1,530 research outputs found

    Transverse rotation and longitudinal translation during prosthetic gait - a literature review

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    Improved technology allows for more accurate gait analysis to increase awareness of nonoptimized prosthetic gait patterns and for the manufacture of sophisticated prosthetic components to improve nonoptimized gait patterns. However, prescriptions are often based on intuition rather than rigorous research findings for evidence-based practice. The number of studies found in the literature that are based on prosthetic research regarding transverse rotation and longitudinal translation is small when compared to topics regarding other types of movements. Some design criteria for prosthetic components described in those studies that permit transverse rotation and longitudinal translation can be found in current designs. However, little research has been conducted to establish their effectiveness on the gait parameters and residual limb. This literature review is an investigation into these motions between the socket and the prosthetic foot, with particular reference to gait characteristics and prosthetic design criteria

    The Effects of Prosthesis Inertial Properties on Prosthetic Knee Moment and Hip Energetics Required to Achieve Able-bodied Kinematics

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    There is a major need in the developing world for a low-cost prosthetic knee that enables users to walk with able-bodied kinematics and low energy expenditure. To efficiently design such a knee, the relationship between the inertial properties of a prosthetic leg and joint kinetics and energetics must be determined. In this paper, using inverse dynamics, the theoretical effects of varying the inertial properties of an above-knee prosthesis on the prosthetic knee moment, hip power, and absolute hip work required for walking with ablebodied kinematics were quantified. The effects of independently varying mass and moment of inertia of the prosthesis, as well as independently varying the masses of each prosthesis segment, were also compared. Decreasing prosthesis mass to 25% of physiological leg mass increased peak late-stance knee moment by 43% and decreased peak swing knee moment by 76%. In addition, it reduced peak stance hip power by 26%, average swing hip power by 76%, and absolute hip work by 22%. Decreasing upper leg mass to 25% of its physiological value reduced absolute hip work by just 2%, whereas decreasing lower leg and foot mass reduced work by up to 22%, with foot mass having the greater effect. Results are reported in the form of parametric illustrations that can be utilized by researchers, designers, and prosthetists. The methods and outcomes presented have the potential to improve prosthetic knee component selection, facilitate ablebodied kinematics, and reduce energy expenditure for users of low-cost, passive knees in developing countries, as well as for users of advanced active knees in developed countries.MIT Department of Physics Pappalardo Program (Fellowship)Massachusetts Institute of Technology. Public Service CenterMassachusetts Institute of Technology. Research Support CommitteeNational Science Foundation (U.S.). Graduate Research Fellowship (Grant 1122374)MIT Tata Center for Technology and Desig

    Bondgraph modelling and simulation of the dynamic behaviour of above-knee prostheses

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    A mathematical model was used to investigate the dynamic behaviour of an above-knee (AK) prosthesis in the swing phase and to analyse the influence of mass and mass distribution on the maximal stump load and the required energy. The model consists of a bondgraph model of the prosthesis and a “walking” model which predicts the walking velocity, step length and the femoral trajectory. Equipment was developed to measure the inertial properties of the components of the prosthesis. \ud \ud Through computer simulation, stickdiagrams of the swing phase and graphs of the variation with time of the hip and stump forces were obtained. It was found that for a normal AK prosthesis with a knee-lock mechanism the axial stump load is greatest at the beginning and at the end of the swing phase. At a walking velocity of 5 km/hr the maximum axial stump load amounts to 2.1 times the static weight of the prosthesis. \ud \ud The maximum axial stump force appeared to be almost directly proportional to the total mass of the prosthesis but independent of the mass distribution. The required energy also increased with the mass of the prosthesis but is' dependent on mass distribution. \ud \ud Because of their comparable weights the influence of the shoe is almost equal to the influence of the prosthetic foot. Thus lightweight shoes should be used with lightweight prosthetic feet in order to add to their advantages

    Kinetics in Individuals with Unilateral Transtibial Amputations Using Running-Specific Prostheses

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    Improvements in rehabilitation and prosthetic design are needed to help promote activities such as running that increase physical activity levels of individuals with lower extremity amputation (ILEA). However, effectively developing these improvements requires a detailed understanding of prosthetic and ILEA running biomechanics. Running-specific prostheses (RSPs) have been developed to improve running performance for ILEA runners, but altered running kinetics may still be necessary to accommodate for the loss of musculoskeletal function caused by lower extremity amputation. The few studies investigating ILEA running with RSPs focus on maximal performance, but our understanding of how ILEA using RSPs modulate kinetics to run at submaximal velocities remains limited. The purpose of this study was to characterize changes in kinetics and mechanical energy across a range of running velocities in ILEA wearing RSPs. This dissertation investigated six specific aims through six corresponding experiments that improve our knowledge of mechanical and anthropometric properties of RSPs and the kinetic profiles of ILEA running at submaximal velocities. Four common RSP designs were tested for mechanical and anthropometric properties. ILEA with unilateral transtibial amputations who wear RSPs and an able-bodied control group participated in the running experiments. Mechanical and anthropometric results indicated that RSP marker placement had little effect on joint kinetic estimations proximal to the prostheses, and trifilar pendulums can measure moments of inertia with <1% error. The running experiments provided the first 3D kinetic descriptions of ILEA running. The prosthetic limb typically generated lower peak kinetic parameters and 50% lower total mechanical work than the intact and control limbs, indicating a greater reliance on the intact limb. To counter the prosthetic limb deficiencies, ILEA increased stride frequencies compared to control subjects. Additionally, the prosthetic limb demonstrated prolonged periods of anterior ground reaction force to increase propulsive impulse and prolonged hip stance phase extension moments that generated increased hip concentric work. The data indicated that ILEA wearing RSPs run differently than able-bodied runners and use several adaptive mechanisms to run at the same velocity and to increase running velocity. These mechanisms are discussed and future directions of research are suggested

    Potential Optimal Gait Performance of Mauch S-N-S Prosthetic Knee Configurations as Predicted by Dynamic Modeling

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    Patients with prosthetic legs routinely suffer from abnormal gait patterns which can cause health issues and eventually lower the quality of their lives. Despite the half-century advance in the technology of prosthetic knees, from the purely mechanical to microprocessor controlled systems, patient testing suggests that very little progress has been made in the quality of the kinetics and kinematics of amputee gait. Moreover, the cost of microprocessor controlled prosthetic knees may be 10 times more than the purely mechanical knees. While prosthetic knees have become more complex and expensive, it is not proven that the prosthetic knee is a central factor limiting amputee patient gait. The goal of this project is to determine the degree to which the Mauch S-N-S prosthetic knee limits the ability of a subject to achieve a close to normal gait pattern. In this research, we developed dynamic models of the Mauch S-N-S prosthetic knee based on gait-like motion tests of a Mauch knee cylinder and used the dynamic models in computational simulations to determine the best achievable gait, on the basis of obtaining near-to-normal gait kinematics and kinetics. Idealized assumptions were made for patient performance capability and characteristics of the other prosthetic leg components, to obtain the desired focus on knee capabilities and limitations. The results indicate that even with this relatively old technology prosthetic knee, subjects have the potential to walk much more normally than the patient-test data indicates. An extension of the study showed the significant interaction of the prosthetic knee and ankle with respect to achieving optimal gait. The methodology of this study can be applied to evaluation other knees, prosthetic components and prosthetic systems combining these component

    An inverse dynamics model for the analysis, reconstruction and prediction of bipedal walking

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    Walking is a constrained movement which may best be observed during the double stance phase when both feet contact the floor. When analyzing a measured movement with an inverse dynamics model, a violation of these constrains will always occur due to measuring errors and deviations of the segments model from reality, leading to inconsistent results. Consistency is obtained by implementing the constraints into the model. This makes it possible to combine the inverse dynamics model with optimization techniques in order to predict walking patterns or to reconstruct non-measured rotations when only a part of the three-dimensional joint rotations is measured. In this paper the outlines of the extended inverse dynamics method are presented, the constraints which define walking are defined and the optimization procedure is described. The model is applied to analyze a normal walking pattern of which only the hip, knee and ankle flexions/extensions are measured. This input movement is reconstructed to a kinematically and dynamically consistent three-dimensional movement, and the joint forces (including the ground reaction forces) and joint moments of force, needed to bring about this movement are estimated

    Potential Optimal Gait Performance of Mauch S-N-S Prosthetic Knee Configurations as Predicted by Dynamic Modeling

    Get PDF
    Patients with prosthetic legs routinely suffer from abnormal gait patterns which can cause health issues and eventually lower the quality of their lives. Despite the half-century advance in the technology of prosthetic knees, from the purely mechanical to microprocessor controlled systems, patient testing suggests that very little progress has been made in the quality of the kinetics and kinematics of amputee gait. Moreover, the cost of microprocessor controlled prosthetic knees may be 10 times more than the purely mechanical knees. While prosthetic knees have become more complex and expensive, it is not proven that the prosthetic knee is a central factor limiting amputee patient gait. The goal of this project is to determine the degree to which the Mauch S-N-S prosthetic knee limits the ability of a subject to achieve a close to normal gait pattern. In this research, we developed dynamic models of the Mauch S-N-S prosthetic knee based on gait-like motion tests of a Mauch knee cylinder and used the dynamic models in computational simulations to determine the best achievable gait, on the basis of obtaining near-to-normal gait kinematics and kinetics. Idealized assumptions were made for patient performance capability and characteristics of the other prosthetic leg components, to obtain the desired focus on knee capabilities and limitations. The results indicate that even with this relatively old technology prosthetic knee, subjects have the potential to walk much more normally than the patient-test data indicates. An extension of the study showed the significant interaction of the prosthetic knee and ankle with respect to achieving optimal gait. The methodology of this study can be applied to evaluation other knees, prosthetic components and prosthetic systems combining these component

    Determination Of Optimal Counter-Mass Location In Active Prostheses For Transfemoral Amputees To Replicate Normal Swing

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    Transfemoral amputees suffer the loss of the knee and ankle joints, as well as partial or complete loss of many of the lower extremity muscle groups involved in ambulation. Recent advances in lower limb prostheses have involved the design of active, powered prosthetic knee and ankle-foot components capable of generating knee and ankle torques similar to that of normal gait. The associated onboard motors, conditioning/processing, and battery units of these active components result in increased mass of the respective prosthesis. While not an issue during stance, this increased mass of the prosthesis affects swing. The goal of this study is to develop and validate mathematical models of the transfemoral residual limb and prosthesis, expand these models to include an active ankle-foot, and investigate counter-mass magnitude(s) and location(s) via model optimization that might improve kinematic symmetry during swing. Single- (thigh only, shank only) and multi-segment (combined thigh and shank) optimization of counter-mass magnitudes and locations indicated that a 2.0 kg counter-mass added 8 cm distal and 10 cm posterior to the distal end of knee unit within the shank segment approximated knee kinematics of able-bodied subjects. This location, however, induced artificial hip torques that reduced hip flexion during swing. While such a counter-mass location and magnitude demonstrated theoretical potential, this location is not clinically realistic; mass can only be added within the prosthesis, distal to the residual limb. Clinically realistic counter-masses must also keep the total prosthetic mass to less than 5 kg; greater mass requires supplemental prosthetic suspension, would likely increase energy expenditure during ambulation, and contribute to increased likelihood of fatigue even with active prosthetic components. The ability to simulate the effects of active prosthetic components inclusive of varying placement of battery and signal conditioning units may advance the design of active prostheses that will minimize kinematic asymmetry and result in greater patient acceptance

    Biomechanical Assessment of Ertl and Burgess Transtibial Amputation Techniques

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    In this dissertation, a model was developed to predict the inertial properties of the shank and foot of persons with TTA and functional differences between Ertl and Burgess amputees during curb negotiation and the sit-to-stand tasks were evaluated. The developed inertial model was able to predict the shank and foot segment mass, COM location, and MOI more accurately than using the intact limb inertial properties. Used as inputs into inverse dynamics equations, the general model predictions produced joint moments which were also similar to the subject-specific measures. Thus, this model is a better predictor than the current method of using the intact limb inertial measures for the amputated limb. The second and third studies showed differences between the Ertl and Burgess amputated limbs in functional ability. During curb negotiation the Ertl amputated limb produced net limb work (sum of ankle, knee, and hip work) similar to that of the intact limbs of both groups on the curb step. This net limb work was produced by the hip early in stance phase as a compensatory mechanism to help propel the body forward. During the sit-to-stand task, the Ertl group was able to perform the task more quickly than the Burgess group. The faster performance time was due in part to larger ground reaction forces in the Ertl amputated limb compared to the Burgess amputated limb. This suggested the Ertl limb was able to bear higher loads overall during this task. While no other differences were found between the amputated limbs, the Ertl intact limb showed unexpected differences. Where the Burgess limbs and Ertl amputated limb adopted a hip strategy to complete the task, the Ertl intact limb adopted a knee strategy. This knee strategy is more similar to the way non-amputees complete the task. Both study 2 and 3 highlighted functional advantages of the Ertl procedure over the Burgess procedure for these tasks and is, to our knowledge, the first study of its kind. Based on these outcomes, it appears that the Ertl procedure does lead to better functional performance during prosthesis use, and further consideration should be given to using this procedure at the time of amputation. Future work needs to continue to focus on functional performance in both groups and begin to contrast the outcomes with post-operative risks following the amputation to better inform patients and clinicians about potential advantages of either technique

    The Effects of the Inertial Properties of Above-Knee Prostheses on Optimal Stiffness, Damping, and Engagement Parameters of Passive Prosthetic Knees

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    Our research aims to design low-cost, high-performance, passive prosthetic knees for developing countries. In this study, we determine optimal stiffness, damping, and engagement parameters for a low-cost, passive prosthetic knee that consists of simple mechanical elements and may enable users to walk with the normative kinematics of able-bodied humans. Knee joint power was analyzed to divide gait into energy-based phases and select mechanical components for each phase. The behavior of each component was described with a polynomial function, and the coefficients and polynomial order of each function were optimized to reproduce the knee moments required for normative kinematics of able-bodied humans. Sensitivity of coefficients to prosthesis mass was also investigated. The knee moments required for prosthesis users to walk with able-bodied normative kinematics were accurately reproduced with a mechanical system consisting of a linear spring, two constant-friction dampers, and three clutches (R[superscript 2]=0.90 for a typical prosthetic leg). Alterations in upper leg, lower leg, and foot mass had a large influence on optimal coefficients, changing damping coefficients by up to 180%. Critical results are reported through parametric illustrations that can be used by designers of prostheses to select optimal components for a prosthetic knee based on the inertial properties of the amputee and his or her prosthetic leg
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