Raasveld Floris V, Daddario Jenna, Liu Wen-Chih, Huang Dun-Wei, Cross Rachel E, Amin Karan, Graham Arthur, Crandell David, Hao David, Valerio Ian L, Eberlin Kyle R
From the Division of Plastic and Reconstructive Surgery, Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Hand and Arm Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Plast Reconstr Surg Glob Open. 2025 May 19;13(5):e6788. doi: 10.1097/GOX.0000000000006788. eCollection 2025 May.
Advances in surgery and prosthetic technology have improved limb control for amputation patients, but restoring sensory and proprioceptive feedback remains a challenge. This study evaluated the application of a vibrotactile sensory feedback device that aims at enhancing gait and reducing phantom limb pain (PLP) in lower extremity (LE) amputation patients who have undergone targeted muscle reinnervation (TMR).
Four male LE amputation patients, 25-68 years of age, who underwent primary TMR, were fitted with a vibrotactile device using pressure sensors located on the sole of the prosthesis and a vibrating actuator on the proximal LE. This device incorporates vibrational stimuli when walking in a prosthesis for real-time sensory and proprioceptive feedback. Participants used the device alongside their regular prosthesis for 31 days. Pain, function, mental health, and satisfaction metrics were assessed using the visual analog scale, patient-reported outcomes measurement information system surveys, and various gait tests at baseline and follow-up. Baseline demographic, surgery, and comorbidity data were collected from chart review.
Three of 4 patients reported reduction in PLP and improvements in gait and device satisfaction. One young patient, who was highly active, showed limited improvement compared with the others. One patient experienced a reduction in anxiety and depression.
The vibrotactile feedback device demonstrated potential in improving PLP and gait among LE amputation patients who underwent primary TMR. Patient activity levels and psychological factors likely play important roles in the clinical effectiveness of the device. Future studies should focus on personalizing interventions based on patient profiles and exploring long-term benefits.
手术和假肢技术的进步改善了截肢患者的肢体控制能力,但恢复感觉和本体感觉反馈仍然是一项挑战。本研究评估了一种旨在增强下肢(LE)截肢且已接受靶向肌肉神经再支配(TMR)患者的步态并减轻幻肢痛(PLP)的振动触觉感觉反馈装置的应用。
4名年龄在25 - 68岁之间、接受初次TMR的男性LE截肢患者,使用位于假肢鞋底的压力传感器和近端LE上的振动致动器,配备了一种振动触觉装置。该装置在使用假肢行走时结合振动刺激,以提供实时感觉和本体感觉反馈。参与者在31天内将该装置与他们的常规假肢一起使用。在基线和随访时,使用视觉模拟量表、患者报告结局测量信息系统调查以及各种步态测试来评估疼痛、功能、心理健康和满意度指标。通过病历审查收集基线人口统计学、手术和合并症数据。
4名患者中有3名报告PLP减轻,步态和装置满意度有所改善。1名活跃程度较高的年轻患者与其他患者相比改善有限。1名患者的焦虑和抑郁有所减轻。
振动触觉反馈装置在改善接受初次TMR的LE截肢患者的PLP和步态方面显示出潜力。患者的活动水平和心理因素可能在该装置的临床效果中发挥重要作用。未来的研究应侧重于根据患者情况进行个性化干预,并探索长期益处。