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.

进行小腿截肢的退伍军人需要假肢才能行走，并且继发性截肢的风险增加 受伤、不适和生活质量下降，正确的假肢对准可以减少这些风险并改善。 目前，假肢医师（临床医生）。 主观对准假体，这可能需要多次临床就诊。 假肢师的步行经验和目视检查，容易出错且耗时。 迫切需要开发用于假体对齐的客观工具，我们的目标是开发一种新方法。 使用无线传感器技术准确、精确且经济高效地[评估]假肢对准， 这可以提高数百万假肢使用者的生活质量并降低二次伤害风险 美国这项研究的目标是确定使用可穿戴传感器的准确性和精确度。 结合一种算法来评估 10 名进行胫骨截肢的退伍军人的假体对齐情况。 [我们将要求 10 名进行小腿截肢的退伍军人在力量跑步机上以 1.25 m/s 的速度行走，同时使用 具有中性对准的假体，在三个平面（矢状面、冠状面、 和横向平面，总共 13 个假体对齐 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度和精确度 估计 10 年内行走过程中假肢和生物柄的动静态角度 (DSA) 接受单侧胫骨截肢的退伍军人（目标 1），DSA 提供有关单侧胫骨截肢的信息 我们还将确定假体和生物柄的方向。 使用 IMU 结合数值算法来估计步长、步长的肢体间对称性指数 频率和接触时间，它们是步行过程中重要的离散时空参数 10 接受单侧胫骨截肢的退伍军人（目标 2）我们将使用 IMU 估计的结果与 使用 3D 动作捕捉和地面反应的传统黄金标准测量计算出的结果 我们还将研究假体对准角度变化与 DSA 之间的关联。 和肢体间对称性指数（目标 3）。] 我们认为 IMU 方法将提供准确的（根- 均方误差 [RMSE]<6°）和精确（类间相关系数 [ICC]>0.75）估计 双腿 DSA 和四肢间对称指数（平均绝对百分比误差 [MAPE]<10%，ICC>0.75） 我们还发现假体对齐的变化将导致 使用 IMU 方法和运动捕捉测量的 DSA 存在显着差异。 假肢对准的变化将导致肢体间对称性指数的显着差异 长度、步频和触地时间[如果我们的结果表明 IMU 方法没有提供。 为了准确和精确地估计 DSA 或对称性指数，我们将考虑使用更复杂的方法 使用 IMU 预测 DSA 的预测模型（例如机器学习）。] 我们的研究成果是开发了一种新方法，该方法使用无线 IMU 传感器来 [评估] 精确的假肢对准（与基于摄像头的运动捕捉系统的精度相当 和测力台地面反作用力系统）、快速（单次访问内）且经济高效（<200 美元）。 还期望该项目将提供数据来支持一项更大的赠款提案，以进行一项研究 研究假肢对齐与舒适度、行走对称性之间的关系，以及 截肢退伍军人的二次伤害风险。]从长远来看，所提出的 IMU 方法可以改善 协调过程，从而最大限度地提高退伍军人的功能独立性和生活质量，以及 减少二次伤害风险。