with their patients and assist them in making informed decisions based upon the best available scientific evidence and mechanical testing data. Key features include properties of new prosthetic liners and to what degree the liners change their mechanical performance over time with continual and typical use. These material performance data are placed within a clinically relevant framework for evaluation and prescription. Further, development of this suite will allow continued provision of this service at a low cost well beyond the funding period. To achieve the aims, custom instrumentation is developed to test liners specifically for limb prosthetics application. The materials are tested for their abilities to provide: cushioning; prosthetic suspension; skin adherence; volume change accommodation; breathability; thermal conductivity; and durability. Both new liners and those used by patients for up to nine months are tested. Both conventional liners and "smart" liners, which change their properties upon an applied voltage or force, are tested. Biomechanical models are implemented to compare limb-socket interface mechanics, limb-socket stability, and thermal stresses on the residual limb for different liners during patient use. The data are then incorporated into a clear and easy-to- understand format presentation for use by practitioners, patients, researchers, and industry. The health relatedness of this application is an evaluation and dissemination strategy that has widespread use in rehabilitation treatment. Quantitative material data are presented in a clinically relevant format to improve amputee patient care and health-related quality of life. Liner selection and prescription should be enhanced, reducing the occurrence of skin breakdown and injury to persons with limb amputation. Further, this research will help to specify quantitative engineering needs of future liners. Potentially, the efforts described in the proposed application can be extended to other areas where the selection of the skin interface is of clinical importance, including wheelchair seating, footwear, insoles and orthotic devices. PUBLIC HEALTH RELEVANCE: The long-term goal of this project is a useful tool for prescription of interface liner materials for patients with limb amputation so as to create prostheses that are mechanically stable during ambulation and do not cause soft tissue injury.