A Biofeedback Smart Cane to Reduce Knee Loading Associated with Osteoarthritis

生物反馈智能手杖可减少与骨关节炎相关的膝盖负荷

• 批准号: 9032838
• 负责人: Patrick Mark Aubin
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-01-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9032838
• 关键词: Activities of Daily Living; Adult; Affect; Age; Arthralgia; Biofeedback; Biomechanics; Body Weight; Canes; Caring; Contralateral; Data; Degenerative polyarthritis; Deterioration; Development; Device or Instrument Development; Disease Progression; Education; Effectiveness; Employment; Equilibrium; Foundations; Future; Gait; Generations; Goals; Health; Housing; Instruction; Joints; Knee; Knee Osteoarthritis; Knee joint; Knowledge; Laboratories; Lead; Measures; Mechanics; Medial; Medical; Methods; Pain; Patients; Phase; Prevalence; Protocols documentation; Quality of life; Recreation; Research; Risk; Severity of illness; Signal Transduction; Symptoms; System; Technology; Testing; Time; Training; United States; Veterans; Walking; Work; abstracting; base; community living; comparative efficacy; disability; experience; improved; instrument; joint destruction; joint function; knee pain; miniaturize; novel; patient population; prototype; public health relevance; sensor; tool; treatment strategy; vibration; Activities of Daily Living; Adult; Affect; Age; Arthralgia; Biofeedback; Biomechanics; Body Weight; Canes; Caring; Contralateral; Data; Degenerative polyarthritis; Deterioration; Development; Device or Instrument Development; Disease Progression; Education; Effectiveness; Employment; Equilibrium; Foundations; Future; Gait; Generations; Goals; Health; Housing; Instruction; Joints; Knee; Knee Osteoarthritis; Knee joint; Knowledge; Laboratories; Lead; Measures; Mechanics; Medial; Medical; Methods; Pain; Patients; Phase; Prevalence; Protocols documentation; Quality of life; Recreation; Research; Risk; Severity of illness; Signal Transduction; Symptoms; System; Technology; Testing; Time; Training; United States; Veterans; Walking; Work; abstracting; base; community living; comparative efficacy; disability; experience; improved; instrument; joint destruction; joint function; knee pain; miniaturize; novel; patient population; prototype; public health relevance; sensor; tool; treatment strategy; vibration

 DESCRIPTION (provided by applicant): Project Summary/Abstract Knee osteoarthritis (OA) is one of five leading causes of disability among adults. About 25% of people with knee OA have pain on walking and have difficulty doing major activities of daily living (ADLs) such as walking 1/4 mile, climbing stairs, or kneelin. Mechanical loading that occurs at the medial tibiofemoral knee joint is strongly associated with the development and progression of knee OA. The knee adduction moment is one measure of knee loading that is associated with medial compartment OA presence, radiographic disease severity, rate of progression, and the presence of OA symptoms. One conservative treatment method for OA patients is the prescription of a walking cane. Studies have shown cane use contralateral to the affected knee can significantly reduce the medial load experienced by the joint if proper cane loading is achieved. Proper cane loading implies the cane supports a substantial portion of one's body weight, e.g. 15% body weight. Recent work has shown that the greater the load placed on the cane the greater the resulting reduction in medial knee load. The importance of reducing the medial knee load is significant. For example, a 20% increase in peak KAM was shown to lead to a 6-fold increase in the risk of knee osteoarthritis over a six-year period. While walking canes can be effective if used correctly there is evidence that very few patients receive instruction on how to use a cane. Sixty seven percent of senior living community cane users self- prescribe their canes and 82% receive no education or demonstration from medical professionals. Therefore we propose that the development of a walking cane that is intuitive to use, encourages greater cane loading, and shown to be more effective at reduce knee loading than a conventional cane would be beneficial for the knee OA patient population. We aim to develop and validate a smart cane that can facilitate proper cane loading by guiding the user to maintain greater longitudinal forces through the cane. The smart cane uses real-time vibrotactile biofeedback to inform the user when proper cane load has been achieved. A first prototype of the smart cane has already been developed which signals the user via handle vibration when a specific cane load, expressed in terms of percent body weight has been applied to the cane. For this study, we propose to evaluate the smart cane in terms of the its ability to increase cane loading and decrease knee loading as compared to a conventional walking cane. Specifically, we aim to demonstrate that, 1) cane loading is greater when walking with a smart cane as compared to walking with a conventional cane and 2) the KAM is reduced when walking with a smart cane as compared to walking with a conventional cane. We hypothesis that H1) mean peak cane load when using a smart cane is greater than mean peak cane load when using a conventional cane, H2) mean peak KAM when using a smart cane is less than mean peak KAM when using a conventional cane, and that mean peak cane loading will be greater (H3.1) and KAM will be reduced (H3.2) when comparing regular cane use before and one week after smart cane practice. We believe that simple biofeedback technologies can be used to improve the efficacy of walking canes. Relaying cane force to the user in real-time may allow knee OA patients to more accurately and consistently load their walking cane to the appropriate level. This consistent long term proper cane use has the potential to result in persistent reduction of knee loading resulting in a decrease in knee pain and improved knee joint function. Developing more effective conservative treatment strategies that can slow the progression of joint deterioration would benefit those suffering from knee OA and improve their quality of life.

 描述（由申请人提供）： 项目摘要/摘要膝关节骨关节炎（OA）是成年人中残疾的五个主要原因之一。大约25％的膝盖OA的人在步行方面疼痛，并且很难进行日常生活的重大活动（ADL），例如步行1/4英里，爬楼梯或跪着。在胫骨膝关节内侧发生的机械负荷与膝骨OA的发育和进展密切相关。膝盖添加力矩是膝关节负荷的一种度量，与媒体隔室的存在，放射学疾病严重程度，进展率和OA症状的存在相关。 OA患者的一种保守治疗方法是行走甘蔗的处方。研究表明，如果达到适当的甘蔗载荷，则拐杖在受影响的膝盖对侧可以通过关节大大降低介质负荷体验。适当的甘蔗载荷意味着拐杖支撑着一个人体重的大部分，例如15％体重。最近的工作表明，放在拐杖上的负载越大，培养基膝盖负荷的减少越大。减少介质膝盖负荷的重要性很大。例如，在六年的时间内，峰峰峰峰增加了20％，膝关节骨关节炎的风险增加了6倍。虽然拐杖正确使用，但如果正确使用，则有证据表明，很少有患者收到有关如何使用拐杖的指导。有67％的高级生活社区拐杖使用者自行拐杖，有82％的人没有接受医疗专业人员的教育或示范。因此，我们建议，使用直观使用的步行甘蔗的发展，鼓励更大的甘蔗载荷，并证明比传统的甘蔗更有效地减少膝盖载荷对膝盖OA患者人群有益。我们旨在开发和验证可以通过引导用户通过拐杖维持更大的纵向力来促进适当甘蔗加载的智能甘蔗。智能甘蔗使用实时颤振生物反馈来通知用户何时达到适当的甘蔗负载。已经开发了智能甘蔗的第一个原型，当以体重百分比表示的特定甘蔗负载被应用于甘蔗时，该原型通过手柄振动向用户发出信号。对于这项研究，我们建议根据与常规步行拐杖相比，根据其增加甘蔗载荷和减少膝盖载荷的能力来评估智能甘蔗的能力。具体来说，我们的目的是证明，1）与传统的拐杖行走相比，用智能拐杖行走时的拐杖负载更大，而2）与智能甘蔗行走时，kaM降低了，而与传统的拐杖行走相比。我们假设H1）平均甘蔗负载，我们认为可以使用简单的生物反馈技术来改善有效的保守治疗策略，这些策略可以减缓联合定义的进展，这将使患有膝关节OA的人受益并改善其生活质量。