Complementary limb motion estimation for the control of active knee prostheses

Toward the Development of User-Centered Neurointegrated Lower Limb Prostheses

The last few years witnessed radical improvements in lower-limb prostheses. Researchers have presented innovative solutions to overcome the limits of the first generation of prostheses, refining specific aspects which could be implemented in future prostheses designs. Each aspect of lower-limb prostheses has been upgraded, but despite these advances, a number of deficiencies remain and the most capable limb prostheses fall far short of the capabilities of the healthy limb. This article describes the current state of prosthesis technology; identifies a number of deficiencies across the spectrum of lower limb prosthetic components with respect to users' needs; and discusses research opportunities in design and control that would substantially improve functionality concerning each deficiency. In doing so, the authors present a roadmap of patients related issues that should be addressed in order to fulfill the vision of a next-generation, neurally-integrated, highly-functional lower limb prosthesis.

A Deep Learning Model with a Self-Attention Mechanism for Leg Joint Angle Estimation across Varied Locomotion Modes

Conventional trajectory planning for lower limb assistive devices usually relies on a finite-state strategy, which pre-defines fixed trajectory types for specific gait events and activities. The advancement of deep learning enables walking assistive devices to better adapt to varied terrains for diverse users by learning movement patterns from gait data. Using a self-attention mechanism, a temporal deep learning model is developed in this study to continuously generate lower limb joint angle trajectories for an ankle and knee across various activities. Additional analyses, including using Fast Fourier Transform and paired t-tests, are conducted to demonstrate the benefits of the proposed attention model architecture over the existing methods. Transfer learning has also been performed to prove the importance of data diversity. Under a 10-fold leave-one-out testing scheme, the observed attention model errors are 11.50% (±2.37%) and 9.31% (±1.56%) NRMSE for ankle and knee angle estimation, respectively, which are small in comparison to other studies. Statistical analysis using the paired t-test reveals that the proposed attention model appears superior to the baseline model in terms of reduced prediction error. The attention model also produces smoother outputs, which is crucial for safety and comfort. Transfer learning has been shown to effectively reduce model errors and noise, showing the importance of including diverse datasets. The suggested joint angle trajectory generator has the potential to seamlessly switch between different locomotion tasks, thereby mitigating the problem of detecting activity transitions encountered by the traditional finite-state strategy. This data-driven trajectory generation method can also reduce the burden on personalization, as traditional devices rely on prosthetists to experimentally tune many parameters for individuals with diverse gait patterns.

A pelvic kinematic approach for calculating hip angles for active hip disarticulation prosthesis control

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.

Continuous Phase Estimation in a Variety of Locomotion Modes Using Adaptive Dynamic Movement Primitives

Accurate gait phase estimation algorithms can be used to synchronize the action of wearable robots to the volitional user movements in real time. Current-day gait phase estimation methods are designed mostly for rhythmic tasks and evaluated in highly controlled walking environments (namely, steady-state walking). Here, we implemented adaptive Dynamic Movement Primitives (aDMP) for continuous real-time phase estimation in the most common locomotion activities of daily living, which are level-ground walking, stair negotiation, and ramp negotiation. The proposed method uses the thigh roll angle and foot-contact information and was tested in real time with five subjects. The estimated phase resulted in an average root-mean-square error of 3.98% ± 1.33% and a final estimation error of 0.60% ± 0.55% with respect to the linear phase. The results of this study constitute a viable groundwork for future phase-based control strategies for lower-limb wearable robots, such as robotic prostheses or exoskeletons.

Bionic intelligent ankle-foot prosthesis based on the conjugate curved surface

Given the poor biomimetic motion of traditional ankle-foot prostheses, it is of great significance to develop an intelligent prosthesis that can realize the biomimetic mechanism of human feet and ankles. To this end, we presented a bionic intelligent ankle-foot prosthesis based on the complex conjugate curved surface. The proposed prosthesis is mainly composed of the rolling conjugated joints with a bionic design and the carbon fiber energy-storage foot. We investigated the flexibility of the prosthetic ankle joint movement, and the ability of the prosthetic foot to absorb ground impact during the gait cycle. Experimental results showed the matching of the ankle/toe position relationship of the human foot during simulated walking, which is helpful to realize the biomimetic motion of the human foot and ankle. It can also help therapists and clinicians provide better rehabilitation for lower-limb amputees.

A reduced-order closed-loop hybrid dynamic model for design and development of lower limb prostheses

This manuscript presents a simplified dynamic human-prosthesis model and simulation framework for the purpose of designing and developing lower limb prosthesis hardware and controllers. The objective was to provide an offline design tool to verify the closed-loop behavior of the prosthesis with the human, in order to avoid relying solely on limiting kinematic and kinetic reference trajectories of (able-bodied) subjects and associated static or inverse dynamic analyses, while not having to resort to complete neuromusculoskeletal models of the human that require extensive optimizations to run. The presented approach employs a reduced-order model that includes only the prosthetic limb and trunk in a multi-body dynamic model. External forces are applied to the trunk during stance phase of the intact leg to represent its presence. Walking is realized by employing the well-known spring-loaded inverted pendulum model, which is shown to generate realistic dynamics on the prosthesis while maintaining a stable and modifiable gait. This simple approach is inspired from the rationale that the human is adaptive, and from the desire to facilitate modifications or inclusions of additional user actions. The presented framework is validated with two use cases, featuring a commercial and research knee prosthesis in combination with a passive ankle prosthesis, performing a continuous sequence of standing still, walking at different velocities and stopping.

Deep learning with an attention mechanism for continuous biomechanical motion estimation across varied activities

Reliable estimation of desired motion trajectories plays a crucial part in the continuous control of lower extremity assistance devices such as prostheses and orthoses. Moreover, reliable estimation methods are also required to predict hard-to-measure biomechanical quantities (e.g., joint contact moment/force) for use in sports injury science. Recognising that human locomotion is an inherently time-sequential and limb-synergetic behaviour, this study investigates models and learning algorithms for predicting the motion of a subject’s leg from the motion of complementary limbs. The novel deep learning model architectures proposed are based on the Long Short-Term Memory approach with the addition of an attention mechanism. A dataset comprising Inertial Measurement Unit signals from 21 subjects traversing varied terrains was used, including stair ascent/descent, ramp ascent/descent, stopped, level-ground walking and the transitions between these conditions. Fourier Analysis is deployed to evaluate the model robustness, in addition to assessing time-based prediction errors. The experiment on three unseen test participants suggests that the branched neural network structure is preferred to tackle the multioutput problem, and the inclusion of an attention mechanism demonstrates improved performance in terms of accuracy, robustness and network size. An experimental comparison found that 57% of the model parameters were not needed after adding attention layers meanwhile the prediction error is lower than the LSTM model without attention mechanism. The attention model has errors of 9.06% and 7.64% (normalised root mean square error) for ankle and hip acceleration prediction respectively. Also, less high-frequency noise is present in the attention model predictions. We conclude that the internal structure of the proposed deep learning model is justified, principally the benefit of using an attention mechanism. Experimental results for biomechanical motion estimation are obtained, showing greater accuracy than only with LSTM. The trained attention model can be used throughout despite transitioning between terrain types. Such a model will be useful in, for example, the control of lower-limb prostheses, instead of the need to identify and switch between different trajectory generators for different walking modes.

Gait Synergy Analysis and Modeling on Amputees and Stroke Patients for Lower Limb Assistive Devices

The concept of synergy has drawn attention and been applied to lower limb assistive devices such as exoskeletons and prostheses for improving human–machine interaction. A better understanding of the influence of gait kinematics on synergies and a better synergy-modeling method are important for device design and improvement. To this end, gait data from healthy, amputee, and stroke subjects were collected. First, continuous relative phase (CRP) was used to quantify their synergies and explore the influence of kinematics. Second, long short-term memory (LSTM) and principal component analysis (PCA) were adopted to model interlimb synergy and intralimb synergy, respectively. The results indicate that the limited hip and knee range of motions (RoMs) in stroke patients and amputees significantly influence their synergies in different ways. In interlimb synergy modeling, LSTM (RMSE: 0.798° (hip) and 1.963° (knee)) has lower errors than PCA (RMSE: 5.050° (hip) and 10.353° (knee)), which is frequently used in the literature. Further, in intralimb synergy modeling, LSTM (RMSE: 3.894°) enables better synergy modeling than PCA (RMSE: 10.312°). In conclusion, stroke patients and amputees perform different compensatory mechanisms to adapt to new interlimb and intralimb synergies different from healthy people. LSTM has better synergy modeling and shows a promise for generating trajectories in line with the wearer’s motion for lower limb assistive devices.

Data-Mined Continuous Hip-knee Coordination Mapping with Motion Lag for Lower-limb Prosthesis Control

Trajectory planning of the knee joint plays an essential role in controlling the lower limb prosthesis. Nowadays, the idea of mapping the trajectory of the healthy limb to the motion trajectory of the prosthetic joint has begun to emerge. However, establishing a simple and intuitive coordination mapping is still challenging. This paper employs the method of experimental data mining to explore such a coordination mapping. The coordination indexes, i.e., the mean absolute relative phase (MARP) and the deviation phase (DP), are obtained from experimental data. Statistical results covering different subjects indicate that the hip motion possesses a stable phase difference with the knee, inspiring us to construct a hip-knee Motion-Lagged Coordination Mapping (MLCM). The MLCM first introduces a time lag to the hip motion to avoid conventional integral or differential calculations. The model in polynomials, which is proved more efficient than Gaussian process regression and neural network learning, is then constructed to represent the mapping from the lagged hip motion to the knee motion. In addition, a strong linear correlation between hip-knee MARP and hip-knee motion lag is discovered for the first time. By using the MLCM, one can generate the knee trajectory for the prosthesis control only via the hip motion of the healthy limb, indicating less sensing and better robustness. Numerical simulations show that the prosthesis can achieve normal gaits at different walking speeds.

EMG-driven control in lower limb prostheses: a topic-based systematic review

BACKGROUND

The inability of users to directly and intuitively control their state-of-the-art commercial prosthesis contributes to a low device acceptance rate. Since Electromyography (EMG)-based control has the potential to address those inabilities, research has flourished on investigating its incorporation in microprocessor-controlled lower limb prostheses (MLLPs). However, despite the proposed benefits of doing so, there is no clear explanation regarding the absence of a commercial product, in contrast to their upper limb counterparts.

OBJECTIVE AND METHODOLOGIES

This manuscript aims to provide a comparative overview of EMG-driven control methods for MLLPs, to identify their prospects and limitations, and to formulate suggestions on future research and development. This is done by systematically reviewing academical studies on EMG MLLPs. In particular, this review is structured by considering four major topics: (1) type of neuro-control, which discusses methods that allow the nervous system to control prosthetic devices through the muscles; (2) type of EMG-driven controllers, which defines the different classes of EMG controllers proposed in the literature; (3) type of neural input and processing, which describes how EMG-driven controllers are implemented; (4) type of performance assessment, which reports the performance of the current state of the art controllers.

RESULTS AND CONCLUSIONS

The obtained results show that the lack of quantitative and standardized measures hinders the possibility to analytically compare the performances of different EMG-driven controllers. In relation to this issue, the real efficacy of EMG-driven controllers for MLLPs have yet to be validated. Nevertheless, in anticipation of the development of a standardized approach for validating EMG MLLPs, the literature suggests that combining multiple neuro-controller types has the potential to develop a more seamless and reliable EMG-driven control. This solution has the promise to retain the high performance of the currently employed non-EMG-driven controllers for rhythmic activities such as walking, whilst improving the performance of volitional activities such as task switching or non-repetitive movements. Although EMG-driven controllers suffer from many drawbacks, such as high sensitivity to noise, recent progress in invasive neural interfaces for prosthetic control (bionics) will allow to build a more reliable connection between the user and the MLLPs. Therefore, advancements in powered MLLPs with integrated EMG-driven control have the potential to strongly reduce the effects of psychosomatic conditions and musculoskeletal degenerative pathologies that are currently affecting lower limb amputees.

Optimization of immune receptor-related hypersensitive cell death response assay using agrobacterium-mediated transient expression in tobacco plants

BACKGROUND

The study of the regulatory mechanisms of evolutionarily conserved Nucleotide-binding leucine-rich repeat (NLR) resistance (R) proteins in animals and plants is of increasing importance due to understanding basic immunity and the value of various crop engineering applications of NLR immune receptors. The importance of temperature is also emerging when applying NLR to crops responding to global climate change. In particular, studies of pathogen effector recognition and autoimmune activity of NLRs in plants can quickly and easily determine their function in tobacco using agro-mediated transient assay. However, there are conditions that should not be overlooked in these cell death-related assays in tobacco.

RESULTS

Environmental conditions play an important role in the immune response of plants. The system used in this study was to establish conditions for optimal hypertensive response (HR) cell death analysis by using the paired NLR RPS4/RRS1 autoimmune and AvrRps4 effector recognition system. The most suitable greenhouse temperature for growing plants was fixed at 22 °C. In this study, RPS4/RRS1-mediated autoimmune activity, RPS4 TIR domain-dependent cell death, and RPS4/RRS1-mediated HR cell death upon AvrRps4 perception significantly inhibited under conditions of 65% humidity. The HR is strongly activated when the humidity is below 10%. Besides, the leaf position of tobacco is important for HR cell death. Position #4 of the leaf from the top in 4-5 weeks old tobacco plants showed the most effective HR cell death.

CONCLUSIONS

As whole genome sequencing (WGS) or resistance gene enrichment sequencing (RenSeq) of various crops continues, different types of NLRs and their functions will be studied. At this time, if we optimize the conditions for evaluating NLR-mediated HR cell death, it will help to more accurately identify the function of NLRs. In addition, it will be possible to contribute to crop development in response to global climate change through NLR engineering.

Improving IMU-based prediction of lower limb kinematics in natural environments using egocentric optical flow

We seek to predict knee and ankle motion using wearable sensors. These predictions could serve as target trajectories for a lower limb prosthesis. In this manuscript, we investigate the use of egocentric vision for improving performance over kinematic wearable motion capture. We present an out-of-the-lab dataset of 23 healthy subjects navigating public classrooms, a large atrium, and stairs for a total of almost 12 hours of recording. The prediction task is difficult because the movements include avoiding obstacles, other people, idiosyncratic movements such as traversing doors, and individual choices in selecting the future path. We demonstrate that using vision improves the quality of the predicted knee and ankle trajectories, especially in congested spaces and when the visual environment provides information that does not appear simply in the movements of the body. Overall, including vision results in 7.9% and 7.0% improvement in root mean squared error of knee and ankle angle predictions respectively. The improvement in Pearson Correlation Coefficient for knee and ankle predictions is 1.5% and 12.3% respectively. We discuss particular moments where vision greatly improved, or failed to improve, the prediction performance. We also find that the benefits of vision can be enhanced with more data. Lastly, we discuss challenges of continuous estimation of gait in natural, out-of-the-lab datasets.

Design of bionic active-passive hybrid-driven prosthesis based on gait analysis and simulation of compound control method

Purpose

The purpose of this paper is to design a prosthetic limb that is close to the motion characteristics of the normal human ankle joint.

Methods

In this study, combined with gait experiments, based on a dynamic ankle joint prosthesis, an active–passive hybrid-driven prosthesis was designed. On this basis, a real-time control algorithm based on the feedforward compensation angle outer loop is proposed. To test the effectiveness of the control method, a multi-body dynamic model and a controller model of the prosthesis were established, and a co-simulation study was carried out.

Results

A real-time control algorithm based on the feedforward compensation angle outer loop can effectively realize the gait angle curve measured in the gait test, and the error is less than the threshold. The co-simulation result and the test result have a high close rate, which reflects the real-time nature of the control algorithm. The use of parallel springs can improve the energy efficiency of the prosthetic system.

Conclusions

Based on the motion characteristics of human ankle joint prostheses, this research has completed an effective and feasible design of active and passive ankle joint prostheses. The use of control algorithms improves the controllability of the active and passive ankle joint prostheses.

Knee Exoskeletons Design Approaches to Boost Strength Capability: A Review

There are different devices to increase the strength capacity of people with walking problems. These devices can be classified into exoskeletons, orthotics, and braces. This review aims to identify the state of the art in the design of these medical devices, based on an analysis of patents and literature. However, there are some difficulties in processing the records due to the lack of filters and standardization in the names, generating discrepancies between the search engines, among others. Concerning the patents, 74 patents were analyzed using search engines such as Google Patents, Derwent, The Lens, Patentscope, and Espacenet over the past ten years. A bibliometric analysis was performed using 63 scientific reports from Web of Science and The Lens in the same period for scientific communications. The results show a trend to use the mechanical design of exoskeletons based on articulated rigid structures and elements that provide force to move the structure. These are generally two types: (a) elastic elements and (b) electromechanical elements. The United States accounts for 32% of the technological patents reviewed. The results suggest that the use of exoskeletons or orthoses customized to the users’ needs will continue to increase over the years due to the worldwide growth in disability, particularly related to mobility difficulties and technologies related to the combined use of springs and actuators.

Biomechanical Signals of Varied Modality and Location Contribute Differently to Recognition of Transient Locomotion

Intent recognition in lower-limb assistive devices typically relies on neuromechanical sensing of an affected limb acquired through embedded device sensors. It remains unknown whether signals from more widespread sources such as the contralateral leg and torso positively influence intent recognition, and how specific locomotor tasks that place high demands on the neuromuscular system, such as changes of direction, contribute to intent recognition. In this study, we evaluated the performances of signals from varying mechanical modalities (accelerographic, gyroscopic, and joint angles) and locations (the trailing leg, leading leg and torso) during straight walking, changes of direction (cuts), and cuts to stair ascent with varying task anticipation. Biomechanical information from the torso demonstrated poor performance across all conditions. Unilateral (the trailing or leading leg) joint angle data provided the highest accuracy. Surprisingly, neither the fusion of unilateral and torso data nor the combination of multiple signal modalities improved recognition. For these fused modality data, similar trends but with diminished accuracy rates were reported during unanticipated conditions. Finally, for datasets that achieved a relatively accurate (≥90%) recognition of unanticipated tasks, these levels of recognition were achieved after the mid-swing of the trailing/transitioning leg, prior to a subsequent heel strike. These findings suggest that mechanical sensing of the legs and torso for the recognition of straight-line and transient locomotion can be implemented in a relatively flexible manner (i.e., signal modality, and from the leading or trailing legs) and, importantly, suggest that more widespread sensing is not always optimal.

Relying on more sense for enhancing lower limb prostheses control: a review

Modern lower limb prostheses have the capability to replace missing body parts and improve the patients' quality of life. However, missing environmental information often makes a seamless adaptation to transitions between different forms of locomotion challenging. The aim of this review is to identify the progress made in this area over the last decade, addressing two main questions: which types of novel sensors for environmental awareness are used in lower limb prostheses, and how do they enhance device control towards more comfort and safety. A literature search was conducted on two Internet databases, PubMed and IEEE Xplore. Based on the criteria for inclusion and exclusion, 32 papers were selected for the review analysis, 18 of those are related to explicit environmental sensing and 14 to implicit environmental sensing. Characteristics were discussed with a focus on update rate and resolution as well as on computing power and energy consumption. Our analysis identified numerous state-of-the-art sensors, some of which are able to "look through" clothing or cosmetic covers. Five control categories were identified, how "next generation prostheses" could be extended. There is a clear tendency towards more upcoming object or terrain prediction concepts using all types of distance and depth-based sensors. Other advanced strategies, such as bilateral gait segmentation from unilateral sensors, could also play an important role in movement-dependent control applications. The studies demonstrated promising accuracy in well-controlled laboratory settings, but it is unclear how the systems will perform in real-world environments, both indoors and outdoors. At the moment the main limitation proves to be the necessity of having an unobstructed field of view.

Wearer-Prosthesis Interaction for Symmetrical Gait: A Study Enabled by Reinforcement Learning Prosthesis Control

With advances in robotic prostheses, rese-archers attempt to improve amputee's gait performance (e.g., gait symmetry) beyond restoring normative knee kinematics/kinetics. Yet, little is known about how the prosthesis mechanics/control influence wearer-prosthesis' gait performance, such as gait symmetry, stability, etc. This study aimed to investigate the influence of robotic transfemoral prosthesis mechanics on human wearers' gait symmetry. The investigation was enabled by our previously designed reinforcement learning (RL) supplementary control, which simultaneously tuned 12 control parameters that determined the prosthesis mechanics throughout a gait cycle. The RL control design facilitated safe explorations of prosthesis mechanics with the human in the loop. Subjects were recruited and walked with a robotic transfemoral prosthesis on a treadmill while the RL controller tuned the control parameters. Stance time symmetry, step length symmetry, and bilateral anteroposterior (AP) impulses were measured. The data analysis showed that changes in robotic knee mechanics led to movement variations in both lower limbs and therefore gait temporal-spatial symmetry measures. Consistent across all the subjects, inter-limb AP impulse measurements explained gait symmetry: the stance time symmetry was significantly correlated with the net inter-limb AP impulse, and the step length symmetry was significantly correlated with braking and propulsive impulse symmetry. The results suggest that it is possible to personalize transfemoral prosthesis control for improved temporal-spatial gait symmetry. However, adjusting prosthesis mechanics alone was insufficient to maximize the gait symmetry. Rather, achieving gait symmetry may require coordination between the wearer's motor control of the intact limb and adaptive control of the prosthetic joints. The results also indicated that the RL-based prosthesis tuning system was a potential tool for studying wearer-prosthesis interactions.

Design and Speed-Adaptive Control of a Powered Geared Five-Bar Prosthetic Knee Using BP Neural Network Gait Recognition

To improve the multi-speed adaptability of the powered prosthetic knee, this paper presented a speed-adaptive neural network control based on a powered geared five-bar (GFB) prosthetic knee. The GFB prosthetic knee is actuated via a cylindrical cam-based nonlinear series elastic actuator that can provide the desired actuation for level-ground walking, and its attitude measurement is realized by two inertial sensors and one load cell on the prosthetic knee. To improve the performance of the control system, the motor control and the attitude measurement of the GFB prosthetic knee are run in parallel. The BP neural network uses input data from only the GFB prosthetic knee, and is trained by natural and artificially modified various gait patterns of different able-bodied subjects. To realize the speed-adaptive control, the prosthetic knee speed and gait cycle percentage are identified by the Gaussian mixture model-based gait classifier. Specific knee motion control instructions are generated by matching the neural network predicted gait percentage with the ideal walking gait. Habitual and variable speed level-ground walking experiments are conducted via an able-bodied subject, and the experimental results show that the neural network control system can handle both self-selected walking and variable speed walking with high adaptability.

Design Optimization in Lower Limb Prostheses: A Review

This paper aims to develop a knowledge base and identify the promising research pathways toward designing lower limb prostheses for optimal biomechanical and clinical outcomes. It is based on the literature search representing the state of the art in the lower limb prosthesis joint design and biomechanical analysis. Current design solutions are organized in terms of fulfilling four key functional roles: body support, propulsion, task flexibility, and loading relief. Biomechanical analyses of these designs reveal that the hypothesized outcomes are not consistently observed. We suggest that these outcomes may be improved by incorporating tools that can predict user performance metrics to optimize the device during the initial design process. We also note that the scope of the solution space of most current designs is limited by focusing on the anthropomorphic design approaches that do not account for the person's altered anatomy post-amputation. The effects of the prosthetic joint behavior on whole-body gait biomechanics and user experience are likewise under-explored. Two research paths to support the goal of better predicting the user outcomes are proposed: experimental parameterization of designs and model-based simulations. However, while work in these areas has introduced promising new possibilities, connecting both to improve real-world performance remains a challenge.

Fusion of Bilateral Lower-Limb Neuromechanical Signals Improves Prediction of Locomotor Activities

Wearable lower-limb assistive devices have the potential to dramatically improve the walking ability of millions of individuals with gait impairments. However, most control systems for these devices do not enable smooth transitions between locomotor activities because they cannot continuously predict the user's intended movements. Intent recognition is an alternative control strategy that uses patterns of signals detected before movement completion to predict future states. This strategy has already enabled amputees to walk and transition seamlessly and intuitively between activities (e.g., level ground, stairs, ramps) using control signals from mechanical sensors embedded in the prosthesis and muscles of their residual limb. Walking requires interlimb coordination because the leading and trailing legs have distinct biomechanical functions. For unilaterally-impaired individuals, these differences tend to be amplified because they develop asymmetric gait patterns; however, state-of-the-art intent recognition approaches have not been systematically applied to bilateral neuromechanical control signals. The purpose of this study was to determine the effect of including contralateral side signals for control in an intent recognition framework. First, we conducted an offline analysis using signals from bilateral lower-limb electromyography (EMG) and joint and limb kinematics recorded from 10 able-bodied subjects as they freely transitioned between level ground, stairs, and ramps without an assistive device. We hypothesized that including information from the contralateral side would reduce classification errors. Compared to ipsilateral sensors only, bilateral sensor fusion significantly reduced error rates; moreover, only one additional sensor from the contralateral side was needed to achieve a significant reduction in error rates. To the best of our knowledge, this is the first study to systematically investigate using simultaneously recorded bilateral lower-limb neuromechanical signals for intent recognition. These results provide a device-agnostic benchmark for intent recognition with bilateral neuromechanical signals and suggest that bilateral sensor fusion can be a simple but effective modular strategy for enhancing the control of lower-limb assistive devices. Finally, we provide preliminary offline results from one above-knee amputee walking with a powered leg prosthesis as a proof-of-concept for the generalizability and benefit of using bilateral sensor fusion to control an assistive device for an impaired population.

Design and Control of a New Biomimetic Transfemoral Knee Prosthesis Using an Echo-Control Scheme

Passive knee prostheses require a significant amount of additional metabolic energy to carry out a gait cycle, therefore affecting the natural human walk performance. Current active knee prostheses are still limited because they do not reply with accuracy of the natural human knee movement, and the time response is relatively large. This paper presents the design and control of a new biomimetic-controlled transfemoral knee prosthesis based on a polycentric-type mechanism. The aim was to develop a knee prosthesis able to provide additional power and to mimic with accuracy of the natural human knee movement using a stable control strategy. The design of the knee mechanism was obtained from the body-guidance kinematics synthesis based on real human walking patterns obtained from computer vision and 3D reconstruction. A biomechanical evaluation of the synthesized prosthesis was then carried out. For the activation and control of the prosthesis, an echo-control strategy was proposed and developed. In this echo-control strategy, the sound side leg is sensed and synchronized with the activation of the knee prosthesis. An experimental prototype was built and evaluated in a test rig. The results revealed that the prosthetic knee is able to mimic the biomechanics of the human knee.

Bio-Inspired Adaptive Control for Active Knee Exoprosthetics

On the quest to bring function of prosthetic legs closer to their biological counterparts, the intuitive interplay of their control with the user's impedance modulation is key. We present two control features to enable more physiological and more user-adaptive control of prosthetic legs: a neuromusculoskeletal impedance model ( ) including a reflexive component, and a human model reference adaptive controller ( ), which can be combined with the former. In stance-phase simulations, the allowed to control a prosthetic leg with physiological knee joint angle and moment. When perturbations were applied, the reduced the resulting root mean square error (RMSE) between simulated and physiological reference angle by 96%. In a pilot experiment with two unimpaired and one amputee subject, gait with the deviated more from a physiological reference than with a conventional visco-elastic impedance controller. Subjects, however, preferred the . When adding the to either of the two impedance controllers, the RMSE between the actual and the physiological reference angle was reduced by up to 54%. Subjects confirmed this finding and reported an easier stance-to-swing transition. Simulation and pilot experiment suggest that a reflex-based impedance controller combined with an adaptive controller may improve user-cooperative behavior of active knee exoprostheses.

Active lower limb prosthetics: a systematic review of design issues and solutions

This paper presents a review on design issues and solutions found in active lower limb prostheses. This review is based on a systematic literature search with a methodical search strategy. The search was carried out across four major technical databases and the retrieved records were screened for their relevance. A total of 21 different active prostheses, including 8 above-knee, 9 below-knee and 4 combined knee-ankle prostheses were identified. While an active prosthesis may help to restore the functional performance of an amputee, the requirements regarding the actuation unit as well as for the control system are high and the development becomes a challenging task. Regarding mechanical design and the actuation unit high force/torque delivery, high efficiency, low size and low weight are conflicting goals. The actuation principle and variable impedance actuators are discussed. The control system is paramount for a “natural functioning” of the prosthesis. The control system has to enable locomotion and should react to the amputee’s intent. For this, multi-level control approaches are reviewed.

Control strategies for active lower extremity prosthetics and orthotics: a review

: Technological advancements have led to the development of numerous wearable robotic devices for the physical assistance and restoration of human locomotion. While many challenges remain with respect to the mechanical design of such devices, it is at least equally challenging and important to develop strategies to control them in concert with the intentions of the user.This work reviews the state-of-the-art techniques for controlling portable active lower limb prosthetic and orthotic (P/O) devices in the context of locomotive activities of daily living (ADL), and considers how these can be interfaced with the user's sensory-motor control system. This review underscores the practical challenges and opportunities associated with P/O control, which can be used to accelerate future developments in this field. Furthermore, this work provides a classification scheme for the comparison of the various control strategies.As a novel contribution, a general framework for the control of portable gait-assistance devices is proposed. This framework accounts for the physical and informatic interactions between the controller, the user, the environment, and the mechanical device itself. Such a treatment of P/Os--not as independent devices, but as actors within an ecosystem--is suggested to be necessary to structure the next generation of intelligent and multifunctional controllers.Each element of the proposed framework is discussed with respect to the role that it plays in the assistance of locomotion, along with how its states can be sensed as inputs to the controller. The reviewed controllers are shown to fit within different levels of a hierarchical scheme, which loosely resembles the structure and functionality of the nominal human central nervous system (CNS). Active and passive safety mechanisms are considered to be central aspects underlying all of P/O design and control, and are shown to be critical for regulatory approval of such devices for real-world use.The works discussed herein provide evidence that, while we are getting ever closer, significant challenges still exist for the development of controllers for portable powered P/O devices that can seamlessly integrate with the user's neuromusculoskeletal system and are practical for use in locomotive ADL.

EMG control of a bionic knee prosthesis: exploiting muscle co-contractions for improved locomotor function

This paper presents the development and experimental evaluation of a volitional control architecture for a powered-knee transfemoral prosthesis that affords the amputee user with direct control of knee impedance using measured electromyogram (EMG) potentials of antagonist muscles in the residual limb. The control methodology incorporates a calibration procedure performed with each donning of the prosthesis that characterizes the co-contraction levels as the user performs volitional phantom-knee flexor and extensor contractions. The performance envelope for EMG control of impedance is then automatically shaped based on the flexor and extensor calibration datasets. The result is a control architecture that is optimized to the user's current co-contraction activity, providing performance robustness to variation in sensor placement or physiological changes in the residual-limb musculature. Experimental results with a single unilateral transfemoral amputee user demonstrate consistent and repeatable control performance for level walking at self-selected speed over a multi-week, multi-session period of evaluation.

Avaliação do quadril de amputados transfemoral durante contração isométrica em dinamômetro isocinético

INTRODUÇÃO: A amputação transfemoral leva a uma série de alterações funcionais na biomecânica corporal que podem interferir no cotidiano do amputado, podendo gerar, ainda, padrões de postura e de marcha para compensar a perda do membro.OBJETIVO: Avaliar e comparar as respostas musculares do quadril de amputados transfemorais durante contrações isométricas, utilizando-se um dinamômetro isocinético.MÉTODO: Participaram do estudo quatro voluntários, sendo dois amputados e dois não amputados. Foi realizada avaliação isométrica no dinamômetro isocinético nas angulações de 30 e 60 graus com duração de 10 segundos. Cada série tinha um total de seis repetições, contabilizando três flexões e três extensões e um intervalo de 20 segundos para cada repetição.RESULTADOS: O membro amputado apresenta menor pico de torque em relação ao não amputado, tanto na flexão como extensão do quadril a 30 e a 60 graus.CONCLUSÃO: Devido à amputação, os indivíduos apresentam menor força muscular de quadril, fato que pode prejudicar as atividades diárias como caminhar, sentar e levantar, e subir e descer escadas.

Recent trends in assistive technology for mobility

Loss of physical mobility makes maximal participation in desired activities more difficult and in the worst case fully prevents participation. This paper surveys recent work in assistive technology to improve mobility for persons with a disability, drawing on examples observed during a tour of academic and industrial research sites in Europe. The underlying theme of this recent work is a more seamless integration of the capabilities of the user and the assistive technology. This improved integration spans diverse technologies, including powered wheelchairs, prosthetic limbs, functional electrical stimulation, and wearable exoskeletons. Improved integration is being accomplished in three ways: 1) improving the assistive technology mechanics; 2) improving the user-technology physical interface; and 3) sharing of control between the user and the technology. We provide an overview of these improvements in user-technology integration and discuss whether such improvements have the potential to be transformative for people with mobility impairments.

Personalized neuromusculoskeletal modeling to improve treatment of mobility impairments: a perspective from European research sites

Mobility impairments due to injury or disease have a significant impact on quality of life. Consequently, development of effective treatments to restore or replace lost function is an important societal challenge. In current clinical practice, a treatment plan is often selected from a standard menu of options rather than customized to the unique characteristics of the patient. Furthermore, the treatment selection process is normally based on subjective clinical experience rather than objective prediction of post-treatment function. The net result is treatment methods that are less effective than desired at restoring lost function. This paper discusses the possible use of personalized neuromusculoskeletal computer models to improve customization, objectivity, and ultimately effectiveness of treatments for mobility impairments. The discussion is based on information gathered from academic and industrial research sites throughout Europe, and both clinical and technical aspects of personalized neuromusculoskeletal modeling are explored. On the clinical front, we discuss the purpose and process of personalized neuromusculoskeletal modeling, the application of personalized models to clinical problems, and gaps in clinical application. On the technical front, we discuss current capabilities of personalized neuromusculoskeletal models along with technical gaps that limit future clinical application. We conclude by summarizing recommendations for future research efforts that would allow personalized neuromusculoskeletal models to make the greatest impact possible on treatment design for mobility impairments.