Center for Limb Loss Prevention and Prosthetic Engineering

项目总结 我们退伍军人康复研究开发中心的使命是预防和治疗肢体缺失 假体工程学是为了改善退伍军人的生活质量和功能状态，这些退伍军人面临着或 已经接受了一次截肢手术。该中心将调查团队聚集在一起，以确定 临床问题，将其建模为假设驱动的研究，进行实验，并提供证据- 在将结果传播给经验丰富的、临床的和科学的受众之前，基于结论。 我们的中心包括三个主要核心：(1)肢体丢失预防，(2)假体工程，和(3) 康复结果。肢体缺失预防核心旨在减少功能性和解剖性肢体缺失 通过研究导致肢体功能异常的疾病过程，开发新的、最先进的 研究脚部的技术。高度专业化的技术，如双平面透视、身体步态 模拟、门控MRI加载和计算建模将被用来量化足部的影响 并比较不同治疗方案的疗效。假肢 工程学的核心目标是增强机动性，降低受伤风险，并改善退伍军人的舒适性 截肢者。我们通过设计和评估新的最先进的假体来满足这些需求 机器人、计算和仪器仪表方面的进展。康复成果核心整合了 医学共病、心理状态和社会因素的复杂多维问题及其影响 对截肢者功能结局的影响。基于团体的治疗方法的发展与评价 干预措施和改进截肢水平决策程序是这一核心的重点。 自从我们上一次在2012年更新中心以来，我们通过15 VA RR&D获得了540万美元的内部资金 赠款和330万美元的外部资金，通过6个非退伍军人事务部的联邦赠款。在同一财政期间(2013- 2015年)，该中心发表了69篇同行评议文章，5本书章节，3篇会议论文，67次会议 摘要，我们的研究人员已经做了108次演讲和特邀讲座。我们还扩大了我们的 通过与密歇根大学多个部门的多次成功合作，提高了研究能力 华盛顿，其他一流研究型大学，领先的研究机构，VAPSHCS健康服务，以及 Eric(流行病学研究和信息学中心)调查人员，以及其他退伍军人管理局的临床医生/科学家 医疗中心。我们目前6300平方英尺的实验室和办公空间将增加近一倍，并 当我们过渡到新的精神健康和 2017年的研究大楼。 我们的中心包括一群高生产率和公认的高级调查人员，其中包括两名 获得享有盛誉的保罗·B·马格努森康复研究奖和两名退伍军人研究奖获得者 职业科学家奖。我们还招募了三名早期博士研究人员和两名职业 发展奖获得者，他们带来了重要的技能组合，进一步推动了中心的使命。我们的中心 调查团队包括具有骨科、康复医学和 康复心理学。这种强大的临床联系确保了我们的研究与退伍军人相关 病人是我们工作的重点。我们制定了令人印象深刻的培训计划，创造了一个新的 将为退伍军人护理做出贡献的一代科学家包括：本科生、研究生和医学 学生、博士后研究员、实习生/住院医师和临床研究员。我们中心的工作进一步加强 由一支技术娴熟的研究团队组成，其中包括：MS工程师、研究助理、生物统计学家和修复师。在……里面 总结，该中心已开发出卓越的基础设施，使其能够同时进行 高质量和高生产率的研究，以响应我们退伍军人的新需求。

PROJECT SUMMARY The mission of our VA Rehabilitation Research and Development Center for Limb Loss Prevention and Prosthetic Engineering is to improve the quality of life and functional status of veterans who are at risk for, or have undergone, a lower extremity amputation. The Center brings together investigative teams that identify clinical problems, model them into hypothesis-driven research, conduct experiments, and make evidence- based conclusions before disseminating the results to veteran, clinical, and scientific audiences. Our Center includes three major cores: (1) Limb Loss Prevention, (2) Prosthetic Engineering, and (3) Rehabilitation Outcomes. The Limb Loss Prevention core aims to reduce functional and anatomical limb loss by studying the disease processes that lead to aberrant limb function and by developing novel, state-of-the-art technologies for studying the foot. Highly specialized techniques, such as biplane fluoroscopy, cadaveric gait simulation, gated MRI loading, and computational modeling, will be employed to quantify the effects of foot deformity, ankle arthritis and diabetes, and to compare the effect of different treatment options. The Prosthetic Engineering core aims are to enhance mobility, reduce the risk of injury, and improve the comfort of veteran amputees. We address these needs by designing and evaluating novel state-of-the-art prostheses that leverage advances in robotics, computation, and instrumentation. The Rehabilitation Outcomes core integrates the complex multi-dimensional issues of medical co-morbidity, psychological status, and social factors and their impact on amputee functional outcome. The development and evaluation of group-based therapeutic interventions, and the improvement of the amputation level decision making process are the foci of this core. Since our last Center renewal in 2012, we have been awarded $5.4M in intramural funding via 15 VA RR&D grants and $3.3M in extramural funding via 6 non-VA federal grants. During the same fiscal period (2013- 2015), the Center has published 69 peer-reviewed articles, 5 book chapters, 3 conference papers, 67 conference abstracts, and our investigators have given 108 presentations and invited lectures. We have also expanded our research capabilities through many successful collaborations with multiple departments at the University of Washington, other top-tier research Universities, leading research institutions, VAPSHCS Health Services, and ERIC (Epidemiology Research an Informatics Center) investigators, as well as clinician/scientists at other VA Medical Centers. Our current 6,300 square feet of laboratory and office space will nearly double, and be transformed into state-of-the-art research facilities when we transition into the new Mental Health and Research Building in 2017. Our Center includes a group of highly productive and recognized senior investigators including two who have won the prestigious Paul B. Magnuson Award for Rehabilitation Research and two recipients of VA Research Career Scientist awards. We have also recruited three early-career PhD researchers and two Career Development Award winners who bring important skillsets to further advance the Center mission. Our Center investigative team includes clinician/scientists with expertise in Orthopaedics, Rehabilitation Medicine, and Rehabilitation Psychology. This strong clinical linkage ensures that our research is relevant to the veteran patients who are the focus of our work. We have developed an impressive training program to create a new generation of scientists who will contribute to veteran care including: undergraduate, graduate and medical students, post-doctoral fellows, interns/residents, and clinical fellows. Our Center’s work is further enhanced by a skilled research team including: MS engineers, research assistants, a biostatistician, and a prosthetist. In summary, this Center has developed a remarkable infrastructure that has enabled it to conduct both high quality, and highly prolific research that is responsive to the emerging needs of our veterans.