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Golshan F, Baddour N, Gholizadeh H, Lemaire ED. A pelvic kinematic approach for calculating hip angles for active hip disarticulation prosthesis control. J Neuroeng Rehabil 2023; 20:152. [PMID: 37946313 PMCID: PMC10634065 DOI: 10.1186/s12984-023-01273-x] [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: 02/10/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Control system design for a microprocessor-controlled hip-knee-ankle-foot (HKAF) prosthesis is a challenge since hip disarticulation amputees lack the entire leg and, therefore, only have pelvis movement as user-guided input. This research proposes a method for determining hip joint angles from pelvis movement in a control system for the next generation of powered prostheses. METHOD Three-dimensional pelvic motion and stance time of 10 transfemoral (TF) prosthetic users were used to identify important features and to develop an algorithm to calculate hip angles from pelvis movement based on correlation and linear regression results. The algorithm was then applied to a separate (independent) TF group to validate algorithm performance. RESULTS The proposed algorithm calculated viable hip angles during walking by utilizing pelvic rotation, pelvic tilt, and stance time. Small angular differences were found between the algorithm results and motion capture data. The greatest difference was for hip maximum extension angle (2.5 ± 2.0°). CONCLUSIONS Since differences between algorithm output and motion data were within participant standard deviations, the developed algorithm could be used to determine the desired hip angle from pelvis movements. This study will aid the future development of gait control systems for new active HKAF prostheses.
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Affiliation(s)
- Farshad Golshan
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada.
| | - Natalie Baddour
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
| | - Hossein Gholizadeh
- Ottawa Hospital Research Institute, Centre for Rehabilitation Research and Development, Ottawa, Canada
| | - Edward D Lemaire
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Centre for Rehabilitation Research and Development, Ottawa, Canada
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Knight AD, Jayaraman C, Elrod JM, Schnall BL, McGuire MS, Sleeman TJ, Hoppe-Ludwig S, Dearth CL, Hendershot BD, Jayaraman A. Functional Performance Outcomes of a Powered Knee-Ankle Prosthesis in Service Members With Unilateral Transfemoral Limb Loss. Mil Med 2023; 188:3432-3438. [PMID: 35895305 DOI: 10.1093/milmed/usac231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/29/2022] [Accepted: 07/23/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Clinical knowledge surrounding functional outcomes of a powered knee-ankle (PKA) device is limited, particularly among younger and active populations with limb loss. Here, three service members (SM) with unilateral transfemoral limb loss received an optimally tuned PKA prosthesis and device-specific training. MATERIALS AND METHODS Once proficiency with the PKA device was demonstrated on benchmark activities, and outcomes with the PKA and standard-of-care (SoC) prostheses were obtained via a modified graded treadmill test, 6-minute walk test, and overground gait assessment. RESULTS All SM demonstrated proficiency with the PKA prosthesis within the minimum three training sessions. With the PKA versus SoC prosthesis, cost of transport during the modified graded treadmill test was 4.0% ± 5.2% lower at slower speeds (i.e., 0.6-1.2 m/s), but 7.0% ± 5.1% greater at the faster walking speeds (i.e., ≥1.4 m/s). For the 6-minute walk test, SM walked 83.9 ± 13.2 m shorter with the PKA versus SoC prosthesis. From the overground gait assessment, SM walked with 20.6% ± 10.5% greater trunk lateral flexion and 31.8% ± 12.8% greater trunk axial rotation ranges of motion, with the PKA versus SoC prosthesis. CONCLUSIONS Compared to prior work with the PKA in a civilian cohort, although SM demonstrated faster device proficiency (3 versus 12 sessions), SM walked with greater compensatory motions compared to their SoC prostheses (contrary to the civilian cohort). As such, it is important to understand patient-specific factors among various populations with limb loss for optimizing device-specific training and setting functional goals for occupational and/or community reintegration, as well as reducing the risk for secondary complications over the long term.
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Affiliation(s)
- Ashley D Knight
- Research & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD 20889, USA
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Department of Rehabilitation Medicine, Uniformed Services of the Health Sciences, Bethesda, MD 20814, USA
| | - Chandrasekaran Jayaraman
- Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL 60611, USA
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA
| | - Jonathan M Elrod
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Barri L Schnall
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Matt S McGuire
- Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL 60611, USA
| | - Todd J Sleeman
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Shenan Hoppe-Ludwig
- Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL 60611, USA
| | - Christopher L Dearth
- Research & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD 20889, USA
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Department of Surgery, Walter Reed National Military Medical Center-Uniformed Services of the Health Sciences, Bethesda, MD 20814, USA
| | - Brad D Hendershot
- Research & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD 20889, USA
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
- Department of Rehabilitation Medicine, Uniformed Services of the Health Sciences, Bethesda, MD 20814, USA
| | - Arun Jayaraman
- Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL 60611, USA
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL 60611, USA
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Shi QQ, Yick KL, Wu J, Huang X, Tse CY, Chan MK. A Scientometric Analysis and Visualization of Prosthetic Foot Research Work: 2000 to 2022. Bioengineering (Basel) 2023; 10:1138. [PMID: 37892868 PMCID: PMC10604169 DOI: 10.3390/bioengineering10101138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
This study aims to highlight recent research work on topics around prosthetic feet through a scientometric analysis and historical review. The most cited publications from the Clarivate Analytics Web of Science Core Collection database were identified and analyzed from 1 January 2000 to 31 October 2022. Original articles, reviews with full manuscripts, conference proceedings, early access documents, and meeting abstracts were included. A scientometric visualization analysis of the bibliometric information related to the publications, including the countries, institutions, journals, references, and keywords, was conducted. A total of 1827 publications met the search criteria in this study. The related publications grouped by year show an overall trend of increase during the two decades from 2000 to 2022. The United States is ranked first in terms of overall influence in this field (n = 774). The Northwestern University has published the most papers on prosthetic feet (n = 84). Prosthetics and Orthotics International has published the largest number of studies on prosthetic feet (n = 151). During recent years, a number of studies with citation bursts and burst keywords (e.g., diabetes, gait, pain, and sensor) have provided clues on the hotspots of prosthetic feet and prosthetic foot trends. The findings of this study are based on a comprehensive analysis of the literature and highlight the research topics on prosthetic feet that have been primarily explored. The data provide guidance to clinicians and researchers to further studies in this field.
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Affiliation(s)
- Qiu-Qiong Shi
- Laboratory for Artificial Intelligence in Design, Hong Kong, China;
| | - Kit-Lun Yick
- Laboratory for Artificial Intelligence in Design, Hong Kong, China;
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Jinlong Wu
- College of Physical Education, Southwest University, Chongqing 400715, China;
| | - Xujia Huang
- School of Recreational Sports and Tourism, Beijing Sport University, Beijing 100084, China;
| | - Chi-Yung Tse
- Centre for Orthopaedic Surgery, Hong Kong, China;
| | - Mei-Ki Chan
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China;
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Yuan J, Bai X, Driscoll B, Liu M, Huang H, Feng J. Standing and Walking Attention Visual Field (SWAVF) task: A new method to assess visuospatial attention during walking. APPLIED ERGONOMICS 2022; 104:103804. [PMID: 35635940 DOI: 10.1016/j.apergo.2022.103804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023]
Abstract
Visuospatial attention during walking has been associated with pedestrian safety and fall risks. However, visuospatial attention measures during walking remained under-explored. Current studies introduced a newly-developed Standing and Walking Visual Attention Field (SWAVF) task to assess visuospatial attention during walking and examined its reliability, validity, and stability. Thirty young adults completed a traditional computerized Attention Visual Field (AVF) task while sitting, and the SWAVF task under walking and standing settings. Nine participants also performed the SWAVF task under additional distraction conditions. Results showed good split-half reliability during standing (r = 0.70) and walking (r = 0.69), moderate concurrent validity with the sitting AVF task (r = 0.42), moderate convergent validity between the standing and walking settings (r = 0.69), good construct validity, and moderate rank-order stability (r = 0.53). Overall, the SWAVF task showed good psychometric properties. Potential applications to the evaluation of prosthetic and other exoskeleton devices, smart glasses, and ground-level traffic lights or signs were discussed.
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Affiliation(s)
- Jing Yuan
- Department of Psychology, North Carolina State University, NC, USA.
| | - Xiaolu Bai
- Department of Psychology, North Carolina State University, NC, USA.
| | - Brendan Driscoll
- Joint Department of Biomedical Engineering, North Carolina State University, University of North Carolina - Chapel Hill, NC, USA.
| | - Ming Liu
- Joint Department of Biomedical Engineering, North Carolina State University, University of North Carolina - Chapel Hill, NC, USA.
| | - He Huang
- Joint Department of Biomedical Engineering, North Carolina State University, University of North Carolina - Chapel Hill, NC, USA.
| | - Jing Feng
- Department of Psychology, North Carolina State University, NC, USA.
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Gao X, Si J, Wen Y, Li M, Huang H. Reinforcement Learning Control of Robotic Knee With Human-in-the-Loop by Flexible Policy Iteration. IEEE TRANSACTIONS ON NEURAL NETWORKS AND LEARNING SYSTEMS 2022; 33:5873-5887. [PMID: 33956634 DOI: 10.1109/tnnls.2021.3071727] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We are motivated by the real challenges presented in a human-robot system to develop new designs that are efficient at data level and with performance guarantees, such as stability and optimality at system level. Existing approximate/adaptive dynamic programming (ADP) results that consider system performance theoretically are not readily providing practically useful learning control algorithms for this problem, and reinforcement learning (RL) algorithms that address the issue of data efficiency usually do not have performance guarantees for the controlled system. This study fills these important voids by introducing innovative features to the policy iteration algorithm. We introduce flexible policy iteration (FPI), which can flexibly and organically integrate experience replay and supplemental values from prior experience into the RL controller. We show system-level performances, including convergence of the approximate value function, (sub)optimality of the solution, and stability of the system. We demonstrate the effectiveness of the FPI via realistic simulations of the human-robot system. It is noted that the problem we face in this study may be difficult to address by design methods based on classical control theory as it is nearly impossible to obtain a customized mathematical model of a human-robot system either online or offline. The results we have obtained also indicate the great potential of RL control to solving realistic and challenging problems with high-dimensional control inputs.
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Huang H(H, Si J, Brandt A, Li M. Taking Both Sides: Seeking Symbiosis Between Intelligent Prostheses and Human Motor Control during Locomotion. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2021; 20:100314. [PMID: 34458654 PMCID: PMC8388605 DOI: 10.1016/j.cobme.2021.100314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Robotic lower-limb prostheses aim to replicate the power-generating capability of biological joints during locomotion to empower individuals with lower-limb loss. However, recent clinical trials have not demonstrated clear advantages of these devices over traditional passive devices. We believe this is partly because the current designs of robotic prothesis controllers and clinical methods for fitting and training individuals to use them do not ensure good coordination between the prosthesis and user. Accordingly, we advocate for new holistic approaches in which human motor control and intelligent prosthesis control function as one system (defined as human-prosthesis symbiosis). We hope engineers and clinicians will work closely to achieve this symbiosis, thereby improving the functionality and acceptance of robotic prostheses and users' quality of life.
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Affiliation(s)
- He (Helen) Huang
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
| | - Jennie Si
- Department of Electrical, Computer, and Energy Engineering, Arizona State University, Tempe, Arizona, USA, 85281
| | - Andrea Brandt
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
| | - Minhan Li
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
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Direct continuous electromyographic control of a powered prosthetic ankle for improved postural control after guided physical training: A case study. ACTA ACUST UNITED AC 2021; 2. [PMID: 34532707 PMCID: PMC8443146 DOI: 10.1017/wtc.2021.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Despite the promise of powered lower limb prostheses, existing controllers do not assist many daily activities that require continuous control of prosthetic joints according to human states and environments. The objective of this case study was to investigate the feasibility of direct, continuous electromyographic (dEMG) control of a powered ankle prosthesis, combined with physical therapist-guided training, for improved standing postural control in an individual with transtibial amputation. Specifically, EMG signals of the residual antagonistic muscles (i.e. lateral gastrocnemius and tibialis anterior) were used to proportionally drive pneumatical artificial muscles to move a prosthetic ankle. Clinical-based activities were used in the training and evaluation protocol of the control paradigm. We quantified the EMG signals in the bilateral shank muscles as well as measures of postural control and stability. Compared to the participant's daily passive prosthesis, the dEMG-controlled ankle, combined with the training, yielded improved clinical balance scores and reduced compensation from intact joints. Cross-correlation coefficient of bilateral center of pressure excursions, a metric for quantifying standing postural control, increased to .83(±.07) when using dEMG ankle control (passive device: .39(±.29)). We observed synchronized activation of homologous muscles, rapid improvement in performance on the first day of the training for load transfer tasks, and further improvement in performance across training days (p = .006). This case study showed the feasibility of this dEMG control paradigm of a powered prosthetic ankle to assist postural control. This study lays the foundation for future study to extend these results through the inclusion of more participants and activities.
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Fleming A, Stafford N, Huang S, Hu X, Ferris DP, Huang H(H. Myoelectric control of robotic lower limb prostheses: a review of electromyography interfaces, control paradigms, challenges and future directions. J Neural Eng 2021; 18:10.1088/1741-2552/ac1176. [PMID: 34229307 PMCID: PMC8694273 DOI: 10.1088/1741-2552/ac1176] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022]
Abstract
Objective.Advanced robotic lower limb prostheses are mainly controlled autonomously. Although the existing control can assist cyclic movements during locomotion of amputee users, the function of these modern devices is still limited due to the lack of neuromuscular control (i.e. control based on human efferent neural signals from the central nervous system to peripheral muscles for movement production). Neuromuscular control signals can be recorded from muscles, called electromyographic (EMG) or myoelectric signals. In fact, using EMG signals for robotic lower limb prostheses control has been an emerging research topic in the field for the past decade to address novel prosthesis functionality and adaptability to different environments and task contexts. The objective of this paper is to review robotic lower limb Prosthesis control via EMG signals recorded from residual muscles in individuals with lower limb amputations.Approach.We performed a literature review on surgical techniques for enhanced EMG interfaces, EMG sensors, decoding algorithms, and control paradigms for robotic lower limb prostheses.Main results.This review highlights the promise of EMG control for enabling new functionalities in robotic lower limb prostheses, as well as the existing challenges, knowledge gaps, and opportunities on this research topic from human motor control and clinical practice perspectives.Significance.This review may guide the future collaborations among researchers in neuromechanics, neural engineering, assistive technologies, and amputee clinics in order to build and translate true bionic lower limbs to individuals with lower limb amputations for improved motor function.
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Affiliation(s)
- Aaron Fleming
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695, United States of America
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America
- Equal contribution as the first author
| | - Nicole Stafford
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL 32611, United States of America
- Equal contribution as the first author
| | - Stephanie Huang
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695, United States of America
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America
| | - Xiaogang Hu
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695, United States of America
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America
| | - Daniel P Ferris
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, United States of America
| | - He (Helen) Huang
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695, United States of America
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States of America
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Yuan J, Cline E, Liu M, Huang H, Feng J. Cognitive measures during walking with and without lower-limb prosthesis: protocol for a scoping review. BMJ Open 2021; 11:e039975. [PMID: 33602700 PMCID: PMC7896605 DOI: 10.1136/bmjopen-2020-039975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Tuning of lower-limb (LL) robotic prosthesis control is necessary to provide personalised assistance to each human wearer during walking. Prostheses wearers' adaptation processes are subjective and the efficiency largely depends on one's mental processes. Therefore, beyond physical motor performance, prosthesis personalisation should consider the wearer's preference and cognitive performance during walking. As a first step, it is necessary to examine the current measures of cognitive performance when a wearer walks with an LL prosthesis, identify the gaps and methodological considerations, and explore additional measures in a walking setting. In this protocol, we outlined a scoping review that will systematically summarise and evaluate the measures of cognitive performance during walking with and without LL prosthesis. METHODS AND ANALYSIS The review process will be guided and documented by CADIMA, an open-access online data management portal for evidence synthesis. Keyword searches will be conducted in seven databases (Web of Science, MEDLINE, BIOSIS, SciELO Citation Index, ProQuest, CINAHL and PsycINFO) up to 2020 supplemented with grey literature searches. Retrieved records will be screened by at least two independent reviewers on the title-and-abstract level and then the full-text level. Selected studies will be evaluated for reporting bias. Data on sample characteristics, type of cognitive function, characteristics of cognitive measures, task prioritisation, experimental design and walking setting will be extracted. ETHICS AND DISSEMINATION This scoping review will evaluate the measures used in previously published studies thus does not require ethical approval. The results will contribute to the advancement of prosthesis tuning processes by reviewing the application status of cognitive measures during walking with and without prosthesis and laying the foundation for developing needed measures for cognitive assessment during walking. The results will be disseminated through conferences and journals.
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Affiliation(s)
- Jing Yuan
- Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA
| | - Emily Cline
- Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA
| | - Ming Liu
- UNC & NC State Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - He Huang
- UNC & NC State Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Jing Feng
- Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA
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Fakoorian S, Roshanineshat A, Khalaf P, Azimi V, Simon D, Hardin E. An Extensive Set of Kinematic and Kinetic Data for Individuals with Intact Limbs and Transfemoral Prosthesis Users. Appl Bionics Biomech 2020; 2020:8864854. [PMID: 33224270 PMCID: PMC7671801 DOI: 10.1155/2020/8864854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/31/2020] [Accepted: 09/28/2020] [Indexed: 11/17/2022] Open
Abstract
This paper introduces an extensive human motion data set for typical activities of daily living. These data are crucial for the design and control of prosthetic devices for transfemoral prosthesis users. This data set was collected from seven individuals, including five individuals with intact limbs and two transfemoral prosthesis users. These data include the following types of movements: (1) walking at three different speeds; (2) walking up and down a 5-degree ramp; (3) stepping up and down; (4) sitting down and standing up. We provide full-body marker trajectories and ground reaction forces (GRFs) as well as joint angles, joint velocities, joint torques, and joint powers. This data set is publicly available at the website referenced in this paper. Data from flexion and extension of the hip, knee, and ankle are presented in this paper. However, the data accompanying this paper (available on the internet) include 46 distinct measurements and can be useful for validating or generating mathematical models to simulate the gait of both transfemoral prosthesis users and individuals with intact legs.
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Affiliation(s)
- Seyed Fakoorian
- Department of Electrical Engineering and Computer Science, Cleveland State University, Cleveland, Ohio 44115, USA
| | - Arash Roshanineshat
- Department of Electrical Engineering and Computer Engineering, University of Arizona, Tucson, AZ 87721, USA
| | - Poya Khalaf
- Department of Mechanical Engineering, Cleveland State University, Cleveland, Ohio 44115, USA
| | - Vahid Azimi
- Department of Electrical Engineering and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30313, USA
| | - Dan Simon
- Department of Electrical Engineering and Computer Science, Cleveland State University, Cleveland, Ohio 44115, USA
| | - Elizabeth Hardin
- Motion Study Laboratory, Cleveland VA Medical Center, Cleveland, Ohio 44106, USA
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Castiglia SF, Ranavolo A, Varrecchia T, De Marchis C, Tatarelli A, Magnifica F, Fiori L, Conte C, Draicchio F, Conforto S, Serrao M. Pelvic obliquity as a compensatory mechanism leading to lower energy recovery: Characterization among the types of prostheses in subjects with transfemoral amputation. Gait Posture 2020; 80:280-284. [PMID: 32563728 DOI: 10.1016/j.gaitpost.2020.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Subjects with transfemoral amputation (TFA) show an asymmetric gait pattern associated with a decreased ability to recover mechanical energy and an increased metabolic cost of walking. RESEARCH QUESTION This study aimed to identify the spatio-temporal and kinematic gait variables correlated with mechanical energy values in subjects with TFA and to observe the ability of the identified parameters to discriminate between TFA and controls according to the type of prosthesis. METHODS The gait of 40 subjects with TFA was evaluated with a motion 3-D optoelectronic system. Nine subjects wore a mechanical prosthesis (TFAm), seventeen a C-Leg prosthesis (TFAc), and fourteen a Genium prosthesis (TFAg). Spatio-temporal and pelvic kinematic parameters were measured. Energy recovery was measured relative to the whole-body center of mass (CoM) kinematics as the fraction of mechanical energy recovered during each walking step (R-step). Correlation tests and multiple linear regression analyses were used to evaluate the correlation and association between kinematic and energy variables, respectively. Receiver operating characteristics curves were plotted to assess the ability of the correlated parameter to distinguish subjects with TFA from controls, and optimal cutoff point values were calculated according to the type of prosthesis. RESULTS Among the spatio-temporal and kinematic parameters correlated to R-step, only pelvic obliquity of the prosthetic side was significantly associated with R-step. It showed an excellent ability to discriminate between TFA and controls. Furthermore, pelvic obliquity showed an excellent discriminative ability in identifying TFAm and TFAc and a good discriminative ability in identifying TFAg from controls. SIGNIFICANCE Pelvic obliquity plays an important role in energy recovery during gait for subjects using prosthetics. This information might be exploited to monitor the adaptation of subjects with TFA to prosthetic devices, to lower the energetic cost of walking potentially, and to reduce the long-term risks of secondary physical complications in prosthetic users.
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Affiliation(s)
- Stefano Filippo Castiglia
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Via Franco Faggiana 1668, 04100, Latina, Italy.
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, 00078 Monte Porzio Catone, Rome, Italy
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, 00078 Monte Porzio Catone, Rome, Italy; Department of Engineering, Roma TRE University, via Vito Volterra 62, 00146, Rome, Italy
| | - Cristiano De Marchis
- Department of Engineering, Roma TRE University, via Vito Volterra 62, 00146, Rome, Italy
| | - Antonella Tatarelli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, 00078 Monte Porzio Catone, Rome, Italy; Department of Neuroscience, Sapienza University of Rome, viale dell'Università 30, 00185, Rome, Italy
| | - Fabrizio Magnifica
- Department of Neuroscience, Sapienza University of Rome, viale dell'Università 30, 00185, Rome, Italy; Italian Air Force Aerospace Medicine Department, Diagnostic Therapeutic and Rehabilitative Aeromedical Center, via Piero Gobetti 2, 00185, Rome, Italy
| | - Lorenzo Fiori
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, 00078 Monte Porzio Catone, Rome, Italy; Department of Physiology and Pharmacology, Sapienza University of Rome, piazzale Aldo Moro, 5, 00185, Rome, Italy
| | - Carmela Conte
- IRCCS Fondazione Don Carlo Gnocchi, Piazzale Morandi, 6, 20121, Milan, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, 00078 Monte Porzio Catone, Rome, Italy
| | - Silvia Conforto
- Department of Engineering, Roma TRE University, via Vito Volterra 62, 00146, Rome, Italy
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Via Franco Faggiana 1668, 04100, Latina, Italy; Movement Analysis Laboratory, Policlinico Italia, Piazza del Campidano, 6, 00162, Rome, Italy
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Wen Y, Si J, Brandt A, Gao X, Huang HH. Online Reinforcement Learning Control for the Personalization of a Robotic Knee Prosthesis. IEEE TRANSACTIONS ON CYBERNETICS 2020; 50:2346-2356. [PMID: 30668514 DOI: 10.1109/tcyb.2019.2890974] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Robotic prostheses deliver greater function than passive prostheses, but we face the challenge of tuning a large number of control parameters in order to personalize the device for individual amputee users. This problem is not easily solved by traditional control designs or the latest robotic technology. Reinforcement learning (RL) is naturally appealing. The recent, unprecedented success of AlphaZero demonstrated RL as a feasible, large-scale problem solver. However, the prosthesis-tuning problem is associated with several unaddressed issues such as that it does not have a known and stable model, the continuous states and controls of the problem may result in a curse of dimensionality, and the human-prosthesis system is constantly subject to measurement noise, environmental change and human-body-caused variations. In this paper, we demonstrated the feasibility of direct heuristic dynamic programming, an approximate dynamic programming (ADP) approach, to automatically tune the 12 robotic knee prosthesis parameters to meet individual human users' needs. We tested the ADP-tuner on two subjects (one able-bodied subject and one amputee subject) walking at a fixed speed on a treadmill. The ADP-tuner learned to reach target gait kinematics in an average of 300 gait cycles or 10 min of walking. We observed improved ADP tuning performance when we transferred a previously learned ADP controller to a new learning session with the same subject. To the best of our knowledge, our approach to personalize robotic prostheses is the first implementation of online ADP learning control to a clinical problem involving human subjects.
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Tatarelli A, Serrao M, Varrecchia T, Fiori L, Draicchio F, Silvetti A, Conforto S, De Marchis C, Ranavolo A. Global Muscle Coactivation of the Sound Limb in Gait of People with Transfemoral and Transtibial Amputation. SENSORS 2020; 20:s20092543. [PMID: 32365715 PMCID: PMC7249183 DOI: 10.3390/s20092543] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/25/2022]
Abstract
The aim of this study was to analyze the effect of the level of amputation and various prosthetic devices on the muscle activation of the sound limb in people with unilateral transfemoral and transtibial amputation. We calculated the global coactivation of 12 muscles using the time-varying multimuscle coactivation function method in 37 subjects with unilateral transfemoral amputation (10, 16, and 11 with mechanical, electronic, and bionic prostheses, respectively), 11 subjects with transtibial amputation, and 22 healthy subjects representing the control group. The results highlighted that people with amputation had a global coactivation temporal profile similar to that of healthy subjects. However, amputation increased the level of the simultaneous activation of many muscles during the loading response and push-off phases of the gait cycle and decreased it in the midstance and swing subphases. This increased coactivation probably plays a role in prosthetic gait asymmetry and energy consumption. Furthermore, people with amputation and wearing electronic prosthesis showed lower global coactivation when compared with people wearing mechanical and bionic prostheses. These findings suggest that the global lower limb coactivation behavior can be a useful tool to analyze the motor control strategies adopted and the ability to adapt to the prosthetic device.
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Affiliation(s)
- Antonella Tatarelli
- Department of Human Neurosciences, University of Rome Sapienza, 00185 Rome, Italy
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
- Correspondence:
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, 04100 Latina, Italy;
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
| | - Lorenzo Fiori
- Department of Physiology and Pharmacology, University of Rome Sapienza, 00185 Rome, Italy;
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
| | - Alessio Silvetti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
| | - Silvia Conforto
- Department of Engineering, Roma TRE University, 00185 Rome, Italy; (S.C.); (C.D.M.)
| | - Cristiano De Marchis
- Department of Engineering, Roma TRE University, 00185 Rome, Italy; (S.C.); (C.D.M.)
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, 00185 Rome, Italy; (T.V.); (F.D.); (A.S.); (A.R.)
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Brandt A, Huang H(H. Effects of extended stance time on a powered knee prosthesis and gait symmetry on the lateral control of balance during walking in individuals with unilateral amputation. J Neuroeng Rehabil 2019; 16:151. [PMID: 31783759 PMCID: PMC6883569 DOI: 10.1186/s12984-019-0625-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 11/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals with lower limb amputation commonly exhibit large gait asymmetries that are associated with secondary health issues. It has been shown that they are capable of attaining improved temporal and propulsive symmetry when walking with a powered knee prosthesis and visual feedback, but they perceive this pattern of gait to be more difficult. Rather than improving the efficiency of gait, improved gait symmetry may be increasing individuals' effort associated with maintaining lateral balance. METHODS In this study, we used a simple visual feedback paradigm to increase the prosthesis-side stance time of six individuals with unilateral TFA or KD as they walked on a powered knee prosthesis at their self-selected speed. As they walked more symmetrically, we evaluated changes in medial-lateral center-of-mass excursion, lateral margin of stability, stride width, and hip abductor activity. RESULTS As the subjects increased their prosthesis-side stance time, their center-of-mass excursion and hip abductor activity significantly increased, while their lateral margin of stability significantly decreased on the prosthesis-side only. Stride width remained relatively unchanged with testing condition. CONCLUSIONS Extended stance time on a powered knee prosthesis (yielding more symmetric gait) challenged the lateral balance of individuals with lower limb amputation. Lateral stability may be a reason they prefer an asymmetric gait, even with more advanced technology. Hip muscular changes post-amputation may contribute to the decline in stability on the prosthesis side. Interventions and advancements in prosthesis control aimed at improving their control of lateral balance may ameliorate the difficulty in walking with improved gait symmetry.
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Affiliation(s)
- Andrea Brandt
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27606 USA
- The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - He ( Helen) Huang
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27606 USA
- The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
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Brandt A, Riddick W, Stallrich J, Lewek M, Huang HH. Effects of extended powered knee prosthesis stance time via visual feedback on gait symmetry of individuals with unilateral amputation: a preliminary study. J Neuroeng Rehabil 2019; 16:112. [PMID: 31511010 PMCID: PMC6737689 DOI: 10.1186/s12984-019-0583-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/28/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Establishing gait symmetry is a major aim of amputee rehabilitation and may be more attainable with powered prostheses. Though, based on previous work, we postulate that users transfer a previously-learned motor pattern across devices, limiting the functionality of more advanced prostheses. The objective of this study was to preliminarily investigate the effect of increased stance time via visual feedback on amputees' gait symmetry using powered and passive knee prostheses. METHODS Five individuals with transfemoral amputation or knee disarticulation walked at their self-selected speed on a treadmill. Visual feedback was used to promote an increase in the amputated-limb stance time. Individuals were fit with a commercially-available powered prosthesis by a certified prosthetist and practiced walking during a prior visit. The same protocol was completed with a passive knee and powered knee prosthesis on separate days. We used repeated-measures, two-way ANOVA (alpha = 0.05) to test for significant effects of the feedback and device factors. Our main outcome measures were stance time asymmetry, peak anterior-posterior ground reaction forces, and peak anterior propulsion asymmetry. RESULTS Increasing the amputated-limb stance time via visual feedback significantly improved the stance time symmetry (p = 0.012) and peak propulsion symmetry (p = 0.036) of individuals walking with both prostheses. With the powered knee prosthesis, the highest feedback target elicited 36% improvement in stance time symmetry, 22% increase in prosthesis-side peak propulsion, and 47% improvement in peak propulsion symmetry compared to a no feedback condition. The changes with feedback were not different with the passive prosthesis, and the main effects of device/ prosthesis type were not statistically different. However, subject by device interactions were significant, indicating individuals did not respond consistently with each device (e.g. prosthesis-side propulsion remained comparable to or was greater with the powered versus passive prosthesis for different subjects). Overall, prosthesis-side peak propulsion averaged across conditions was 31% greater with the powered prosthesis and peak propulsion asymmetry improved by 48% with the powered prosthesis. CONCLUSIONS Increasing prosthesis-side stance time via visual feedback favorably improved individuals' temporal and propulsive symmetry. The powered prosthesis commonly enabled greater propulsion, but individuals adapted to each device with varying behavior, requiring further investigation.
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Affiliation(s)
- Andrea Brandt
- Joint Department of Biomedical Engineering, North Carolina State University, 4402D Engineering Building III, NC State University, Raleigh, NC 27606 USA
- The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | | | - Jonathan Stallrich
- Department of Statistics, North Carolina State University, Raleigh, NC 27606 USA
| | - Michael Lewek
- Department of Allied Health Sciences, Division of Physical Therapy, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - He Helen Huang
- Joint Department of Biomedical Engineering, North Carolina State University, 4402D Engineering Building III, NC State University, Raleigh, NC 27606 USA
- The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
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