Study of composite elastic elements for transfemoral prostheses: the MyLeg Project

In this thesis, the work on the design and realization of a semi-active foot prosthesis with variable stiffness system is presented. The final prosthesis was the result of a path started by the design of the elastic composite elements of an ESR prosthesis, a passive prosthetic device, generally prescribed to amputees with K3 and K4 of level of ambulation. The design of both the ESR prosthesis and the final variable stiffness prosthesis was carried out using a new systematic methodology of prosthesis design. This methodology has been developed and then presented in the same thesis by the author. Modelling and simulation techniques are illustrated step by step. With the variable stiffness prosthesis, the aim is to allow future users to perform more daily activities without being restricted by the conditions of the ground. It has been chosen to develop a semi-active prosthesis rather than a bionic foot for two main reasons: a bionic foot may be too expensive for most future users; and a bionic foot may be undesirable for too much weight; the much weight can be due to the motor and batteries, in addition to the structure that will certainly be much more complex than the structure of a semi-active prosthesis. To investigate the effectiveness of the variable stiffness, human subjects with amputees will be carried out

Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction

The human–prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human–prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.N/

Biomechanics of Prosthetic Knee Systems : Role of Dampening and Energy Storage Systems

One significant drawback of the commercial passive and microprocessored prosthetic devices, the inability of delivering positive energy when needed, is due to the absence of the knee flexion during stance phase. Moreover, consequences such as circumduction and disturbed gait pattern take place due to the improper energy flow at the knee and the absence of the positive energy delivery during the swing phase. Current generation powered design has solved these problems by delivering the needed energy with heavy battery demanding motors, which increase the mass of the device significantly. Hence, the gait quality of transfemoral amputees has not improved significantly in the last 50 years due to the inefficient energy flow distribution causing the patient to hike his/her pelvis, which leads to back pain in the long run. In this context, state-of-art prosthetics technology is trending toward creating energy regenerative devices, which are able to harvest/ return energy during ambulation by a spring mechanism, since a spring not only permits significant power demand reduction but also provides high power-to-weight ratio. This study will examine the sagittal plane knee moment versus knee flexion angle properties robotically, clinically and theoretically to explore the functional stiffness of a healthy knee as well as a prosthetic knee during the energy return and harvest phases of gait. With this intention, a prosthetic knee test method will be developed for investigating the torque-angle properties of the knee by iteratively modifying the hip trajectory until achieving the closest to healthy knee biomechanics by a 3-Degree of Freedom (DOF) Simulator. This research reveals that constant spring stiffness is suboptimal to varying gait requirements for different types of activity, due to the variability of the power requirements of the knee caused by the passive, viscous and elastic characteristics and the activation dependent properties of the muscles. Exploring this variation is crucial for the design of tran

Biomechanics of Prosthetic Knee Systems : Role of Dampening and Energy Storage Systems

One significant drawback of the commercial passive and microprocessored prosthetic devices, the inability of delivering positive energy when needed, is due to the absence of the knee flexion during stance phase. Moreover, consequences such as circumduction and disturbed gait pattern take place due to the improper energy flow at the knee and the absence of the positive energy delivery during the swing phase. Current generation powered design has solved these problems by delivering the needed energy with heavy battery demanding motors, which increase the mass of the device significantly. Hence, the gait quality of transfemoral amputees has not improved significantly in the last 50 years due to the inefficient energy flow distribution causing the patient to hike his/her pelvis, which leads to back pain in the long run. In this context, state-of-art prosthetics technology is trending toward creating energy regenerative devices, which are able to harvest/ return energy during ambulation by a spring mechanism, since a spring not only permits significant power demand reduction but also provides high power-to-weight ratio. This study will examine the sagittal plane knee moment versus knee flexion angle properties robotically, clinically and theoretically to explore the functional stiffness of a healthy knee as well as a prosthetic knee during the energy return and harvest phases of gait. With this intention, a prosthetic knee test method will be developed for investigating the torque-angle properties of the knee by iteratively modifying the hip trajectory until achieving the closest to healthy knee biomechanics by a 3-Degree of Freedom (DOF) Simulator. This research reveals that constant spring stiffness is suboptimal to varying gait requirements for different types of activity, due to the variability of the power requirements of the knee caused by the passive, viscous and elastic characteristics and the activation dependent properties of the muscles. Exploring this variation is crucial for the design of tran

Portable haptic device for lower limb amputee gait feedback: Assessing static and dynamic perceptibility

Loss of joints and severed sensory pathway cause reduced mobility capabilities in lower limb amputees. Although prosthetic devices attempt to restore normal mobility functions, lack of awareness and control of limb placement increase the risk of falling and causing amputee to have high level of visual dependency. Haptic feedback can serve as a cue for gait events during ambulation thus providing sense of awareness of the limb position. This paper presents a wireless wearable skin stretch haptic device to be fitted around the thigh region. The movement profile of the device was characterized and a preliminary work with able-bodied participants and an above-knee amputee to assess the ability of users to perceive the delivered stimuli during static and dynamic mode is reported. Perceptibility was found to be increasing with stretch magnitude. It was observed that a higher magnitude of stretch was needed for the stimuli to be accurately perceived during walking in comparison to static standing, most likely due to the intense movement of the muscle and increased motor skills demand during walking activity

Biomechatronics: Harmonizing Mechatronic Systems with Human Beings

This eBook provides a comprehensive treatise on modern biomechatronic systems centred around human applications. A particular emphasis is given to exoskeleton designs for assistance and training with advanced interfaces in human-machine interaction. Some of these designs are validated with experimental results which the reader will find very informative as building-blocks for designing such systems. This eBook will be ideally suited to those researching in biomechatronic area with bio-feedback applications or those who are involved in high-end research on manmachine interfaces. This may also serve as a textbook for biomechatronic design at post-graduate level

Designing and Modeling a Fail-Safe Mechanism to Be Used in Attachment of a Transcutaneous Femoral Implant to a Prosthetic Device

Amputations are quite common and even modern prosthetic devices are plagued by problems. There are approximately 2 million people living with limb loss in the U.S. and on average 185,000 amputations occur yearly. Common attachment mechanisms for external prosthetic components to a residual limb, that is, sockets, pose numerous challenges. Issues include skin irritation, discomfort, socket fit issues, and immobility. Issues include skin irritation, discomfort, socket fit issues, and immobility. Transcutaneous implants have great potential as a connection method for external prosthetic components to a residual limb but because the implants are typically solid, they correlate to extremely high infection rates at the skin interface. Only one such system is FDA-approved but is inadequate due to its corresponding high infection rates and suboptimal fail-safe mechanism. Highly porous transcutaneous technology potentially offers a solution to this problem via providing a permanent mounting point that bridges the skin and soft tissues while being anchored in the bone. However, a porous metal transcutaneous implant cannot be properly employed until a highly effective safety mechanism is engineered that prevents damage to the residual bone of the user when accidental loads are applied. Existing products on the market lack optimized fail-safe devices. A fail-safe mechanism is essential to release the prosthesis in both falls and more extreme circumstances, such as the device becoming caught, to prevent injury to the prosthetic device and the user’s residual skeleton and surrounding tissues. Hence, the present work, including manual calculations, finite element analysis, and mechanical testing, was undertaken to develop an optimized fail-safe mechanism to be incorporated into a porous metal transcutaneous implant system

Emulation of Ankle Function for Different Gaits through Active Foot Prosthesis: Actuation Concepts, Control and Experiments

A main effort has been devoted in this thesis to consider the effects of the actuator components (i.e. springs, dampers and motors) and their configuration (i.e. the way they are assembled) in power and energy requirement of powered foot prostheses. It has been investigated which actuation mechanism would have the least requirements to perform a certain human gait (e.g. walking, running, ascending or descending the stairs). This thesis shows that the components of the robotic foot and their configurations are important design factors. This information is fundamental for building mechanical prototypes of active foot prostheses. In addition, the human body is equipped with muscle assemblies to actuate a joint. In robotics this phenomenon is called over-actuation. In this thesis, it was investigated if and how this fact could be used to reduce power-energy requirements in active foot prosthesis. Furthermore, the control structures of the active foot prostheses are investigated and discussed and the results of the first laboratory experiments with the Powered Ankle Knee Ortho-prosthesis (the PAKO platform) are explained. In continuation to this topic, some master controller schemes were introduced for gait identification. A video of experiments with PAKO platform can be seen here: https://www.youtube.com/watch?v=i7N3L6RsNN

Use of stance control knee-ankle-foot orthoses : a review of the literature

The use of stance control orthotic knee joints are becoming increasingly popular as unlike locked knee-ankle-foot orthoses, these joints allow the limb to swing freely in swing phase while providing stance phase stability, thus aiming to promote a more physiological and energy efficient gait. It is of paramount importance that all aspects of this technology is monitored and evaluated as the demand for evidence based practice and cost effective rehabilitation increases. A robust and thorough literature review was conducted to retrieve all articles which evaluated the use of stance control orthotic knee joints. All relevant databases were searched, including The Knowledge Network, ProQuest, Web of Knowledge, RECAL Legacy, PubMed and Engineering Village. Papers were selected for review if they addressed the use and effectiveness of commercially available stance control orthotic knee joints and included participant(s) trialling the SCKAFO. A total of 11 publications were reviewed and the following questions were developed and answered according to the best available evidence: 1. The effect SCKAFO (stance control knee-ankle-foot orthoses) systems have on kinetic and kinematic gait parameters 2. The effect SCKAFO systems have on the temporal and spatial parameters of gait 3. The effect SCKAFO systems have on the cardiopulmonary and metabolic cost of walking. 4. The effect SCKAFO systems have on muscle power/generation 5. Patient’s perceptions/ compliance of SCKAFO systems Although current research is limited and lacks in methodological quality the evidence available does, on a whole, indicate a positive benefit in the use of SCKAFOs. This is with respect to increased knee flexion during swing phase resulting in sufficient ground clearance, decreased compensatory movements to facilitate swing phase clearance and improved temporal and spatial gait parameters. With the right methodological approach, the benefits of using a SCKAFO system can be evidenced and the research more effectively converted into clinical practice

The effect of prefabricated wrist-hand orthoses on grip strength

Prefabricated wrist-hand orthoses (WHOs) are commonly prescribed to manage the functional deficit and compromised grip strength as a result of rheumatoid changes. It is thought that an orthosis which improves wrist extension, reduces synovitis and increases the mechanical advantage of the flexor muscles will improve hand function. Previous studies report an initial reduction in grip strength with WHO use which may increase following prolonged use. Using normal subjects, and thus in the absence of pain as a limiting factor, the impact of ten WHOs on grip strength was measured using a Jamar dynamometer. Tests were performed with and without WHOs by right-handed, female subjects, aged 20-50 years over a ten week period. During each test, a wrist goniometer and a forearm torsiometer were used to measure wrist joint position when maximum grip strength was achieved. The majority of participants achieved maximum grip strength with no orthosis at 30° extension. All the orthoses reduced initial grip strength but surprisingly the restriction of wrist extension did not appear to contribute in a significant way to this. Reduction in grip must therefore also be attributable to WHO design characteristics or the quality of fit. The authors recognize the need for research into the long term effect of WHOs on grip strength. However if grip is initially adversely affected, patients may be unlikely to persevere with treatment thereby negating all therapeutic benefits. In studies investigating patient opinions on WHO use, it was a stable wrist rather than a stronger grip reported to have facilitated task performance. This may explain why orthoses that interfere with maximum grip strength can improve functional task performance. Therefore while it is important to measure grip strength, it is only one factor to be considered when evaluating the efficacy of WHOs