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（由申请人提供）：由于脚和脚踝等自然结构的丧失，下肢截肢者的感觉受损，尽管假肢可能会影响身体在运动过程中与地面的相互作用。尽管肢体丧失的功能缺陷尚未得到解决，但这种感觉缺陷在患有周围神经病变的个体中更为明显，并且是独立运动的重要障碍。本研究的目的是研究一种有针对性的干预措施。地址假肢康复中的这一持续存在的问题结合了生物医学科学中的两个新兴概念，首先，通过鞋垫施加到足底表面的亚阈值（难以察觉的）振动刺激已被证明可以有效改善人们与周围环境的平衡。其次，粉红噪声（其结构呈现幂律缩放 1/f 的信号，使得 1/f 的频率越小）。振动，f，振幅越大）已被证明在健康运动系统的生理输出中普遍存在，该项目建议通过假肢接受腔（假肢和残肢之间的接口）提供亚阈值振动刺激。特别是以粉红噪声的形式，这种结构的刺激可能更容易被身体接受，因为它模拟了缺席的脚和脚踝的“自然”信号，因此该项目将确定身体的变化。通过假肢接受腔施加振动触觉刺激诱导的经胫骨截肢者的功能表现在研究的第一个部分中，将随机和粉红噪声刺激条件与安静站立和水平行走期间的无刺激条件进行比较，以隔离振动触觉的影响。研究的第二部分将通过检查干扰站立和在不平坦地形上行走时的表现来研究干预对适应性的影响；量化每种刺激条件下由增加引起的表现恶化。据推测，在存在亚阈值粉红噪声刺激的情况下，跨胫骨截肢者的表现和适应性将得到改善，这种简单且廉价的干预措施将来可能很容易融入假肢技术中，以增强感觉并促进普遍收益。在功能上，提高个体在较低水平后保持活跃、保持健康和生活质量的能力 肢体放大。