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
• 负责人: Alena Grabowski
• 金额: --
• 依托单位: VA EASTERN COLORADO HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10641932
• 关键词: 3-Dimensional; Acceleration; Activities of Daily Living; Affect; Algorithms; Amputation; Applications Grants; Back Pain; Biological; Biomechanics; Clinical; Consumption; Data; Degenerative polyarthritis; Development; Diabetes Mellitus; Frequencies; Goals; Hip Osteoarthritis; Impairment; Individual; Injury; Knee Osteoarthritis; Leg; Length; Limb Prosthesis; Lower Extremity; Machine Learning; Measurement; Measures; Methods; Motion; Obesity; Outcome; Persons; Physical Function; Process; Prosthesis; Quality of life; Reaction; Rehabilitation therapy; Reporting; Research; Risk; Risk Reduction; System; Technology; Time; United States; Veterans; Visit; Visual; Walking; cost; cost efficient; experience; foot; functional independence; improved; indexing; limb amputation; novel; predictive modeling; prosthesis wearer; prosthetic alignment; prosthetic foot; reconstruction; sensor; sensor technology; tool; treadmill; wearable sensor technology; wireless; wireless sensor

Veterans with transtibial amputation require a prosthesis to walk and are at an increased risk of secondary injury, discomfort, and reduced quality of life. Proper prosthetic alignment can reduce these risks and improve functional ability and comfort in individuals with transtibial amputation. Currently, prosthetists (clinicians) subjectively align a prosthesis, and this may require several clinical visits. Subjective alignment relies on prosthetists’ experience and visual inspection of walking, which is prone to errors and time consuming. Thus, there is an urgent need to develop objective tools for prosthesis alignment. We aim to develop a novel method to [assess] prosthesis alignment accurately, precisely, and cost-efficiently using wireless sensor technology, which could improve quality of life and reduce secondary injury risk for the millions of prosthesis users in the United States. The goal of this study is to determine the accuracy and precision of using wearable sensors combined with an algorithm to assess prosthesis alignment in 10 Veterans with transtibial amputation. [We will ask 10 Veterans with transtibial amputation to walk on a force-treadmill at 1.25 m/s while they use a prosthesis with neutral alignment and that varies by 3° and 6° in one of three planes, the sagittal, coronal, and transverse planes, for a total of 13 prosthesis alignments. For each alignment condition, we will determine the accuracy and precision of using inertial measurement units (IMUs) combined with a numerical algorithm to estimate dynamic-to-static angle (DSA) of the prosthesis and the biological shank during walking in 10 Veterans with unilateral transtibial amputation (Aim 1), where DSA provides information regarding the orientation of the prosthesis and the biological shank. We will also determine the accuracy and precision of using IMUs combined with a numerical algorithm to estimate inter-limb symmetry indices of step length, step frequency, and contact time, which are important discrete temporal-spatial parameters during walking in 10 Veterans with unilateral transtibial amputation (Aim 2). We will compare results estimated using IMUs with results calculated using traditional gold-standard measurements of 3D motion capture and ground reaction forces. We will also investigate the association between angular changes in prosthesis alignment and DSA and interlimb symmetry indices (Aim 3).] We hypothesize that the IMU method will provide accurate (root- mean squared error [RMSE]<6°) and precise (inter-class correlation coefficient [ICC]>0.75) estimations of DSA for both legs and inter-limb symmetry indices (mean absolute percentage error [MAPE]<10%, ICC>0.75) of temporal-spatial parameters. We also hypothesize that changes in prosthesis alignment will result in significant differences in DSA using the IMU method and motion capture measurements. We hypothesize that changes in prosthesis alignment will result in significant differences in interlimb symmetry index of step length, step frequency, and ground contact time. [If our results suggest that the IMU method does not provide accurate and precise estimations of DSA or symmetry indices, we will consider using a more sophisticated prediction model (e.g. machine learning) to predict DSA using IMUs.] The outcome of our research is the development of a novel method that uses wireless IMU sensors to [assess] prosthesis alignment accurately (comparable accuracy with camera-based motion capture system and force plate ground reaction force system), quickly (within a single visit), and cost-efficiently (<$200). [We also expect that this project will provide data to support a larger grant proposal to conduct a study that investigates the relationship between prosthesis alignment and comfort level, walking symmetry, and secondary injury risk in Veterans with amputations.] In the long term, the proposed IMU method could improve the alignment process and thus maximize Veterans’ functional independence and quality of life, as well as reduce secondary injury risk.

具有跨置截肢的退伍军人需要假肢走路，并且有次要的风险增加 伤害，不适和生活质量降低。适当的假肢一致性可以降低这些风险并改善 跨性别者的功能能力和舒适性。目前，假肢主义者（临床医生） 主观对准依赖 假肢的经验和对步行的视觉检查，这很容易出现错误和耗时。那， 迫切需要开发客观的假体一致性工具。我们旨在开发一种新颖的方法 使用无线传感器技术，准确，精确，精确地评估假体对准， 这可以改善生活质量，并减少数百万假体使用者的继发性伤害风险 美国。这项研究的目的是确定使用可穿戴传感器的准确性和精度 结合算法，以评估10名跨性别截肢退伍军人的假体比对。 [我们将要求10名带有瞬态截肢的退伍军人在使用1.25 m/s的部队行程上行走 具有中性比对的假体，在三个平面之一中，矢状，冠状，冠状，冠 和横向平面，共有13个假体比对。对于每个对齐条件，我们将确定 使用惯性测量单元（IMU）与数值算法相结合的准确性和精度 估计假体和生物柄的动态到静态角度（DSA）10 具有单方面截肢截肢的退伍军人（AIM 1），DSA提供有关该信息的信息 假体和生物柄的方向。我们还将确定的准确性和精度 使用IMU与数值算法组合来估计步长的LIMB间对称指数，步骤 频率和接触时间，这是在10中行走过程中重要的离散临时空间参数 具有单方面截肢截肢的退伍军人（AIM 2）。我们将比较使用IMU估计的结果 结果使用3D运动捕获和地面反应的传统金标准测量值计算 力量。我们还将研究假体比对与DSA的角变化之间的关联 和Interlimb对称指数（AIM 3）。]我们假设IMU方法将提供准确的（root- 平均平方误差[RMSE] <6°）和精度（类间相关系数[ICC]> 0.75）的估计 双腿和LIMB对称指数的DSA（平均绝对百分比误差[MAPE] <10％，ICC> 0.75） 临时空间参数。我们还假设假体一致性变化将导致 使用IMU方法和运动捕获测量值的DSA有显着差异。我们假设 假体一致性的变化将导致跨越对称索引的显着差异 长度，步长频率和接地接触时间。 [如果我们的结果表明IMU方法不提供 DSA或对称指数的准确和精确估计，我们将考虑使用更复杂的 预测模型（例如机器学习）使用IMU预测DSA。] 我们研究的结果是开发了一种新方法，该方法使用无线IMU传感器来 [评估]准确的对准（与基于摄像机的运动捕获系统的准确性相当） 和力板地面反作用力系统），迅速（在一次访问中）和成本效益（<$ 200）。 [我们 还希望该项目将提供数据，以支持更大的赠款建议，以进行一项研究 调查假体一致性与舒适水平，步行对称性和 从长远来看，截肢的退伍军人的继发性伤害风险。 对齐过程，从而最大化退伍军人的职能独立性和生活质量，以及 降低继发伤害风险。