Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes
Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of...
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| Veröffentlicht in: | PloS one 2014-06, Vol.9 (6), p.e99387-e99387 |
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| creator | Simon, Ann M Ingraham, Kimberly A Fey, Nicholas P Finucane, Suzanne B Lipschutz, Robert D Young, Aaron J Hargrove, Levi J |
| description | Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide. |
| doi_str_mv | 10.1371/journal.pone.0099387 |
| format | Article |
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However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0099387</identifier><identifier>PMID: 24914674</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Amputation ; Amputees - rehabilitation ; Ankle ; Ankle Joint - physiology ; Ascent ; Biology and Life Sciences ; Biomechanical Phenomena - physiology ; Biomechanics ; Configurations ; Descent ; Design ; Devices ; Electric Impedance ; Engineering and Technology ; Femur - surgery ; Gait ; Goals ; Humans ; Joint Prosthesis ; Kinematics ; Knee ; Knee Joint - physiology ; Medicine ; Microprocessors ; Middle Aged ; Parameter modification ; Prostheses ; Prostheses and implants ; Prosthetics ; R&D ; Rehabilitation ; Research & development ; Robotics ; Time Factors ; Trans-femoral amputees ; Walking ; Walking - physiology ; Young Adult</subject><ispartof>PloS one, 2014-06, Vol.9 (6), p.e99387-e99387</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Simon et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Simon et al 2014 Simon et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-97eb044eec91c24356835ec5e12af2272f548bb1f97ed97df1dfe16accc3c8213</citedby><cites>FETCH-LOGICAL-c692t-97eb044eec91c24356835ec5e12af2272f548bb1f97ed97df1dfe16accc3c8213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4051756/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4051756/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24914674$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Brody, James P.</contributor><creatorcontrib>Simon, Ann M</creatorcontrib><creatorcontrib>Ingraham, Kimberly A</creatorcontrib><creatorcontrib>Fey, Nicholas P</creatorcontrib><creatorcontrib>Finucane, Suzanne B</creatorcontrib><creatorcontrib>Lipschutz, Robert D</creatorcontrib><creatorcontrib>Young, Aaron J</creatorcontrib><creatorcontrib>Hargrove, Levi J</creatorcontrib><title>Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.</description><subject>Adult</subject><subject>Amputation</subject><subject>Amputees - rehabilitation</subject><subject>Ankle</subject><subject>Ankle Joint - physiology</subject><subject>Ascent</subject><subject>Biology and Life Sciences</subject><subject>Biomechanical Phenomena - physiology</subject><subject>Biomechanics</subject><subject>Configurations</subject><subject>Descent</subject><subject>Design</subject><subject>Devices</subject><subject>Electric Impedance</subject><subject>Engineering and Technology</subject><subject>Femur - surgery</subject><subject>Gait</subject><subject>Goals</subject><subject>Humans</subject><subject>Joint Prosthesis</subject><subject>Kinematics</subject><subject>Knee</subject><subject>Knee Joint - physiology</subject><subject>Medicine</subject><subject>Microprocessors</subject><subject>Middle Aged</subject><subject>Parameter modification</subject><subject>Prostheses</subject><subject>Prostheses and implants</subject><subject>Prosthetics</subject><subject>R&D</subject><subject>Rehabilitation</subject><subject>Research & development</subject><subject>Robotics</subject><subject>Time Factors</subject><subject>Trans-femoral amputees</subject><subject>Walking</subject><subject>Walking - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Simon, Ann M</au><au>Ingraham, Kimberly A</au><au>Fey, Nicholas P</au><au>Finucane, Suzanne B</au><au>Lipschutz, Robert D</au><au>Young, Aaron J</au><au>Hargrove, Levi J</au><au>Brody, James P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-06-10</date><risdate>2014</risdate><volume>9</volume><issue>6</issue><spage>e99387</spage><epage>e99387</epage><pages>e99387-e99387</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24914674</pmid><doi>10.1371/journal.pone.0099387</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Amputation Amputees - rehabilitation Ankle Ankle Joint - physiology Ascent Biology and Life Sciences Biomechanical Phenomena - physiology Biomechanics Configurations Descent Design Devices Electric Impedance Engineering and Technology Femur - surgery Gait Goals Humans Joint Prosthesis Kinematics Knee Knee Joint - physiology Medicine Microprocessors Middle Aged Parameter modification Prostheses Prostheses and implants Prosthetics R&D Rehabilitation Research & development Robotics Time Factors Trans-femoral amputees Walking Walking - physiology Young Adult |
| title | Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes |
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