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PhD M/FOptimization of prostheses to improve autonomy and daily life activities in lowerlimb amputee

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Français - Anglais

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General information

Reference : UMR5525-ROMCIM-007
Workplace : LA TRONCHE
Date of publication : Wednesday, July 31, 2019
Scientific Responsible name : Estelle PALLUEL
Type of Contract : PhD Student contract / Thesis offer
Contract Period : 36 months
Start date of the thesis : 1 October 2019
Proportion of work : Full time
Remuneration : 2 135,00 € gross monthly

Description of the thesis topic

Objectives :
Principal : To establish neural signatures for prosthesis adjustment, prosthetic gait improvement and detection of undesirable events.
Secondary :
- To improve physical activity in amputees by decreasing fatigability and discomfort associated with prosthesis use.
- To promote accessibility to sports such as skiing, biking, hiking by increasing the autonomy of these patients (e.g. distance, speed, wearing time of the prosthesis)

Description of the projet :
In France the number of lower limb amputees is estimated at about 130,000, with 8,000 new cases each year [1]. The adjustment of the prostheses is essentially based on the patient's comments, the visual analysis of the posture and locomotion with the prosthesis, and the clinical examination of the stump. One challenge is to find the best compromise between an efficient and comfortable walk [3]. The mechanical efficiency of the prosthesis is generally reached through strong tightening constraints of the socket around the stump while the comfort assumes a much more limited tightening. A more objective adjustment of the prostheses and the learning of a comfortable and effective prosthetic walk are key factors in the rehabilitation of the amputated patient, his return to independent walking, then his involvement in physical and sports activities (https://www.youtube.com/watch?v=MEWlh_AzBbY&feature=youtu.be&t=2s). The objectives of the project are:
1. To establish sensorimotor signatures from multi-sensor data to
a. Optimize and objectify the adjustments made by the orthoprothesists
b. Establish individual sensorimotor signatures to define an efficient and comfortable walking with the prosthesis for each patient. These signatures can then be used as feedbacks for the rehabilitation of walking
c. To detect and predict the occurrence of undesirable events (injuries, bedsores, etc ...).
2. To propose specifications of a connected prosthesis that wil define
a. The minimum set of sensors to be installed on the prosthesis and / or the patient
b. The indicators of performance and comfort to be achieved
c. The sensorimotor feedbacks to be presented to the patient and the orthoprothesists for the learning, the improvement walking, and the practice of physical activity.

The sensorimotor signatures will be established from the fusion of real-time analysis data of healthy and amputated lower limb movements (inertial units) and the pressures exerted in the prosthetic socket (FSR sensors) in gait initiation, gait and running tasks. This approach might be extended to other physical and sports activities such as cycling, skiing, etc.

To fulfill these objectives, the project will be carried out on about fifty prosthetic volunteers recruited by Chabloz Orthopédie (https://www.chabloz-ortho.com/fr/). The aim is to develop a connected prosthesis prototype with a high recovery potential that can be jointly exploited by a start-up from the laboratory (https://www.linksium.fr/projet/ optimove /) and by Chabloz Orthopedics.

[1] P.L. Ephraim, S.T. Wegener, E.J. MacKenzie, et al., Phantom pain, residual limb pain, and back pain in amputees: Results of a national survey, Arch. Phys. Med. Rehabil. 86 (2005) 1910–1919.
[2] M.B. Silver-Thorn, J.W. Steege, D.S. Childress, A review of prosthetic interface stress investigations, J. Rehabil. Res. Dev. 33 (1996) 253–266.
[3] J.P. Pell, P.T. Donnan, F.G. Fowkes, et al., Quality of life following lower limb amputation for peripheral arterial disease., Eur. J. Vasc. Surg. 7 (1993) 448–451.

Work Context

The PhD student will be enrolled at Ecole Doctorale Ingénierie pour la santé la Cognition et l'Environnement (EDISCE : https://www.adum.fr/as/ed/edisce/page.pl)in the specialty "Mouvement et Comportement pour la santé et l'Autonomie (MCA)"

Constraints and risks

The experiments will be done at SPM and by Chabloz Orthopédie. The equipement is already available in the lab.

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