? 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
|Effective start/end date||9/24/15 → 8/31/17|
- National Institutes of Health: $425,398.00
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