Enhancing the prosthetic interface: 1/f vibrotactile socket stimulation to improve the adaptability of trans-tibial amputees

 描述(申请人提供)：因失去足部和脚踝等自然结构而导致肢体截肢的患者感觉受损。这些结构在运动过程中身体与地面的相互作用中扮演着非常重要的角色。虽然假体可以解决肢体丧失的功能缺陷，但感觉缺陷仍有待解决。这种感觉缺陷在有周围神经病变的个体中更为明显，是独立运动的重要障碍。这项研究的目的是调查为解决假肢康复中的这一持续问题而开发的有针对性的干预措施，该干预措施结合了生物医学科学中的两个新兴概念。首先，通过鞋垫对足底表面进行亚阈值(无形)振动刺激，已被证明通过增强来自神经病变肢体的微弱传入感觉信号，有效地改善了周围神经病患者的平衡。其次，粉色噪声(一种信号，其结构表现为1/f的幂定律，使得振荡频率f越小，幅度越大)已被证明在健康运动系统的生理输出中无处不在。该项目建议通过假肢插座--假肢和残肢之间的接口--提供阈值以下的振动刺激，特别是以粉色噪音的形式。这种结构的刺激可能更容易被身体接受，因为它模仿了缺失的脚和脚踝的“自然”信号。因此，本项目将确定通过假体插座施加振动触觉刺激对经胫骨截肢者的功能表现的影响。在研究的第一个PRT中，随机和粉色噪声刺激条件将与安静站立和水平行走时无刺激条件进行比较，以隔离粉色噪声结构对随机噪声结构的影响。研究的第二部分将调查干预对适应性的影响，方法是检查受惊站立和在不平坦的地形上行走时的表现；量化每种刺激条件下因平衡挑战增加而导致的表现恶化。假设在阈值以下粉色噪声刺激的存在下，跨胫骨截肢者的表现和适应能力将得到改善。这种简单而廉价的干预未来可能很容易被纳入假肢技术中，以增强感觉并促进普遍的功能增强，从而提高个人保持活跃的能力，并在较低水平后保持健康和生活质量。 截肢。

 DESCRIPTION (provided by applicant): Individuals with lower limb amputation have impaired sensation due to the loss of natural structures such as the foot and the ankle. These structures play a very important role in the body's interaction with the ground during movement. Although prostheses may address the functional deficits of limb loss, the sensory deficit is yet to be addressed. This sensory deficit is more pronounced in individuals with peripheral neuropathy and is an important barrier to independent locomotion. The purpose of this study is to investigate a targeted intervention developed to address this ongoing issue in prosthetic rehabilitation that combines two emerging concepts in biomedical science. Firstly, sub-threshold (imperceptible) vibratory stimulation when applied via insoles to the plantar surface of the feet has been shown to be effective in improving the balance of people with peripheral neuropathy, by enhancing the weak afferent sensory signals from the neuropathic extremity. Secondly, pink noise (a signal with a structure that exhibits a power-law scaling, 1/f, such that the smaller the frequency of oscillation, f, the larger the amplitude) has been shown to be ubiquitous in the physiological outputs of the healthy locomotor system. This project proposes to deliver sub-threshold vibratory stimulation via the prosthetic socket - the interface between the prosthetic limb and residual limb - specifically in the form of pink noise. A stimulus of this structure may b more readily accepted by the body as it emulates the 'natural' signal of the absent foot and ankle. As such this project will determine the changes in functional performance induced by vibrotactile stimulation applied via the prosthetic socket in trans-tibial amputees. In the first prt of the study stochastic and pink noise stimulation conditions will be compared to the no stimulation condition during quiet standing and level walking, to isolate the effect of the pink noise structure over a random one. The second part of the study will investigate the effect of the intervention on adaptability by examining performance in perturbed standing and in walking on uneven terrain; quantifying in each stimulation condition the deterioration in performance induced by increased challenges to balance. It is hypothesised that performance and adaptability of trans-tibial amputees will improve in the presence of sub- threshold pink noise stimulation. This simple and inexpensive intervention may in future be readily incorporated into prosthetic technology to enhance sensation and promote universal gains in function, improving the ability of individuals to remain active and maintain health and quality of life following lower limb amputation.