Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes

Ann M Simon, Kimberly A Ingraham, Nicholas P Fey, Suzanne B Finucane, Robert D Lipschutz, Aaron J Young, Levi J Hargrove, Ann M Simon, Kimberly A Ingraham, Nicholas P Fey, Suzanne B Finucane, Robert D Lipschutz, Aaron J Young, Levi J Hargrove

Abstract

Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Diagram of finite state machine…
Figure 1. Diagram of finite state machine for level ground walking.
Figure 2. Users (A) walking, (B) ascending…
Figure 2. Users (A) walking, (B) ascending a ramp, and (C) climbing stairs using the powered prosthesis.
Figure 3. Average prosthetic knee and ankle…
Figure 3. Average prosthetic knee and ankle joint kinematics and kinetics for each user.
Joint powers are normalized by the mass of the user wearing the powered prosthesis.

References

    1. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R (2008) Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil 89: 422–429.
    1. Schmalz T, Blumentritt S, Jarasch R (2002) Energy expenditure and biomechanical characteristics of lower limb amputee gait: the influence of prosthetic alignment and different prosthetic components. Gait Posture 16: 255–263.
    1. Ossur The POWER KNEE. . Accessed: May 21, 2014.
    1. Au S, Weber J, Herr H (2009) Powered ankle-foot prosthesis improves walking metabolic energy. IEEE Trans Robot 25: 51–66.
    1. Sup F, Varol HA, Mitchell J, Withrow TJ, Goldfarb M (2009) Preliminary Evaluations of a Self-Contained Anthropomorphic Transfemoral Prosthesis. IEEE ASME Trans Mechatron 14: 667–676.
    1. Bellman RD, Holgate MA, Sugar TG (2008) SPARKy 3: Design of an active robotic ankle prosthesis with two actuated degrees of freedom using regenerative kinetics. IEEE/RAS-EMBS International Conferernce on Biomedical Robotics and Biomechatronics. Scottsdale, AZ, USA.
    1. Sup F, Bohara A, Goldfarb M (2008) Design and Control of a Powered Transfemoral Prosthesis. Int J Rob Res 27: 263–273.
    1. Eilenberg MF, Geyer H, Herr H (2010) Control of a powered ankle-foot prosthesis based on a neuromuscular model. IEEE Trans Neural Syst Rehabil Eng 18: 164–173.
    1. Vallery H, van Asseldonk EH, Buss M, van der Kooij H (2009) Reference trajectory generation for rehabilitation robots: complementary limb motion estimation. IEEE Trans Neural Syst Rehabil Eng 17: 23–30.
    1. Au S, Berniker M, Herr H (2008) Powered ankle-foot prosthesis to assist level-ground and stair-descent gaits. Neural Netw 21: 654–666.
    1. Sup F, Varol HA, Mitchell J, Withrow TJ, Goldfarb M (2009) Self-Contained Powered Knee and Ankle Prosthesis: Initial Evaluation on a Transfemoral Amputee. IEEE Int Conf Rehabil Robot 2009: 638–644.
    1. Lawson B, Varol H, Huff A, Erdemir E, Goldfarb M (2012) Control of Stair Ascent and Descent with a Powered Transfemoral Prosthesis. IEEE Trans Neural Syst Rehabil Eng.
    1. Aldridge JM, Sturdy JT, Wilken JM (2012) Stair ascent kinematics and kinetics with a powered lower leg system following transtibial amputation. Gait Posture 36: 291–295.
    1. Goldfarb M, Lawson BE, Shultz AH (2013) Realizing the promise of robotic leg prostheses. Sci Transl Med 5: 210–215.
    1. Herr HM, Grabowski AM (2012) Bionic ankle-foot prosthesis normalizes walking gait for persons with leg amputation. Proc Biol Sci 279: 457–464.
    1. Sup F, Varol HA, Goldfarb M (2011) Upslope walking with a powered knee and ankle prosthesis: initial results with an amputee subject. IEEE Trans Neural Syst Rehabil Eng 19: 71–78.
    1. Rouse EJ, Hargrove LJ, Perreault EJ, Kuiken TA (2012) Estimation of human ankle impedance during walking using the Perturberator robot. IEEE International Conference on Biomedical Robotics and Biomechatronics. Rome, Italy.
    1. Fey NP, Simon AM, Young AJ, Hargrove LJ (2013) Knee swing-initiation and ankle plantar flexion control using an active prosthesis across walking speeds and users. Annual meeting of the American Society of Biomechanics. Omaha, NE.
    1. Datta D, Ariyaratnam R, Hilton S (1996) Timed walking test – an all-embracing outcome measure for lower-limb amputees? Clin Rehabil 10: 227–232.
    1. Gailey RS, Roach KE, Applegate EB, Cho B, Cunniffe B, et al. (2002) The amputee mobility predictor: an instrument to assess determinants of the lower-limb amputee's ability to ambulate. Arch Phys Med Rehabil 83: 613–627.
    1. McFadyen BJ, Winter DA (1988) An integrated biomechanical analysis of normal stair ascent and descent. J Biomech 21: 733–744.
    1. Winter DA (1990) Biomechanics and motor control of human movement. New York: A Wiley-Interscience Publication.
    1. Winter DA (1983) Energy generation and absorption at the ankle and knee during fast, natural, and slow cadences. Clin Orthop Relat Res: 147–154.
    1. Riener R, Rabuffetti M, Frigo C (2002) Stair ascent and descent at different inclinations. Gait Posture 15: 32–44.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa