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Weathersby EJ, Garbini JL, Larsen BG, McLean JB, Vamos AC, Sanders JE. Automatic Control of Prosthetic Socket Size for People WithTranstibial Amputation: Implementation and Evaluation. IEEE Trans Biomed Eng 2020; 68:36-46. [PMID: 32386137 DOI: 10.1109/tbme.2020.2992739] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The purpose was to design, implement, and test a control system for a motor-actuated, cable-panel prosthetic socket that automatically maintains socket fit by continuous adjustment of the socket size. METHODS Sockets with motor-driven adjustable panels were fabricated for participants with transtibial amputation. A proportional-integral control system was implemented to adjust socket size based on Socket Fit Metric (SFM) data collected by an inductive sensor embedded within the socket wall. The sensed distance was representative of limb-to-socket distance. Testing was conducted with participants walking on a treadmill to characterize the system's capability to maintain a set point and to respond to a change in the set point. RESULTS Test results from 10 participants with transtibial amputation showed that the Integral of Absolute Error (IAE) to maintain a set point ranged from 0.001 to 0.046 mm with a median of 0.003 mm. When the set point was changed, IAE errors ranged from 0.001 to 0.005 mm, with a median of 0.003 mm. An IAE of 0.003 mm corresponded to approximately a 0.08% socket volume error, which was considered clinically acceptable. CONCLUSION The capability of the control system to maintain and respond to a change in set point indicates that it is ready for evaluation outside of the laboratory. SIGNIFICANCE Integration of the developed control system into everyday prostheses may improve quality of life of prosthesis users by relieving them of the burden of continually adjusting socket size to maintain fit.
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Li B, Xiang Q, Zhang X. The center of pressure progression characterizes the dynamic function of high-arched feet during walking. JOURNAL OF LEATHER SCIENCE AND ENGINEERING 2020. [DOI: 10.1186/s42825-019-0016-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The medial longitudinal arch height has an effect on kinetic parameters during gait and might be related to the risk of injury. For the assessment of foot structures, the center of pressure (COP) trajectory is a more reliable and practical parameter than plantar pressure. This study aimed to clarify the COP trajectory and velocity characteristics in the medial-lateral and anterior-posterior direction of individuals with a high-arched foot during barefoot walking.
Methods
Sixty-two healthy young adults were asked to walk over a Footscan pressure plate to record the COP parameters during the stance phase of walking.
Results
Compared to normal arched feet, the COP during forefoot contact and foot flat phases of high-arched feet shifted anteriorly (19.9 mm and 15.1 mm, respectively), and the mean velocity of COP in anterior-posterior direction decreased by 0.26 m/s and increased by 0.044 m/s during these two phases respectively.
Conclusions
The findings of this study suggest that the displacement and velocity of COP in anterior-posterior direction was different between high-arched and normal-arched subjects during barefoot walking, which can be used for the assessment of gait characteristics for high-arched individuals. The results of this study may provide insights into modifying clinical intervention for individuals with high-arched feet to enhance rehabilitation and prevent injuries and have implications for assessing the design of footwear and foot orthotics.
Graphical abstract
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Jin H, Xu R, Wang S, Wang J. Use of 3D-Printed Heel Support Insoles Based on Arch Lift Improves Foot Pressure Distribution in Healthy People. Med Sci Monit 2019; 25:7175-7181. [PMID: 31549689 PMCID: PMC6777389 DOI: 10.12659/msm.918763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background 3D-printed insoles are widely used. This study was conducted to test a customized three-dimensional (3D)-printed heel support insole based on arch lift and to investigate whether the pressure distribution on the sole was improved while maintaining foot function. Material/Methods The design was based on a 3D plantar contour scanning modeling technique. Thirty healthy male participants walked along a 10-m track under 3 self-controlled interventions. A customized 3D-printed heel support insole based on arch lift was inserted into the socks for the experimental condition A. For condition B, a customized 3D-printed heel-supporting insole was inserted into the socks, and a standardized pre-made heel-supporting insole was inserted into the socks as a control (condition C). We used the Footscan® pressure plate to measure the plantar parameters in the forefoot contact and foot flange phases in each condition. Results Compared with condition B and the control condition, the peak pressure under the heel was significantly lower in condition A (P<0.05), and the peak pressure in the midfoot region was not significantly increased (P>0.05). Conclusions The biomechanical properties of the customized 3D-printed heel support are better than those of the traditional heel support insole, especially when there is a need for an additional increase in heel height. Patients do not decrease midfoot motion function while using this customized insole.
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Affiliation(s)
- Hui Jin
- Department of Pain Medicine, Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Rui Xu
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Shuxin Wang
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Jincheng Wang
- Orthopedic Medical Center, Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
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Sinitski EH, Lemaire ED, Baddour N, Besemann M, Dudek N, Hebert JS. Maintaining stable transtibial amputee gait on level and simulated uneven conditions in a virtual environment. Disabil Rehabil Assist Technol 2019; 16:40-48. [DOI: 10.1080/17483107.2019.1629186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Emily H. Sinitski
- Ottawa Hospital Research Institute, Ottawa, Canada
- University of Ottawa, Department of Mechanical Engineering, Ottawa, Canada
| | - Edward D. Lemaire
- Ottawa Hospital Research Institute, Ottawa, Canada
- University of Ottawa, Faculty of Medicine, Ottawa, Canada
| | - Natalie Baddour
- University of Ottawa, Department of Mechanical Engineering, Ottawa, Canada
| | | | - Nancy Dudek
- University of Ottawa, Faculty of Medicine, Ottawa, Canada
| | - Jacqueline S. Hebert
- University of Alberta, Faculty of Medicine, Edmonton, Canada
- Glenrose Rehabilitation Hospital, Edmonton, Canada
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Glanzer EM, Adamczyk PG. Design and Validation of a Semi-Active Variable Stiffness Foot Prosthesis. IEEE Trans Neural Syst Rehabil Eng 2018; 26:2351-2359. [PMID: 30371376 DOI: 10.1109/tnsre.2018.2877962] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This paper presents the design and validation of a novel lower limb prosthesis called the variable stiffness foot (VSF), designed to vary its forefoot stiffness in response to user activity. The VSF is designed as a semi-active device that adjusts its stiffness once per stride during swing phases, in order to minimize size, mass, and power consumption. The forefoot keel is designed as an overhung composite beam, whose stiffness is varied by moving a support fulcrum to change the length of the overhang. Stiffness modulation is programmed in response to the gait characteristics detected through foot trajectory reconstruction based on an embedded inertial sensor. The prototype VSF has a mass of only 649 g including the battery, and a build height of 87 mm. Mechanical testing demonstrated a forefoot stiffness range of 10-32 N/mm for the prototype, a threefold range of stiffness variation. The stiffness range can be altered by changing the keel material or geometry. Actuation testing showed that the VSF can make a full-scale stiffness adjustment within three strides, and tracks moderate speed-driven variations within one swing phase. Human subjects testing demonstrated greater energy storage and return with lower stiffness settings. This capability may be useful for the modulating prosthesis energy return to better mimic human ankle function. Subjective feedback indicated clear perception by the subjects of contrasts among the stiffness settings, including interpretation of scenarios for which different settings may be beneficial. Future applications of the VSF include adapting stiffness to optimize stairs, ramps, turns, and standing.
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Koehler-McNicholas SR, Nickel EA, Barrons K, Blaharski KE, Dellamano CA, Ray SF, Schnall BL, Hendershot BD, Hansen AH. Mechanical and dynamic characterization of prosthetic feet for high activity users during weighted and unweighted walking. PLoS One 2018; 13:e0202884. [PMID: 30208040 PMCID: PMC6135372 DOI: 10.1371/journal.pone.0202884] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 08/12/2018] [Indexed: 11/19/2022] Open
Abstract
Many Service members and Veterans with lower-limb amputations have the potential for high function and the desire to resume physically demanding occupations that require them to carry heavy loads (e.g., military service, firefighters, farmers, ranchers, construction workers). However, it is currently unclear which prosthetic feet best accommodate heavy load carriage while also providing good overall function and mobility during unweighted activities. The main objective of this study was to investigate the ability of currently available prosthetic ankle-foot systems to accommodate weighted walking by examining the mechanical characteristics (i.e., forefoot stiffness) and dynamic function (i.e., rocker radius, effective foot length ratio, and late-stance energy return) of prosthetic feet designed for high activity users. Load versus deflection curves were obtained for nine prosthetic ankle-foot systems using a servohydraulic test frame and load cell. Effective roll-over shape characteristics and late-stance energy return measures were then obtained using quantitative gait analysis for three users with unilateral, transtibial amputation. Results from mechanical and dynamic testing showed that although forefoot stiffness varied across the nine feet investigated in this study, changes measured in roll-over shape radius and effective foot length ratio were relatively small in response to weighted walking. At the same time, prosthetic feet with more compliant forefoot keel structures appeared to provide more late-stance energy return compared to feet with stiffer forefoot keel structures. These results suggest that prosthetic ankle-foot systems with compliant forefoot keel structures may better accommodate weighted walking by reducing the metabolic cost of physically demanding activities. However, to more fully understand the biomechanical and functional implications of these results, other factors, such as the residual-limb strength of the user and the overall stiffness profile of the prosthetic foot, should also be considered.
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Affiliation(s)
- Sara R. Koehler-McNicholas
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Eric A. Nickel
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, United States of America
| | - Kyle Barrons
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, United States of America
| | - Kathryn E. Blaharski
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, United States of America
| | - Clifford A. Dellamano
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, United States of America
- Department of Biomedical Engineering, College of Engineering, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Samuel F. Ray
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | - Barri L. Schnall
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
| | - Brad D. Hendershot
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
- Department of Defense-Veterans Affairs Extremity Trauma and Amputation Center of Excellence, Bethesda, Maryland, United States of America
- Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | - Andrew H. Hansen
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, United States of America
- Program in Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
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Ba Duan Jin Preliminary Analysis of the Second Type of Plantar Pressure. PHYSICAL ACTIVITY AND HEALTH 2018. [DOI: 10.5334/paah.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Brandt A, Wen Y, Liu M, Stallings J, Huang HH. Interactions Between Transfemoral Amputees and a Powered Knee Prosthesis During Load Carriage. Sci Rep 2017; 7:14480. [PMID: 29101394 PMCID: PMC5670174 DOI: 10.1038/s41598-017-14834-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 10/17/2017] [Indexed: 11/29/2022] Open
Abstract
Machines and humans become mechanically coupled when lower limb amputees walk with powered prostheses, but these two control systems differ in adaptability. We know little about how they interact when faced with real-world physical demands (e.g. carrying loads). Here, we investigated how each system (i.e. amputee and powered prosthesis) responds to changes in the prosthesis mechanics and gravitational load. Five transfemoral amputees walked with and without load (i.e. weighted backpack) and a powered knee prosthesis with two pre-programmed controller settings (i.e. for load and no load). We recorded subjects' kinematics, kinetics, and perceived exertion. Compared to the no load setting, the load setting reduced subjects' perceived exertion and intact-limb stance time when they carried load. When subjects did not carry load, their perceived exertion and gait performance did not significantly change with controller settings. Our results suggest transfemoral amputees could benefit from load-adaptive powered knee controllers, and controller adjustments affect amputees more when they walk with (versus without) load. Further understanding of the interaction between powered prostheses, amputee users, and various environments may allow researchers to expand the utility of prostheses beyond simple environments (e.g. firm level ground without load) that represent only a subset of real-world environments.
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Affiliation(s)
- Andrea Brandt
- University of North Carolina, Joint Department of Biomedical Engineering, Chapel Hill, Raleigh, 27514, USA
- North Carolina State University, Joint Department of Biomedical Engineering, Chapel Hill, Raleigh, 27695, USA
| | - Yue Wen
- University of North Carolina, Joint Department of Biomedical Engineering, Chapel Hill, Raleigh, 27514, USA
- North Carolina State University, Joint Department of Biomedical Engineering, Chapel Hill, Raleigh, 27695, USA
| | - Ming Liu
- University of North Carolina, Joint Department of Biomedical Engineering, Chapel Hill, Raleigh, 27514, USA
- North Carolina State University, Joint Department of Biomedical Engineering, Chapel Hill, Raleigh, 27695, USA
| | - Jonathan Stallings
- North Carolina State University, Department of Statistics, Raleigh, 27695, USA
| | - He Helen Huang
- University of North Carolina, Joint Department of Biomedical Engineering, Chapel Hill, Raleigh, 27514, USA.
- North Carolina State University, Joint Department of Biomedical Engineering, Chapel Hill, Raleigh, 27695, USA.
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