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Orthopedic and Rehabilitation Engineering

Orthopedic and Rehabilitation Engineering - Poster Session C

Poster K9 - EVALUATING THE EFFECTIVENESS OF AN ADVANCED VIBRATIONAL LINER PROTOTYPE

Friday, October 25, 2024

10:00 AM - 11:00 AM EST

Location: Exhibit Hall E, F & G

Presenting Author(s)

Norah Stivala

Undergraduate Student
University of Pittsburgh
Nazareth, Pennsylvania, United States

Primary Investigator(s)

Goeran Fiedler, PhD

Associate Professor
University of Pittsburgh
Pittsburgh, Pennsylvania, United States

Co-Author(s)

Kacey Roehrich, MRT

Biomedical Engineer
University of Pittburgh, United States

Introduction: Of the 185K people in the U.S. who have an amputation each year, 80% of them experience phantom limb pain (PLP) (Flor 2002, Amputee Coalition 2023). This phenomenon is when an amputee feels pain in the limb that is no longer present. This pain can be excruciating in some cases, so it is imperative that a successful therapy is procured. Currently, there are various therapies and treatments that have been used for PLP, but none of them have been greatly effective or beneficial for long-term use. For example, certain drugs such as antidepressants and opioids have been successful at combatting the pain, but these medications can be addictive and have other side effects (Kaur & Guan 2018).

Vibration therapy is an alternative way to treat PLP without harsh drugs. The goal of vibration therapy is to stimulate the nerves with a vibrational device and therefore distract the nerves from firing painful signals to the brain. A study was performed by T. Lundeberg in Sweden where mechanical vibratory stimulation was administered to a group of amputees to test the validity of vibration therapy to relieve PLP (Lundeberg 1985). 90% of the patients in the study claimed the “best pain-reducing effect was obtained when stimulation was applied with moderate pressure over a large area” (Lundeberg 1985). In our study, we have created a prosthetic liner with motors integrated within it to replicate this same effect (Perry et al 2023).

Materials and

Methods: This study aimed to enhance the performance of a patented vibrational liner prototype to make it more effective at combatting PLP (Perry et al 2023). To accomplish this, one transtibial and three transfemoral participants were recruited from the Prosthetics and Orthotics program at the University of Pittsburgh. Following an IRB approved protocol, the participants participated in motor placement testing where a small, cylindrical motor was placed at various posterior, anterior, lateral, and medial positions on their residual limb to determine sensitivity to vibration. The participants were asked to rate their sensitivity at each location on a scale from one to five to discover areas that might benefit from vibrational stimulation in the event of PLP. Following this collection of data, vibrational liner prototypes were created for each participant. The cylindrical motors were embedded into each liner at the areas recorded to be the most sensitive to vibration. Once the prototypes were created, the participants completed four, in-lab testing sessions to ensure no adverse effects were present. During these in-lab sessions, the participants activated the vibration in their liner for two ten-minute durations with a break in between. Positive results from this in-lab testing allowed the participants to take their prototype home with them to collect further data regarding the effectiveness of the vibrational liner.

Results, Conclusions, and Discussions: The motor placement testing showcased that four amputees with different levels of amputation have a similar area of sensitivity on their residual limbs. However, even with the motors placed at these sensitive areas within the liner, the participants still claimed to want more vibration to help ease phantom pain. In addition, the in-lab testing with the vibrational liners showcased there are no adverse effects of the liner when used for the two ten-minute durations with a break in between. The participants also experienced no discomfort from the liner after it was embedded with the vibrational motors. The effectiveness of the liner in combatting PLP is still being tested. There is more data forthcoming as the participants continue to use the prototype at home; although, the data collected so far from the at-home testing has been promising.

Establishing the effectiveness of the vibrational liner through this study will allow for a non-invasive and drug free way for amputees to treat their PLP. The aim is for the amputee to constantly wear the vibrational liner and be able to simply turn the liner on when they are experiencing phantom pain without disrupting their day. There is not a definitive way to know when the pain will come, so having the therapy to treat phantom pain within a liner would be a convenient way to relieve the pain. The amputee can then go about any daily activities even while experiencing PLP. In conclusion, liner-based vibration therapy may be a promising new way to mitigate PLP.

Acknowledgements (Optional): This project was supported by a Summer Undergraduate Research Internship stipend. I would like to thank Dr. Goeran Fiedler for directing me throughout this project and answering all of my questions along the way. I would also like to thank Bob Maguire for providing guidance and allowing me to utilize the Prosthetics and Orthotics lab to meet with participants. In addition, I would like to thank Kacey Roehrich for being my partner in this research. Finally, I would like to thank the participants for their time.