Optimizing Prosthetic and Bicycle Fit for Veterans with Transtibial Amputations

优化小腿截肢退伍军人的假肢和自行车适配

基本信息

项目摘要

Over one million people in the United States have a leg amputation and this number continues to grow due to the prevalence of diabetes and recent military conflicts. Because of the functional impairment caused by an amputation, it is extremely important to advance rehabilitation that optimizes the use of prostheses so that Veterans with amputations can regain the greatest possible level of health, function, and physical activity. [Low-impact exercise such as bicycling could facilitate return to work/duty after amputation by improving cardiovascular fitness, muscle strength, endurance, and quality of life for Veterans with transtibial amputations (TTAs). Bicycling as exercise could also prevent the deleterious effects of vascular disease and diabetes by improving cardiovascular function, controlling body weight, decreasing the rate of re-amputation, and improving quality of life for Veterans with TTAs. However, it is likely that discomfort and the increased potential for secondary musculoskeletal injury due to the lack of a proper prosthetic/bike fit discourages Veterans with TTAs from using bicycling for rehabilitation and exercise. Moreover, it is unclear how prosthetic and bicycle components, such as pylon length (PL), pedal attachment position (PAP) beneath the prosthetic forefoot versus the pylon, and crank arm length (CAL) affect the biomechanics, metabolic costs, and comfort/ satisfaction of Veterans with TTAs. Thus, our goal is to challenge the state-of-the-science by developing evidence-based prosthetic and bicycle fit guidelines that optimize the biomechanics, metabolic costs, efficiency (mechanical power/metabolic power) and comfort/satisfaction for Veterans with TTAs.] The Department of Veterans Affairs (VA) and Department of Defense (DoD) Rehabilitation Directive has put forth an initiative that aims to dramatically improve and restore function in wounded Veterans and Service members so that they have the choice to return to active duty or productive civilian employment. Our proposed research will establish optimal prosthetic/bicycle fit guidelines, which would enhance function by improving cardiovascular health, controlling body weight, decreasing re-amputation rates, and enhancing quality of life of Veterans with TTAs, thus helping to fulfill this initiative and having high potential impact. Specifically, we aim to: 1) Study 15 Veterans with unilateral TTAs to determine the effects of systematically varying PL, PAP beneath the prosthetic forefoot versus the pylon, and CAL for the affected leg on bicycling biomechanics, metabolic costs, and comfort/satisfaction. 2) Synthesize and disseminate our findings into practical, evidence-based quantitative prosthetic/bicycle fit guidelines for Veterans with TTAs. We hypothesize that a longer PL and shorter CAL for the affected compared to the unaffected leg along with a PAP beneath the pylon compared to beneath the forefoot will maximize mechanical power symmetry and reduce metabolic cost and muscle activity, and thus maximize efficiency and comfort/satisfaction during bicycling in Veterans with unilateral TTAs. [The utilization of evidence-based prosthetic/bicycle fit guidelines that increase symmetry, improve comfort, reduce the risk of injury, decrease metabolic costs, and improve efficiency will directly benefit Veterans with TTAs by increasing their physical activity and function.] Optimized prosthetic/bicycle fit guidelines will allow Veterans TTAs who were previously unable to comfortably ride a bicycle, as well as those currently riding a bicycle, to ride longer with less effort and discomfort, potentially leading to an improved quality of life. Moreover, the prosthetic/bicycle fit guidelines generated by this research will ensure that clinicians are able to fit Veterans with TTAs to bicycles more effectively, leading to shorter appointment times and fewer revisits due to enhanced function and reduced comorbidities.
美国有超过一百万人腿部截肢,并且这个数字还在持续增长,原因是 糖尿病的流行和最近的军事冲突。由于某种原因造成的功能障碍 截肢后,推进优化假肢使用的康复极其重要,以便 截肢退伍军人可以最大程度地恢复健康、功能和身体活动。 [骑自行车等低影响运动可以通过改善截肢后恢复工作/职责的方式 经胫骨截肢退伍军人的心血管健康、肌肉力量、耐力和生活质量 (TTAs)。骑自行车作为运动还可以预防血管疾病和糖尿病的有害影响 改善心血管功能,控制体重,降低再截肢率,改善 拥有 TTA 的退伍军人的生活质量。然而,不适感和增加的可能性可能会增加 由于缺乏合适的假肢/自行车而导致的继发性肌肉骨骼损伤阻碍了退伍军人进行 TTA 使用自行车进行康复和锻炼。此外,目前尚不清楚假肢和自行车如何 组件,例如假肢前足下方的支架长度 (PL)、踏板连接位置 (PAP) 与塔架相比,曲柄臂长度 (CAL) 会影响生物力学、代谢成本和舒适度/ 退伍军人对 TTA 的满意度。因此,我们的目标是通过开发 基于证据的假肢和自行车适配指南,可优化生物力学、代谢成本和效率 (机械功率/代谢功率)和 TTA 退伍军人的舒适度/满意度。] 退伍军人事务部 (VA) 和国防部 (DoD) 康复指令提出了一项倡议: 旨在显着改善和恢复受伤退伍军人和现役军人的功能,以便他们 可以选择重返现役或生产性民事就业。我们提出的研究将建立 最佳假肢/自行车适配指南,可通过改善心血管健康来增强功能, 通过 TTA 控制体重、降低再截肢率并提高退伍军人的生活质量, 从而帮助实现这一举措并产生巨大的潜在影响。具体来说,我们的目标是: 1) 研究 15 退伍军人通过单边 TTA 确定系统性改变 PL、PAP 的影响 假肢前脚与支架的比较,以及受影响腿的 CAL 在自行车生物力学、代谢成本、 和舒适度/满意度。 2) 将我们的研究结果综合并传播为实用的、基于证据的定量分析 针对有 TTA 的退伍军人的假肢/自行车适配指南。我们假设较长的 PL 和较短的 CAL 受影响的腿与未受影响的腿相比,以及塔下的 PAP 与塔下的 PAP 相比 前足将最大限度地提高机械动力的对称性,并降低代谢成本和肌肉活动,从而 通过单侧 TTA 最大限度地提高退伍军人骑自行车时的效率和舒适度/满意度。 [利用 基于证据的假肢/自行车适配指南,可增加对称性、提高舒适度、降低风险 损伤、降低代谢成本和提高效率将通过增加 TTA 直接使退伍军人受益 他们的身体活动和功能。] 优化的假肢/自行车适配指南将允许退伍军人 TTA 以前不能舒适地骑自行车的人以及现在骑自行车的人,要骑更长时间 更少的努力和不适,可能会提高生活质量。此外, 这项研究产生的假肢/自行车适配指南将确保临床医生能够适配退伍军人 更有效地使用自行车 TTA,从而缩短预约时间并减少重访次数 增强功能并减少合并症。

项目成果

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Alena Grabowski其他文献

Alena Grabowski的其他文献

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{{ truncateString('Alena Grabowski', 18)}}的其他基金

Improving Socket Fit in Female and Male Veterans with Transtibial and TransfemoralAmputation
改善经小腿和经股截肢术的女性和男性退伍军人的接受腔贴合度
  • 批准号:
    10609490
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
Improving Socket Fit in Female and Male Veterans with Transtibial and TransfemoralAmputation
改善经小腿和经股截肢术的女性和男性退伍军人的接受腔贴合度
  • 批准号:
    10424648
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
Use of Wearable Sensors to Assess Prosthetic Alignment in Veterans with Unilateral Transtibial Amputations
使用可穿戴传感器评估单侧小腿截肢退伍军人的假肢对准情况
  • 批准号:
    10483310
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
Use of Wearable Sensors to Assess Prosthetic Alignment in Veterans with Unilateral Transtibial Amputations
使用可穿戴传感器评估单侧小腿截肢退伍军人的假肢对准情况
  • 批准号:
    10641932
  • 财政年份:
    2022
  • 资助金额:
    --
  • 项目类别:
How Do Lower Limb Prosthetic Stiffness and Power Affect the Biomechanics, Metabolic Costs, and Satisfaction of Veterans with Transtibial Amputations DuringWalking?
下肢假肢刚度和力量如何影响小腿截肢退伍军人步行时的生物力学、代谢成本和满意度?
  • 批准号:
    10201776
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
Can Sensory Feedback Training Improve the Biomechanical and Metabolic Effects of Using Passive or Powered Lower Limb Prostheses During Walking for Veterans with Transtibial Amputations?
感觉反馈训练能否改善小腿截肢退伍军人在行走过程中使用被动或动力下肢假肢的生物力学和代谢效应?
  • 批准号:
    10653769
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
Can Sensory Feedback Training Improve the Biomechanical and Metabolic Effects of Using Passive or Powered Lower Limb Prostheses During Walking for Veterans with Transtibial Amputations?
感觉反馈训练能否改善小腿截肢退伍军人在行走过程中使用被动或动力下肢假肢的生物力学和代谢效应?
  • 批准号:
    10201777
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
How Do Lower Limb Prosthetic Stiffness and Power Affect the Biomechanics, Metabolic Costs, and Satisfaction of Veterans with Transtibial Amputations DuringWalking?
下肢假肢刚度和力量如何影响小腿截肢退伍军人步行时的生物力学、代谢成本和满意度?
  • 批准号:
    10652963
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
Optimizing Prosthetic and Bicycle Fit for Veterans with Transtibial Amputations
优化小腿截肢退伍军人的假肢和自行车适配
  • 批准号:
    9925065
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
Development of a Novel Device to Measure Socket Pistoning
新型套筒活塞测量装置的研制
  • 批准号:
    9137137
  • 财政年份:
    2016
  • 资助金额:
    --
  • 项目类别:

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