Torsional stiffness and user preference: lower limb amputee lab test

扭转刚度和用户偏好：下肢截肢者实验室测试

• 批准号: 9033047
• 负责人: Glenn Klute
• 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/9033047
• 关键词: Address; Adoption; Aging; American; Amputees; Articular Range of Motion; Behavior; Biomechanics; Clinic; Clinical; Clinical Trials; Conflict (Psychology); Crowding; Data; Development; Devices; Diabetes Mellitus; Equilibrium; Etiology; Exhibits; Fall injury; Feedback; Freedom; Future; Gait; Glare; Goals; Growth; Height; Home environment; Housing; Human; Incidence; Individual; Laboratories; Life; Limb Prosthesis; Limb structure; Literature; Lower Extremity; Mechanics; Metabolic; Middle East; Motion; Motor; National Research Council; One-Step dentin bonding system; Operative Surgical Procedures; Overweight; Patients; Performance; Play; Population; Process; Property; Prosthesis; Quality of life; Reporting; Research; Research Support; Role; Sampling; Scientist; Skin; Soft Tissue Injuries; Source; Speed; Surgeon; System; Technology; Testing; Toes; Torque; Torsion; United States; Veterans; Violence; Walking; War; Weight; World War II; abstracting; arm; clinically relevant; clinically significant; cooking; cost; design; disability; falls; human subject; improved; improved functioning; improved mobility; innovation; limb amputation; meetings; new technology; novel; preference; public health relevance; research study; residual limb; sensor; walking speed

 DESCRIPTION (provided by applicant): Project Summary (Public Abstract) The violent conflict of war always results in amputees. After World War II, a team of well-known clinician scientists led by H. D. Eberhart examined the biomechanics of human gait and reported to the National Research Council Committee on Artificial Limbs, advisory to the Veterans Affairs and the Office of the Surgeon General of the United States Army, that transverse plane motions and their frictional effects "are a major source of discomfort and the chief cause of dissolution of the skin" in lower limb amputees. This was quite remarkable given the state-of-the-art of prosthetic limbs in 1947. Identifying a problem is one thing, solving it is another. Thirty years went by before Lamoureux and Radcliffe reported in 1977 that a greater degree of freedom in the transverse plane of the prosthesis might improve the changing of direction of ambulatory amputees. As our own research suggests that turning maneuvers comprise about 30% of daily steps, it is not too surprising that evidence in the literature reports the benefits of commercially-available torsion adapters to include improved walking performance, reduced metabolic costs, the potential to reduce residual limb soft tissue injuries, and improved balance and stability. While these devices are available for prescription, a glaring problem remains. None of the commercially-available transverse plane torsion adapters can be adjusted by the user. When patients are fit with these devices, the prosthetist sets the stiffness and that is it. The selected stiffness is expected to be adequate for all of an amputee's activities. To address this deficiency, we developed a novel prosthesis whose transverse plane stiffness can be adjusted by the user. The specific aims of the proposed research are to determine: (1) the preferred transverse plane stiffness and (2) the transverse plane stiffness that minimizes the transverse plane moment applied to the residual limb of Veteran lower limb amputees during different ambulatory activities at different speeds. We believe this research will significantly improve the function and quality of life of Veteran lower limb amputees. Developing new technology that allows the prosthetic limbs of Veteran amputees perform like a natural limb is where the VA should be: at the forefront of prosthetic technology and prescription practice.

 描述（由申请人提供）： 项目概要（公共摘要） 战争的暴力冲突总是导致截肢。 第二次世界大战后，由 H. D. Eberhart 领导的著名临床科学家团队研究了人类步态的生物力学，并向国家研究委员会人工肢体委员会报告。向退伍军人事务部和美国陆军军医长办公室提出的咨询意见指出，横向平面运动及其摩擦效应“是不适的主要原因，也是导致机体解散的主要原因”。下肢截肢者的“皮肤”。考虑到 1947 年假肢的最先进水平，这是相当了不起的。发现问题是一回事，解决问题是另一回事。三十年后，Lamoureux 和 Radcliffe 在 1977 年报告说，假肢横向平面的更大自由度可能会改善行走截肢者的方向改变，因为我们自己的研究表明，转动动作占日常动作的 30%。毫不奇怪，文献中的证据报告了市售扭转适配器的好处，包括改善行走性能、降低代谢成本、减少残肢软组织损伤的潜力以及改善平衡性和稳定性。可以通过处方获得， 明显的问题仍然存在。当患者安装这些装置时，用户无法调节市售的横向平面扭转适配器，假肢师会设置刚度，仅此而已。截肢者的 为了解决这一缺陷，我们开发了一种新型假体，其横向平面刚度可由用户调节。本研究的具体目标是确定：（1）首选横向平面刚度和（2）横向平面刚度。那 最大限度地减少退伍军人下肢截肢者在不同速度的不同行走活动中施加于残肢的横向平面力矩我们相信这项研究将显着改善退伍军人下肢截肢者的功能和生活质量开发允许假肢的新技术。退伍军人截肢者的表现就像自然肢体一样，这正是 VA 应该做到的：处于假肢技术和处方实践的最前沿。