INTERFACE MECHANICS, MATERIALS AND TISSUE RESPONSE

界面力学、材料和组织反应

• 批准号: 6936590
• 负责人: Joan E. Sanders
• 金额: $ 34.11万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-13 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6936590
• 关键词: amputation; artificial limbs; bioengineering /biomedical engineering; biological fluid transport; biomaterials; biomechanics; body composition; body fluids; body water; clinical research; functional ability; human subject; mechanical stress; rehabilitation; shear stress; tibia

DESCRIPTION (provided by applicant): The broad, long-term objectives of this application are to develop methods to predict and treat diurnal and long-term residual limb shape changes to reduce the occurrence of skin breakdown in persons with lower-limb amputation. The specific aims are to assess interface-stress stability in trans-tibial amputee subjects under different socket-modification treatments designed to overcome fit problems induced by shape changes. A further aim is to better understand the sources of diurnal and long-term shape changes and to correlate them with residual limb fluid transport and other patient tissue characteristics that can be assessed in clinical evaluation. To address the aims fluid-filled cells at controlled volumes, a uniform-thickness insert, and material patches affixed to the inside of the socket at locations of soft-tissue loss are used with an existing interface pressure and shear stress measurement system and a custom, high-resolution, residual-limb scanner. The capabilities of the treatments to keep interface stresses consistent over both diurnal and 12-mo intervals, despite changes in residual limb shape, are determined and compared with no treatment. It is expected that for diurnal fluctuations: the fluid-filled cells perform better than the other treatments; the optimal cell fluid volume to keep interface stresses consistent matches the residual limb volume loss; and using the fluid cells distal limb movement in the socket is identical to that of the initial fit. For long-term changes, it is expected that both local material patches affixed to the inside of the socket and the fluid-filled cells are needed to stabilize interface stresses. To better understand the physiologic sources of residual limb shape change, residual limb extracellular water content, fluid transport, and tissue content are measured on a population of trans-tibial amputee subjects. It is expected that diurnal shrinkage reflects a slow loss of extracellular water over the course of the day. Long-term shrinkage, however, is expected to reflect a reduction in muscle tissue content. The health relatedness of this project is improvement in the quality of life of persons with amputated limbs. The development of methods to predict and overcome the detrimental effects of residual limb shape change and ultimately prevent soft-tissue breakdown will help to prevent secondary disability and morbidity in the amputee population.

描述（由申请人提供）：本申请的广泛、长期目标是开发预测和治疗昼夜和长期残肢形状变化的方法，以减少下肢截肢者皮肤破损的发生。具体目的是评估经胫骨截肢者在不同的接受腔修改治疗下的界面应力稳定性，这些治疗旨在克服形状变化引起的贴合问题。进一步的目标是更好地了解每日和长期形状变化的来源，并将其与残肢液体输送和可在临床评估中评估的其他患者组织特征相关联。为了实现控制体积的液体填充细胞的目标，将厚度均匀的插入物和在软组织损失位置处固定在接受腔内部的材料贴片与现有的界面压力和剪切应力测量系统以及定制的，高分辨率残肢扫描仪。尽管残肢形状发生变化，但治疗在每日和 12 个月的时间间隔内保持界面应力一致的能力已被确定，并与未治疗进行比较。预计对于昼夜波动：充满液体的细胞比其他处理表现更好；保持界面应力一致的最佳细胞液体积与残肢体积损失相匹配；并且使用流体细胞远端肢体在插座中的运动与初始配合的运动相同。对于长期变化，预计需要固定在插座内部的局部材料贴片和充满液体的单元来稳定界面应力。为了更好地了解残肢形状变化的生理来源，对一群经胫骨截肢者的残肢细胞外含水量、液体输送和组织含量进行了测量。预计昼夜收缩反映了一天中细胞外水的缓慢流失。然而，长期收缩预计反映了肌肉组织含量的减少。该项目的健康相关性是改善截肢者的生活质量。开发预测和克服残肢形状变化的有害影响并最终防止软组织破坏的方法将有助于预防截肢人群的继发性残疾和发病率。