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

增强假肢界面：1/f 振动触觉插座刺激可提高经胫骨截肢者的适应性

• 批准号: 9011322
• 负责人: NIKOLAOS STERGIOU
• 金额: $ 42.54万
• 依托单位: UNIVERSITY OF NEBRASKA OMAHA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-24 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9011322
• 关键词: Acceleration; Address; Affect; Affinity; Amputation; Amputees; Ankle; Awareness; Biological; Complex; Detection; Deterioration; Development; Devices; Discipline; Elderly; Equilibrium; Esthesia; Exhibits; Feedback; Frequencies; Future; Gait; Health; Hour; Hypesthesia; Incidence; Individual; Intervention; Joints; Laws; Life; Limb Prosthesis; Limb structure; Locomotion; Lower Extremity; Measures; Mechanics; Mediation; Mental Health; Mosses; Movement; Neuropathy; Noise; Numbness; Output; Pattern; Performance; Peripheral Nervous System Diseases; Physiological; Planet Mars; Play; Population; Positioning Attribute; Prosthesis; Prosthetic rehabilitation; Quality of life; Research; Role; Science; Sensory; Signal Transduction; Skin; Stimulus; Structure; Surface; System; Tactile; Technology; Testing; Thigh structure; Time; Walking; base; clinically relevant; experience; falls; foot; graduate student; improved; improved functioning; infancy; innovation; interest; intervention effect; limb amputation; novel; physical conditioning; prosthesis control; prosthetic socket; public health relevance; residual limb; response; sensory feedback; theories; undergraduate student; vibration; ward

 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.

 描述（应用程序提供）：由于脚和脚踝等自然结构的丧失，具有下肢截肢的个体受损。这些结构在运动过程中与地面的互动中起着非常重要的作用。尽管假体可能解决肢体损失的功能赤字，但仍有感官不足仍有待解决。在患有周围神经病的个体中，这种感觉不足更为明显，并且是独立运动的重要障碍。这项研究的目的是调查开发的有针对性的干预措施，以解决这个正在进行的假体康复中的问题，结合了生物医学科学中的两个新兴概念。首先，通过增强神经病肢体神经病肢体的弱传统感觉信号，通过增强神经病的弱相似感官信号来改善外周神经病的人的平衡，从而有效地改善了脚表面，从而有效地改善了脚表面。其次，粉红色噪声（具有表现出幂律缩放的结构的信号为1/f，使振荡频率较小，f，放大器越大）已被证明在健康的运动系统的物理输出中无处不在。该项目的建议是通过假体插座进行亚阈值振动模拟 - 假肢和残留肢体之间的界面 - 特别是以这种结构的刺激形式，可能会更容易被人体接受，因为它会模仿没有脚和脚踝的“自然”信号。因此，该项目将确定通过跨腹膜上的假体插座应用的纤维状刺激引起的功能性能的变化。在研究的第一个PRT中，随机和粉红色的噪声刺激条件将与安静的站立和水平步行期间的无刺激条件进行比较，以隔离粉红色噪声结构在随机方面的影响。该研究的第二部分将通过检查扰动站立和在不平坦的地形上行走中的表现来研究干预对适应性的影响；在每种刺激条件下量化绩效的恶化会导致平衡挑战的增加。假设在阈值粉红色的噪声刺激的情况下，跨内向截肢器的性能和适应性将改善。这种简单且廉价的干预措施可能很容易被纳入假肢技术，以增强感觉并促进正常的功能，提高个人保持活跃的能力，并在较低的情况下保持健康和生活质量 肢体截肢。