1
|
Cortino RJ, Best TK, Gregg RD. Data-Driven Phase-Based Control of a Powered Knee-Ankle Prosthesis for Variable-Incline Stair Ascent and Descent. IEEE TRANSACTIONS ON MEDICAL ROBOTICS AND BIONICS 2024; 6:175-188. [PMID: 38304755 PMCID: PMC10829527 DOI: 10.1109/tmrb.2023.3328656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Powered knee-ankle prostheses can offer benefits over conventional passive devices during stair locomotion by providing biomimetic net-positive work and active control of joint angles. However, many modern control approaches for stair ascent and descent are often limited by time-consuming hand-tuning of user/task-specific parameters, predefined trajectories that remove user volition, or heuristic approaches that cannot be applied to both stair ascent and descent. This work presents a phase-based hybrid kinematic and impedance controller (HKIC) that allows for semi-volitional, biomimetic stair ascent and descent at a variety of step heights. We define a unified phase variable for both stair ascent and descent that utilizes lower-limb geometry to adjust to different users and step heights. We extend our prior data-driven impedance model for variable-incline walking, modifying the cost function and constraints to create a continuously-varying impedance parameter model for stair ascent and descent over a continuum of step heights. Experiments with above-knee amputee participants (N=2) validate that our HKIC controller produces biomimetic ascent and descent joint kinematics, kinetics, and work across four step height configurations. We also show improved kinematic performance with our HKIC controller in comparison to a passive microprocessor-controlled device during stair locomotion.
Collapse
Affiliation(s)
- Ross J Cortino
- Department of Robotics, University of Michigan, Ann Arbor, MI 48109
| | - T Kevin Best
- Department of Robotics, University of Michigan, Ann Arbor, MI 48109
| | - Robert D Gregg
- Department of Robotics, University of Michigan, Ann Arbor, MI 48109
| |
Collapse
|
2
|
Shi QQ, Yick KL, Wu J, Huang X, Tse CY, Chan MK. A Scientometric Analysis and Visualization of Prosthetic Foot Research Work: 2000 to 2022. Bioengineering (Basel) 2023; 10:1138. [PMID: 37892868 PMCID: PMC10604169 DOI: 10.3390/bioengineering10101138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
This study aims to highlight recent research work on topics around prosthetic feet through a scientometric analysis and historical review. The most cited publications from the Clarivate Analytics Web of Science Core Collection database were identified and analyzed from 1 January 2000 to 31 October 2022. Original articles, reviews with full manuscripts, conference proceedings, early access documents, and meeting abstracts were included. A scientometric visualization analysis of the bibliometric information related to the publications, including the countries, institutions, journals, references, and keywords, was conducted. A total of 1827 publications met the search criteria in this study. The related publications grouped by year show an overall trend of increase during the two decades from 2000 to 2022. The United States is ranked first in terms of overall influence in this field (n = 774). The Northwestern University has published the most papers on prosthetic feet (n = 84). Prosthetics and Orthotics International has published the largest number of studies on prosthetic feet (n = 151). During recent years, a number of studies with citation bursts and burst keywords (e.g., diabetes, gait, pain, and sensor) have provided clues on the hotspots of prosthetic feet and prosthetic foot trends. The findings of this study are based on a comprehensive analysis of the literature and highlight the research topics on prosthetic feet that have been primarily explored. The data provide guidance to clinicians and researchers to further studies in this field.
Collapse
Affiliation(s)
- Qiu-Qiong Shi
- Laboratory for Artificial Intelligence in Design, Hong Kong, China;
| | - Kit-Lun Yick
- Laboratory for Artificial Intelligence in Design, Hong Kong, China;
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Jinlong Wu
- College of Physical Education, Southwest University, Chongqing 400715, China;
| | - Xujia Huang
- School of Recreational Sports and Tourism, Beijing Sport University, Beijing 100084, China;
| | - Chi-Yung Tse
- Centre for Orthopaedic Surgery, Hong Kong, China;
| | - Mei-Ki Chan
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China;
| |
Collapse
|
3
|
Miramand L, Moisan G, Richard V, McFadyen BJ, Turcot K. Whole body movement strategies during sit-to-stand and stair ascent in individuals with a lower limb amputation: A systematic review. Clin Biomech (Bristol, Avon) 2022; 100:105811. [PMID: 36395552 DOI: 10.1016/j.clinbiomech.2022.105811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with a lower limb amputation use compensatory strategies during essential tasks such as sit-to-stand and stair ascent leading to secondary physical conditions. The ensuing biomechanical parameters outlining the motion strategies they put in place need to be identified and described. METHODS We searched three databases (Embase, IEEE Xplore and PubMed) for articles on the spatiotemporal, the kinematics and the kinetics that compared the amputated, the intact lower limbs, or the trunk of individuals with a unilateral transtibial or transfemoral amputation with the limbs of a control group. FINDINGS We found twenty articles. During sit-to-stand, individuals with a lower limb amputation increased the trunk inclination angle toward the intact lower limb, explaining higher ground reaction forces and peak knee sagittal power generation. During stair ascent, individuals with a lower limb amputation increased the stance phase duration on the intact lower limb. Moreover, individuals with a lower limb amputation increased both lower limbs hip extension moment and power, and the amputated lower limb knee extension moment. In both tasks, the individuals with a transfemoral amputation presented larger differences than those with transtibial compared to the control group. INTERPRETATION Both lower limbs intact joint moment and power were increased to compensate for the prosthesis passive joint and to ensure stability. Stair gait studies mainly focused on the lower limbs' biomechanical changes in the sagittal plane, while sit-to-stand studies focused on asymmetries without comparing the lower limbs independently. Better methodological descriptions are essential to enhance the external validity of previous results.
Collapse
Affiliation(s)
- Ludovic Miramand
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada; Faculty of Medicine, Département de kinésiologie, Université Laval, Québec, Canada.
| | - Gabriel Moisan
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada; Faculty of Medicine, Département de kinésiologie, Université Laval, Québec, Canada
| | - Vincent Richard
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada; Faculty of Medicine, Département de kinésiologie, Université Laval, Québec, Canada
| | - Bradford J McFadyen
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada; Faculty of Medicine, Département de réadaptation, Université Laval, Québec, Canada
| | - Katia Turcot
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada; Faculty of Medicine, Département de kinésiologie, Université Laval, Québec, Canada
| |
Collapse
|
4
|
Hahn A, Bueschges S, Prager M, Kannenberg A. The effect of microprocessor controlled exo-prosthetic knees on limited community ambulators: systematic review and meta-analysis. Disabil Rehabil 2022; 44:7349-7367. [PMID: 34694952 DOI: 10.1080/09638288.2021.1989504] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE The clinical benefits of microprocessor-controlled prosthetic knees (MPKs) in community ambulators have been well-established. A systematic review in limited community ambulators published in 2014 found benefits in safety, performance-based, and patient-reported outcomes. This work updates the previous analysis to the current state of the published evidence. METHODS Systematic review and meta-analysis of the effect of MPKs in limited community ambulators. RESULTS Thirteen research projects presented in 15 publications were identified. Overall validity was "high" in nine studies, "moderate" in three, and "low" in one. The literature described a total of 2366 patients, with 704 classified as limited community ambulators. The use of MPKs in limited community ambulators led to a reduction in falls (SMD g: -0.59; 95% confidence interval (CI) [-0.85, -0.32; I2=0%]), fear of falling (SMD g: 1.2; 95%CI [0.55, 1.85; I2=80%]), risk of falling as indicated by the TUG (SMD g: -0.45, 95%CI [-0.87, -0.02; I2=0%]), an improvement in mobility grade (0.51; 95%CI [0.47,0.55]), self-selected walking speed (SMD g: 0.47; 95%CI [0.14,0.81; I2=0%]), and patient-reported ambulation (MD 9.32; 95%CI [3.61, 15.02; I2=7%]), and utility (MD 7.76; 95%CI [2.05-13.47; I2=0%]). Other outcomes exhibited trends in favor of MPK use or remained insensitive. No outcome was identified favoring non-MPKs. CONCLUSIONS These results suggest that MPKs may be considered a valuable therapeutic option in limited community ambulators with a transfemoral amputation.Implications for rehabilitationAbove knee amputees may be treated with a large variety of artificial exo-prosthetic knee components.Microprocessor-controlled prosthetic knees have proven to be advantageous and cost effective for community ambulators.The current analysis shows similar effects in safety, mobility, and patient perception also for limited community ambulators.Microprocessor-controlled prosthetic knees are a viable therapeutic option for limited community ambulators.
Collapse
Affiliation(s)
- Andreas Hahn
- Otto Bock HealthCare Products GmbH, Vienna, Austria
| | - Simon Bueschges
- STAT-UP Statistical Consulting & Data Science GmbH, Munich, Germany
| | | | | |
Collapse
|
5
|
Hood S, Gabert L, Lenzi T. Powered Knee and Ankle Prosthesis with Adaptive Control Enables Climbing Stairs with Different Stair Heights, Cadences, and Gait Patterns. IEEE T ROBOT 2022; 38:1430-1441. [PMID: 35686286 PMCID: PMC9175645 DOI: 10.1109/tro.2022.3152134] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Powered prostheses can enable individuals with above-knee amputations to ascend stairs step-over-step. To accomplish this task, available stair ascent controllers impose a pre-defined joint impedance behavior or follow a pre-programmed position trajectory. These control approaches have proved successful in the laboratory. However, they are not robust to changes in stair height or cadence, which is essential for real-world ambulation. Here we present an adaptive stair ascent controller that enables individuals with above-knee amputations to climb stairs of varying stair heights at their preferred cadence and with their preferred gait pattern. We found that modulating the prosthesis knee and ankle position as a function of the user's thigh in swing provides toe clearance for varying stair heights. In stance, modulating the torque-angle relationship as a function of the prosthesis knee position at foot contact provides sufficient torque assistance for climbing stairs of different heights. Furthermore, the proposed controller enables individuals to climb stairs at their preferred cadence and gait pattern, such as step-by-step, step-over-step, and two-steps. The proposed adaptive stair controller may improve the robustness of powered prostheses to environmental and human variance, enabling powered prostheses to more easily move from the lab to the real-world.
Collapse
Affiliation(s)
- Sarah Hood
- Department of Mechanical Engineering and the Robotics Center at the University of Utah, Salt Lake City, UT 84112 USA
| | - Lukas Gabert
- Department of Mechanical Engineering and the Robotics Center at the University of Utah, Salt Lake City, UT 84112 USA
| | - Tommaso Lenzi
- Department of Mechanical Engineering and the Robotics Center at the University of Utah, Salt Lake City, UT 84112 USA
| |
Collapse
|
6
|
Thibaut A, Beaudart C, Maertens DE Noordhout B, Geers S, Kaux JF, Pelzer D. Impact of microprocessor prosthetic knee on mobility and quality of life in patients with lower limb amputation: a systematic review of the literature. Eur J Phys Rehabil Med 2022; 58:452-461. [PMID: 35148043 PMCID: PMC9987462 DOI: 10.23736/s1973-9087.22.07238-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Advanced technologies have made available the development of microprocessor prosthetic knee (MPK) to improve autonomy of patients with lower limb amputation. In the present systematic review, we aimed to evaluate the impact of the use of all types of MPK on patients' functional status and quality of life. EVIDENCE ACQUISITION We conducted this review according to the PRISMA Guidelines on Medline (via Ovid), Scopus and SportDiscuss. All identified articles were screened for their eligibility by two reviewers using Covidence software. The Cochrane Risk of Bias (RoB) or the NIH Quality Assessment Tool were used to assess the quality of the studies. EVIDENCE SYNTHESIS Eighteen articles were included in the present review (7 randomized controlled trials - RCT), 6 cross-sectional and 5 follow-up studies). Number of participants included varied from 20 to 602, protocols' length varied from a single session to 12 weeks of use of MPK. Taken together, MPK users compared to NMPK users tend to present better functional status and mobility. Quality of life was also positively impacted in MPK users. On the other hand, the superiority of more advanced MPKs such as the Genium® is less clear, especially given the improvements over time of other MPKs such as the C-leg® and the Rheo knee®. CONCLUSIONS Based on our results, while it is clear that MPKs outperform NMPKs both for functional status and quality of life, additional benefits of one MPK over another is less clear. Future studies are needed to clarify these aspects.
Collapse
Affiliation(s)
- Aurore Thibaut
- CNRF Department of Physical Medicine and Sports Traumatology, University Hospital of Liege, Liege, Belgium.,Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Charlotte Beaudart
- CNRF Department of Physical Medicine and Sports Traumatology, University Hospital of Liege, Liege, Belgium.,World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | | | - Sybille Geers
- Department of Physical Medicine and Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | - Jean-François Kaux
- CNRF Department of Physical Medicine and Sports Traumatology, University Hospital of Liege, Liege, Belgium
| | - Doriane Pelzer
- CNRF Department of Physical Medicine and Sports Traumatology, University Hospital of Liege, Liege, Belgium -
| |
Collapse
|
7
|
Cortino RJ, Bolívar-Nieto E, Best TK, Gregg RD. Stair Ascent Phase-Variable Control of a Powered Knee-Ankle Prosthesis. IEEE INTERNATIONAL CONFERENCE ON ROBOTICS AND AUTOMATION : ICRA : [PROCEEDINGS]. IEEE INTERNATIONAL CONFERENCE ON ROBOTICS AND AUTOMATION 2022; 2022:5673-5678. [PMID: 36061070 PMCID: PMC9432737 DOI: 10.1109/icra46639.2022.9811578] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Passive prostheses cannot provide the net positive work required at the knee and ankle for step-over stair ascent. Powered prostheses can provide this net positive work, but user synchronization of joint motion and power input are critical to enabling natural stair ascent gaits. In this work, we build on previous phase variable-based control methods for walking and propose a stair ascent controller driven by the motion of the user's residual thigh. We use reference kinematics from an able-bodied dataset to produce knee and ankle joint trajectories parameterized by gait phase. We redefine the gait cycle to begin at the point of maximum hip flexion instead of heel strike to improve the phase estimate. Able-bodied bypass adapter experiments demonstrate that the phase variable controller replicates normative able-bodied kinematic trajectories with a root mean squared error of 12.66° and 2.64° for the knee and ankle, respectively. The knee and ankle joints provided on average 0.39 J/kg and 0.21 J/kg per stride, compared to the normative averages of 0.34 J/kg and 0.21 J/kg, respectively. Thus, this controller allows powered knee-ankle prostheses to perform net positive mechanical work to assist stair ascent.
Collapse
Affiliation(s)
- Ross J Cortino
- Department of Electrical Engineering and Computer Science and the Robotics Institute, University of Michigan, Ann Arbor, MI 48109
| | - Edgar Bolívar-Nieto
- Department of Electrical Engineering and Computer Science and the Robotics Institute, University of Michigan, Ann Arbor, MI 48109
| | - T Kevin Best
- Department of Electrical Engineering and Computer Science and the Robotics Institute, University of Michigan, Ann Arbor, MI 48109
| | - Robert D Gregg
- Department of Electrical Engineering and Computer Science and the Robotics Institute, University of Michigan, Ann Arbor, MI 48109
| |
Collapse
|
8
|
Buffinton CM, Blaho RK, Bieryla KA. Biomechanics of Single Stair Climb With Implications for Inverted Pendulum Modeling. J Biomech Eng 2021; 143:1105245. [PMID: 33764410 DOI: 10.1115/1.4050639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Indexed: 11/08/2022]
Abstract
Step-by-step (SBS) stair navigation is used by those with movement limitations or lower-limb prosthetics and by humanoid robots. Knowledge of biomechanical parameters for SBS gait, however, is limited. Inverted pendulum (IP) models used to assess dynamic stability have not been applied to SBS gait. This study examined the ability of the linear inverted pendulum (LIP) model and a closed-form, variable-height inverted pendulum (VHIP) model to predict capture-point (CP) stability in healthy adults executing a single stair climb. A second goal was to provide baseline kinematic and kinetic data for SBS gait. Twenty young adults executed a single step onto stairs of two heights, while attached marker positions and ground reaction forces were recorded. opensim software determined body kinematics and joint kinetics. Trials were analyzed with LIP and VHIP models, and the predicted CP compared to the actual center-of-pressure (CoP) on the stair. Lower-limb joint moments were larger than those reported for step-over-step (SOS) stair gait. Leading knee rather than trailing ankle was dominant. Center-of-mass (CoM) velocity peaked at push-off. The VHIP model accounted for only slightly more than half of the forward progression of the vertical projection of the CoM and was not better than LIP predictions. This suggests that IP models are limited in modeling SBS gait, likely due to large hip and knee moments. The results from this study may also provide target values and strategies to aid design of lower-limb prostheses and powered exoskeletons.
Collapse
Affiliation(s)
| | - Roberta K Blaho
- Department of Biomedical Engineering, Bucknell University, One Dent Drive, Lewisburg, PA 17837
| | - Kathleen A Bieryla
- Shiley School of Engineering, University of Portland, 5000 N. Willamette Boulevard, Portland, OR 97203
| |
Collapse
|
9
|
Inoue K, Fukuda T, Wada T. A Control Method for Transfemoral Prosthetic Knees Based on Thigh Angular Motion .. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:6644-6647. [PMID: 31947365 DOI: 10.1109/embc.2019.8856490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To regain the locomotive ability in daily living, many prosthetic knee joint units have been developed for transfemoral amputees. Until now, several prosthetic knees have been developed for stair ascent as commercial products. Such microprocessor controlled knees are multifunctional, and they are able to realize many activities of daily living for transfemoral amputees. However, those prosthetic knees are very expensive, so they have not been widely adopted. The purpose of the present study was to develop a control method for transfemoral prosthetic knees that deals with variation of gait parameters within subjects. We made improvement on the control algorithm that we previously developed for level walking and stair ascending. To evaluate the newly proposed algorithm and threshold values, the database of the level walking was used. Although gait detection for the stance phase of stair ascending could not be evaluated because of absence of a database for stair ascent, the precision and recall of the gate detection algorithm for the stance phase and swing phase of level walking were increased.
Collapse
|