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Teater RH, Zelik KE, McDonald KA. Biomechanical effects of adding an articulating toe joint to a passive foot prosthesis for incline and decline walking. PLoS One 2024; 19:e0295465. [PMID: 38758923 PMCID: PMC11101096 DOI: 10.1371/journal.pone.0295465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/23/2024] [Indexed: 05/19/2024] Open
Abstract
Walking on sloped surfaces is challenging for many lower limb prosthesis users, in part due to the limited ankle range of motion provided by typical prosthetic ankle-foot devices. Adding a toe joint could potentially benefit users by providing an additional degree of flexibility to adapt to sloped surfaces, but this remains untested. The objective of this study was to characterize the effect of a prosthesis with an articulating toe joint on the preferences and gait biomechanics of individuals with unilateral below-knee limb loss walking on slopes. Nine active prosthesis users walked on an instrumented treadmill at a +5° incline and -5° decline while wearing an experimental foot prosthesis in two configurations: a Flexible toe joint and a Locked-out toe joint. Three participants preferred the Flexible toe joint over the Locked-out toe joint for incline and decline walking. Eight of nine participants went on to participate in a biomechanical data collection. The Flexible toe joint decreased prosthesis Push-off work by 2 Joules during both incline (p = 0.008; g = -0.63) and decline (p = 0.008; g = -0.65) walking. During incline walking, prosthetic limb knee flexion at toe-off was 3° greater in the Flexible configuration compared to the Locked (p = 0.008; g = 0.42). Overall, these results indicate that adding a toe joint to a passive foot prosthesis has relatively small effects on joint kinematics and kinetics during sloped walking. This study is part of a larger body of work that also assessed the impact of a prosthetic toe joint for level and uneven terrain walking and stair ascent/descent. Collectively, toe joints do not appear to substantially or consistently alter lower limb mechanics for active unilateral below-knee prosthesis users. Our findings also demonstrate that user preference for passive prosthetic technology may be both subject-specific and task-specific. Future work could investigate the inter-individual preferences and potential benefits of a prosthetic toe joint for lower-mobility individuals.
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Affiliation(s)
- Rachel H. Teater
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States of America
| | - Karl E. Zelik
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States of America
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, United States of America
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, TN, United States of America
| | - Kirsty A. McDonald
- School of Health Sciences, University of New South Wales, Sydney, NSW, Australia
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Al-Haddad LA, Alawee WH, Basem A. Advancing task recognition towards artificial limbs control with ReliefF-based deep neural network extreme learning. Comput Biol Med 2024; 169:107894. [PMID: 38154161 DOI: 10.1016/j.compbiomed.2023.107894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023]
Abstract
In the rapidly advancing field of biomedical engineering, effective real-time control of artificial limbs is a pressing research concern. Addressing this, the current study introduces a pioneering method for augmenting task recognition in prosthetic control systems, combining a ReliefF-based Deep Neural Networks (DNNs) approach. This paper has leveraged the MILimbEEG dataset, a comprehensive rich source collection of EEG signals, to calculate statistical features of Arithmetic Mean (AM), Standard Deviation (SD), and Skewness (S) across various motor activities. Supreme Feature Selection (SFS), of the adopted time-domain features, was performed using the ReliefF algorithm. The highest scored DNN-ReliefF developed model demonstrated remarkable performance, achieving accuracy, precision, and recall rates of 97.4 %, 97.3 %, and 97.4 %, respectively. In contrast, a traditional DNN model yielded accuracy, precision, and recall rates of 50.8 %, 51.1 %, and 50.8 %, highlighting the significant improvements made possible by incorporating SFS. This stark contrast underscores the transformative potential of incorporating ReliefF, situating the DNN-ReliefF model as a robust platform for forthcoming advancements in real-time prosthetic control systems.
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Affiliation(s)
- Luttfi A Al-Haddad
- Training and Workshops Center, University of Technology- Iraq, Baghdad, Iraq.
| | - Wissam H Alawee
- Training and Workshops Center, University of Technology- Iraq, Baghdad, Iraq; Control and Systems Engineering Department, University of Technology- Iraq, Baghdad, Iraq
| | - Ali Basem
- Air Conditioning Engineering Department, Faculty of Engineering, Warith Al-Anbiyaa University, Iraq
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Wasser JG, Hendershot BD, Acasio JC, Dodd LD, Krupenevich RL, Pruziner AL, Miller RH, Goldman SM, Valerio MS, Senchak LT, Murphey MD, Heltzel DA, Fazio MG, Dearth CL, Hager NA. Exploring relationships among multi-disciplinary assessments for knee joint health in service members with traumatic unilateral lower limb loss: a two-year longitudinal investigation. Sci Rep 2023; 13:21177. [PMID: 38040780 PMCID: PMC10692131 DOI: 10.1038/s41598-023-48662-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 11/29/2023] [Indexed: 12/03/2023] Open
Abstract
Motivated by the complex and multifactorial etiologies of osteoarthritis, here we use a comprehensive approach evaluating knee joint health after unilateral lower limb loss. Thirty-eight male Service members with traumatic, unilateral lower limb loss (mean age = 38 yr) participated in a prospective, two-year longitudinal study comprehensively evaluating contralateral knee joint health (i.e., clinical imaging, gait biomechanics, physiological biomarkers, and patient-reported outcomes); seventeen subsequently returned for a two-year follow-up visit. For this subset with baseline and follow-up data, outcomes were compared between timepoints, and associations evaluated between values at baseline with two-year changes in tri-compartmental joint space. Upon follow-up, knee joint health worsened, particularly among seven Service members who presented at baseline with no joint degeneration (KL = 0) but returned with evidence of degeneration (KL ≥ 1). Joint space narrowing was associated with greater patellar tilt (r[12] = 0.71, p = 0.01), external knee adduction moment (r[13] = 0.64, p = 0.02), knee adduction moment impulse (r[13] = 0.61, p = 0.03), and CTX-1 concentration (r[11] = 0.83, p = 0.001), as well as lesser KOOSSport and VR-36General Health (r[16] = - 0.69, p = 0.01 and r[16] = - 0.69, p = 0.01, respectively). This longitudinal, multi-disciplinary investigation highlights the importance of a comprehensive approach to evaluate the fast-progressing onset of knee osteoarthritis, particularly among relatively young Service members with lower limb loss.
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Affiliation(s)
- Joseph G Wasser
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Brad D Hendershot
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA.
| | - Julian C Acasio
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
| | - Lauren D Dodd
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Rebecca L Krupenevich
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Alison L Pruziner
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
| | - Ross H Miller
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - Stephen M Goldman
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Michael S Valerio
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Lien T Senchak
- Department of Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Mark D Murphey
- Department of Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - David A Heltzel
- Department of Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Michael G Fazio
- Department of Diagnostic Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Christopher L Dearth
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Falls Church, VA, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Nelson A Hager
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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