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Design of a Semi-Powered Stance-Control Swing-Assist Transfemoral Prosthesis.

ABSTRACT: This paper describes the design of a new type of knee prosthesis called a stance-control, swing-assist (SCSA) knee prosthesis. The device is motivated by the recognition that energetically-passive stance-controlled microprocessor-controlled knees (SCMPKs) offer many desirable characteristics, such as quiet operation, low weight, high-impedance stance support, and an inertially-driven swing-phase motion. Due to the latter, however, SCMPKs are also highly susceptible to swing-phase perturbations, which can increase the likelihood of falling. The SCSA prosthesis supplements the behavior of an SCMPK with a small motor that maintains the low output impedance of the SCMPK swing state, while adding a supplemental closed-loop controller around it. This paper elaborates upon the motivation for the SCSA prosthesis, describes the design of a prosthesis prototype, and provides human-subject testing data that demonstrates potential device benefits relative to an SCMPK during both non-perturbed and perturbed walking.

SUBMITTER: Lee JT

PROVIDER: S-EPMC7977329 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Design of a Semi-Powered Stance-Control Swing-Assist Transfemoral Prosthesis.

Lee J T JT Bartlett H L HL Goldfarb M M

IEEE/ASME transactions on mechatronics : a joint publication of the IEEE Industrial Electronics Society and the ASME Dynamic Systems and Control Division 20191107 1

This paper describes the design of a new type of knee prosthesis called a stance-control, swing-assist (SCSA) knee prosthesis. The device is motivated by the recognition that energetically-passive stance-controlled microprocessor-controlled knees (SCMPKs) offer many desirable characteristics, such as quiet operation, low weight, high-impedance stance support, and an inertially-driven swing-phase motion. Due to the latter, however, SCMPKs are also highly susceptible to swing-phase perturbations, ...[more]

PMID: 33746502

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Project description:BackgroundTransfemoral amputees experience a complex host of physical, psychological, and social challenges, compounded by the functional limitations of current transfemoral prostheses. However, the specific relationships between human factors and prosthesis design and performance characteristics have not yet been adequately investigated. The present study aims to address this knowledge gap.MethodsA comprehensive single-cohort survey of 114 unilateral transfemoral amputees addressed a broad range of demographic and clinical characteristics, functional autonomy, satisfaction and attitudes towards their current prostheses, and design priorities for an ideal transfemoral prosthesis, including the possibility of active assistance from a robotic knee unit. The survey was custom-developed based on several standard questionnaires used to assess motor abilities and autonomy in activities of daily living, prosthesis satisfaction, and quality of life in lower-limb amputees. Survey data were analyzed to compare the experience (including autonomy and satisfaction) and design priorities of users of transfemoral prostheses with versus without microprocessor-controlled knee units (MPKs and NMPKs, respectively), with a subsequent analyses of cross-category correlation, principal component analysis (PCA), cost-sensitivity segmentation, and unsupervised K-means clustering applied within the most cost-sensitive participants, to identify functional groupings of users with respect to their design priorities.ResultsThe cohort featured predominantly younger (< 50 years) traumatic male amputees with respect to the general transfemoral amputee population, with pronounced differences in age distribution and amputation etiology (traumatic vs. non-traumatic) between MPK and NMPK groups. These differences were further reflected in user experience, with MPK users reporting significantly greater overall functional autonomy, satisfaction, and sense of prosthesis ownership than those with NMPKs, in conjunction with a decreased incidence of instability and falls. Across all participants, the leading functional priorities for an ideal transfemoral prosthesis were overall stability, adaptability to variable walking velocity, and lifestyle-related functionality, while the highest-prioritized general characteristics were reliability, comfort, and weight, with highly variable prioritization of cost according to reimbursement status. PCA and user clustering analyses revealed the possibility for functionally relevant groupings of prosthesis features and users, based on their differential prioritization of these features-with implications towards prosthesis design tradeoffs.ConclusionsThis study's findings support the understanding that when appropriately prescribed according to patient characteristics and needs in the context of a proactive rehabilitation program, advanced transfemoral prostheses promote patient mobility, autonomy, and overall health. Survey data indicate overall stability, modularity, and versatility as key design priorities for the continued development of transfemoral prosthesis technology. Finally, observed associations between prosthesis type, user experience, and attitudes concerning prosthesis ownership suggest both that prosthesis characteristics influence device acceptance and functional outcomes, and that psychosocial factors should be specifically and proactively addressed during the rehabilitation process.

Project description:Regular use of prostheses is critical for individuals with lower limb amputations to achieve everyday mobility, maintain physical and physiological health, and achieve a better quality of life. Use of prostheses is influenced by numerous factors, with prosthetic design playing a critical role in facilitating mobility for an amputee. Thus, prostheses design can either promote biomechanically efficient or inefficient gait behavior. In addition to increased energy expenditure, inefficient gait behavior can expose prosthetic user to an increased risk of secondary musculoskeletal injuries and may eventually lead to rejection of the prosthesis. Consequently, researchers have utilized the technological advancements in various fields to improve prosthetic devices and customize them for user specific needs. One evolving technology is powered prosthetic components. Presently, an active area in lower limb prosthetic research is the design of novel controllers and components in order to enable the users of such powered devices to be able to reproduce gait biomechanics that are similar in behavior to a healthy limb. In this case series, we studied the impact of using a powered knee-ankle prostheses (PKA) on two transfemoral amputees who currently use advanced microprocessor controlled knee prostheses (MPK). We utilized outcomes pertaining to kinematics, kinetics, metabolics, and functional activities of daily living to compare the efficacy between the MPK and PKA devices. Our results suggests that the PKA allows the participants to walk with gait kinematics similar to normal gait patterns observed in a healthy limb. Additionally, it was observed that use of the PKA reduced the level of asymmetry in terms of mechanical loading and muscle activation, specifically in the low back spinae regions and lower extremity muscles. Further, the PKA allowed the participants to achieve a greater range of cadence than their predicate MPK, thus allowing them to safely ambulate in variable environments and dynamically control speed changes. Based on the results of this case series, it appears that there is considerable potential for powered prosthetic components to provide safe and efficient gait for individuals with above the knee amputation.

Dataset Information

Design of a Semi-Powered Stance-Control Swing-Assist Transfemoral Prosthesis.

Publications

Design of a Semi-Powered Stance-Control Swing-Assist Transfemoral Prosthesis.

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