Experimental Demonstration of the Lower Leg Trajectory Error Framework Using Physiological Data as Inputs

The Moment Criterion of Anthropomorphicity of Prosthetic Feet as a Potential Predictor of Their Functionality for Transtibial Amputees

The purpose of this paper is to discuss a new quantitative mechanical parameter of prosthetic feet called the Index of Anthropomorphicity (IA), which has the potential to be adopted as an objective predictor of their functionality. The objectives are to present the research findings supporting the introduction of IA and unify previous results into a coherent theory. The IA is founded on the moment criterion of the anthropomorphicity of prosthetic feet. The term "anthropomorphicity" is defined for this application. Studies with a small number of human subjects and prostheses have shown that the value of the parameter is positively correlated with patient comfort and with the restoration of certain normal gait characteristics. Confirmatory studies with controlled human trials and mechanical tests with a wider selection of prosthesis types can give prosthesis manufacturers a new criterion to follow in the design process, and prosthetists may use the IA for selecting more suitable prostheses for a patient's comfort and health.

Characterization of the ankle dynamic joint stiffness as a function of gait speed for overground and treadmill walking

The ankle dynamic joint stiffness (DJS), defined as the slope of the joint angle-moment plot, measures the resistance of the ankle joint to movement when the foot is in contact with the ground. DJS helps to stabilize the ankle joint, and its characterization helps to identify gait pathology and assist foot prosthesis design. This study analyzes the available gait dynamics data to obtain ankle DJS parameters for population groups according to age, gender, and gait speed for overground and treadmill walking. This study classified the groups into five walking speeds normalized using the Froude number. Herein, 12 ankle DJS parameters were determined. These include four linear segments: controlled plantar flexion (CP), early response phase (ERP), large response phase (LRP), and descending phase (DP), their corresponding turning points, the net mechanical work, the absorbed work, and the loop direction. Ankle dynamics data for 92 individuals was collected from two gait data repositories. The analysis reveals a notable disparity in stiffness values between overground and treadmill gait. Specifically, the CP stiffness is significantly higher for overground gait. In contrast, the DP stiffness displays an opposing pattern, with higher values observed during treadmill walking. A negative stiffness for LRP was found at fast speeds for all groups. The sorted data, analysis tools, and findings of this study are meant to help practitioners design prosthetic and rehabilitation devices based on age, gender, and walking environment at different gait speeds.

Biomechanical evaluation over level ground walking of user-specific prosthetic feet designed using the lower leg trajectory error framework

The walking pattern and comfort of a person with lower limb amputation are determined by the prosthetic foot’s diverse set of mechanical characteristics. However, most design methodologies are iterative and focus on individual parameters, preventing a holistic design of prosthetic feet for a user’s body size and walking preferences. Here we refined and evaluated the lower leg trajectory error (LLTE) framework, a novel quantitative and predictive design methodology that optimizes the mechanical function of a user’s prosthesis to encourage gait dynamics that match their body size and desired walking pattern. Five people with unilateral below-knee amputation walked over-ground at self-selected speeds using an LLTE-optimized foot made of Nylon 6/6, their daily-use foot, and a standardized commercial energy storage and return (ESR) foot. Using the LLTE feet, target able-bodied kinematics and kinetics were replicated to within 5.2% and 13.9%, respectively, 13.5% closer than with the commercial ESR foot. Additionally, energy return and center of mass propulsion work were 46% and 34% greater compared to the other two prostheses, which could lead to reduced walking effort. Similarly, peak limb loading and flexion moment on the intact leg were reduced by an average of 13.1%, lowering risk of long-term injuries. LLTE-feet were preferred over the commercial ESR foot across all users and preferred over the daily-use feet by two participants. These results suggest that the LLTE framework could be used to design customized, high performance ESR prostheses using low-cost Nylon 6/6 material. More studies with large sample size are warranted for further verification.