scholarly journals Experimental characterization of the moment-angle curve during level and slope locomotion of transtibial amputee: Which parameters can be extracted to quantify the adaptations of microprocessor prosthetic ankle?

Author(s):  
Julie Davot ◽  
Marie Thomas-Pohl ◽  
Coralie Villa ◽  
Xavier Bonnet ◽  
Eric Lapeyre ◽  
...  

In case of transtibial amputation, the deficit resulting from the loss of the lower limb can be partly compensated with a prosthetic foot and adapted rehabilitation. New prosthetic feet have been developed for transtibial amputees to mimic ankle adaptability to varying terrain. Among them, Microprocessor Prosthetic Ankles (MPA) have a microprocessor to control an electric or a hydraulic actuator to adapt ankle kinematics in stairs and slopes. The objective is to investigate parameters extracted from the moment-angle curve (MAC) and use them to compare 3 MPA during level and slope locomotion against energy storing and return (ESR) foot. Five persons with lower limb transtibial amputation successively fitted with 3 MPA (Propriofoot™, Elan™, Meridium™) compared to their ESR foot. The participants had 2 weeks of adaptation before data acquisition and then a 3 week wash-out period. Range of motion, equilibrium point, hysteresis, late stance energy released, and quasi-stiffness were computed on level ground and 12% slope (upward and downward) thanks to the MAC at the ankle. The study shows the relevance of MAC parameters to evaluate the behavior of MPA. In particular, compared to ESR, all MPA tested in the present study demonstrated a better angle adaptation between walking conditions but a decrease of available energy for the propulsion. Among MPA, main results were: (i) for the Propriofoot™: an adaptation of the ankle angle without modification of the pattern of the MAC (ii) for the Elan™: a limited adaptation of the range of motion but a modification of the energy released (iii) for the Meridium™, the highest adaptation of the range of motion but the lowest available energy of propulsion. One of the main findings of the research is to show and quantify the relationship between range of motion and energy available when using different prosthetic feet in different walking conditions.

Author(s):  
Francy L. Sinatra ◽  
Stephanie L. Carey ◽  
Rajiv Dubey

Previous studies have been conducted to develop a biomechanical model for a human’s lower limb. Amongst them, there have been several studies trying to quantify the kinetics and kinematics of lower-limb amputees through motion analysis [5, 10, 11]. Currently, there are various designs for lower-limb prosthetic feet such as the Solid Ankle Cushion Heel (SACH) from Otto Bock (Minneapolis) or the Flex Foot from Ossur (California). The latter is a prosthetic foot that allows for flexibility while walking and running. Special interest has been placed in recording the capabilities of these energy-storing prosthetic feet. This has been done through the creation of biomechanical models with motion analysis. In these previous studies the foot has been modeled as a single rigid-body segment, creating difficulties when trying to calculate the power dissipated by the foot [5, 20, 21]. This project studies prosthetic feet with energy-storing capabilities. The purpose is to develop an effective way of calculating power by using a biomechanical model. This was accomplished by collecting biomechanical data using an eight camera VICON (Colorado) motion analysis system including two AMTI (BP-400600, Massachusetts) force plates. The marker set that was used, models the foot using several segments, hence mimicking the motion the foot undergoes and potentially leading to greater accuracy. By developing this new marker set, it will be possible to combine the kinematic and kinetic profile gathered from it with previous studies that determined metabolic information. This information will allow for the better quantification and comparison of the energy storage and return (ES AR) feet and perhaps the development of new designs.


Author(s):  
Michelle Roland ◽  
Peter G. Adamczyk ◽  
Michael E. Hahn

The calculated roll-over shape and respective radius of intact and prosthetic feet has been shown to be a useful measure of lower limb function during walking [1–2]. Hansen et al [3] reported that the roll-over radius, R, is constant over a range of speeds for the intact foot-ankle system. It may be assumed that the prosthetic foot R would also be constant with increased walking speed. Similarly, the angular stiffness of prosthetic feet is not likely to change with walking speed, as the material stiffness remains unchanged. However, the effective angular stiffness of the intact ankle may increase with the plantar flexor moment during the stance phase of gait, which typically increases in magnitude with walking speed.


2013 ◽  
Vol 7 (3) ◽  
Author(s):  
Andrew H. Hansen ◽  
Eric A. Nickel

The human ankle-foot system conforms to a circular effective rocker shape for walking, but to a much flatter effective shape for standing and swaying. Many persons with lower limb amputations have impaired balance and reduced balance confidence, and may benefit from prostheses designed to provide flatter effective rocker shapes during standing and swaying tasks. This paper describes the development and testing of an ankle-foot prosthesis prototype that provides distinctly different mechanical properties for walking and standing/swaying. The prototype developed was a single-axis prosthetic foot with a lockable ankle for added stability during standing and swaying. The bimodal ankle-foot prosthesis prototype was tested on pseudoprostheses (walking boots with prosthetic feet beneath) for walking and standing/swaying loads, and was compared to an Otto Bock single-axis prosthetic foot and to able-bodied data collected in a previous study. The height-normalized radius of the effective rocker shape for walking with the bimodal ankle-foot prototype was equal to that found earlier for able-bodied persons (0.17); the standing and swaying effective shape had a lower height-normalized radius (0.70) compared with that previously found for able-bodied persons (1.11). The bimodal ankle-foot prosthesis prototype had a similar radius as the Otto Bock single-axis prosthetic foot for the effective rocker shape for walking (0.17 for both), but had a much larger radius for standing and swaying (0.70 for bimodal, 0.34 for single-axis). The results suggest that the bimodal ankle-foot prosthesis prototype provides two distinct modes, including a biomimetic effective rocker shape for walking and an inherently stable base for standing and swaying. The radius of the prototype's effective rocker shape for standing/swaying suggests that it may provide inherent mechanical stability to a prosthesis user, since the radius is larger than the typical body center of mass’s distance from the floor (between 50–60% of height). Future testing is warranted to determine if the bimodal ankle-foot prosthesis will increase balance and balance confidence in prosthesis users.


2006 ◽  
Vol 30 (2) ◽  
pp. 213-223 ◽  
Author(s):  
H. Goujon ◽  
X. Bonnet ◽  
P. Sautreuil ◽  
M. Maurisset ◽  
L. Darmon ◽  
...  

This paper reports on a functional evaluation of prosthetic feet based on gait analysis. The aim is to analyse prosthetic feet behaviour under loads applied during gait in order to quantify user benefits for each foot. Ten traumatic amputees (six trans-tibial and four trans-femoral) were tested using their own prosthetic foot. An original protocol is presented to calculate the forefoot kinematics together with the overall body kinematics and ground reaction forces during gait. In this work, sagittal motion of the prosthetic ankle and the forefoot, time-distance parameters and ground reaction forces were examined. It is shown that an analysis of not only trans-tibial but also trans-femoral amputees provides an insight in the performance of prosthetic feet. Symmetry and prosthetic propulsive force were proved to be mainly dependant on amputation level. In contrast, the flexion of the prosthetic forefoot and several time-distance parameters are highly influenced by foot design. Correlations show influential of foot and ankle kinematics on other parameters. These results suggest that prosthetic foot efficiency depends simultaneously on foot design and gait style. The evaluation, proposed in this article, associated to clinical examination should help to achieve the best prosthetic foot match to a patient.


2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Michael McGrath ◽  
Katherine C. Davies ◽  
Piotr Laszczak ◽  
Beata Rek ◽  
Joe McCarthy ◽  
...  

BACKGROUND: Lower limb amputees have a high incidence of comorbidities, such as osteoarthritis, which are believed to be caused by kinetic asymmetries. A lack of prosthetic adaptation to different terrains requires kinematic compensations, which may influence these asymmetries. METHOD: Six SIGAM grade E-F trans-tibial amputees (one bilateral) wore motion capture markers while standing on force plates, facing down a 5° slope. The participants were tested under three prosthetic conditions; a fixed attachment foot (FIX), a hydraulic ankle (HYD) and a microprocessor foot with a ‘standing support’ mode (MPF). The resultant ground reaction force (GRF) and support moment for prosthetic and sound limbs were chosen as outcome measures. These were compared between prosthetic conditions and to previously captured able-bodied control data. RESULTS: The distribution of GRF between sound and prosthetic limbs was not significantly affected by foot type. However, the MPF condition required fewer kinematic compensations, leading to a reduction in sound side support moment of 59% (p=0.001) and prosthetic side support moment of 43% (p=0.02) compared to FIX. For the bilateral participant, only the MPF positioned the GRF vector anterior to the knees, reducing the demand on the residual joints to maintain posture. CONCLUSION: For trans-tibial amputees, loading on lower limb joints is affected by prosthetic foot technology, due to the kinematic compensations required for slope adaptation. MPFs with ‘standing support’ might be considered reasonable and necessary for bilateral amputees, or amputees with stability problems due to the reduced biomechanical compensations evident. LAYMAN’S ABSTRACT: Lower limb prostheses work well on flat ground but often don’t adapt well to uneven ground or slopes. As a result, amputees tend to put more of their weight through their healthy leg. This can lead to problems like back pain and arthritis. In this study, the posture and weight distribution of below knee amputees were analysed while they stood facing down a slope. They did this with three different prosthetic feet; one with no ‘ankle’ joint, one with an ‘ankle’ (which could always move) and one with a computer-controlled ‘ankle’ (which could adapt to the slope but then resist movement when the wearer was stood still). Changing the prosthetic feet did not affect the amount of weight put through each limb, but when they had ‘ankle’ joints, the amputees were able to stand up straight, with a better posture. This meant that the demand on their joints was reduced, particularly on the healthy limb. One participant had below knee amputations on both legs. For this participant, only the computer-controlled device allowed her to stand up straight and well balanced. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/33517/25933 How to Cite: McGrath M, Davies KC, Laszczak P, Rek B, McCarthy J, Zahedi S, Moser D. The influence of hydraulic ankles and microprocessor-control on the biomechanics of trans-tibial amputees during quiet standing on a 5° slope. Canadian Prosthetics & Orthotics Journal. 2019;Volume2, Issue2, No.2. https://doi.org/10.33137/cpoj.v2i2.33517 CORRESPONDING AUTHOR Dr. Michael McGrath,Research Scientist–Clinical EvidenceBlatchford Group, Unit D Antura, Bond Close, Basingstoke, RG24 8PZ, United KingdomEmail: [email protected]: https://orcid.org/0000-0003-0195-970X  


2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Victor Prost ◽  
Kathryn M. Olesnavage ◽  
W. Brett Johnson ◽  
Matthew J. Major ◽  
Amos G. Winter

An experimental prosthetic foot intended for evaluating a novel design objective is presented. This objective, called the lower leg trajectory error (LLTE), enables the optimization of passive prosthetic feet by modeling the trajectory of the shank during single support for a given prosthetic foot and selecting design variables that minimize the error between this trajectory and able-bodied kinematics. A light-weight, fully characterized test foot with variable ankle joint stiffness was designed to evaluate the LLTE. The test foot can replicate the range of motion of a physiological ankle over a range of different ankle joint stiffnesses. The test foot consists of a rotational ankle joint machined from acetal resin, interchangeable U-shaped nylon springs that range from 1.5 N · m/deg to 24 N · m/deg, and a flexible nylon forefoot with a bending stiffness of 16 N · m2. The U-shaped springs were designed to support a constant moment along their length to maximize strain energy density; this feature was critical in creating a high-stiffness and high-range of motion ankle. The design performed as predicted during mechanical and in vivo testing, and its modularity allowed us to rapidly vary the ankle joint stiffness. Qualitative feedback from preliminary testing showed that this design is ready for use in large scale clinical trials to further evaluate the use of the LLTE as an optimization objective for passive prosthetic feet.


2019 ◽  
Vol 19 (06) ◽  
pp. 1950050
Author(s):  
M. T. KARIMI ◽  
R. B. TAHMASEBI ◽  
B. SATVATI ◽  
F. FATOYE

Flat foot is the most common foot disorder that influences the alignment of the lower limb structure. It is controversial whether the use of foot insole influences kinetic and kinematic of the leg or not. Therefore, this study investigated the influence of foot insole on the gait performance in subjects with flat foot disorder. A group of flat foot subject was recruited into this study (the number of subjects was 15). The motion of the leg joints was determined using the Qualysis motion analysis system. Moreover, the force applied on the lower limb was recorded by a Kistler force plate. The range of motion of the lower limb joints, the moments applied on the lower limb joints and force transmitted through the leg were the parameters used in this study. The difference between these parameters during walking with and without insole was evaluated using the paired [Formula: see text]-test. Significant value was set at [Formula: see text]. There was no significant difference between the range of motion of ankle joint while walking with and without insole. However, the medial directed force applied on the leg decreased significantly [Formula: see text]. The use of foot insole did not influence the moments transmitted through the hip and knee joints. The walking speed of the subjects improved while walking with foot insole. Use of foot insole influenced the magnitude of the force applied on the leg and the adductor moment of ankle joint due to its influence on foot alignment. As the walking speed of the improved subjects follows the use of insole, it can be concluded that it may have a positive effects on the performance of flat foot subjects.


2018 ◽  
Vol 62 ◽  
pp. 349-354 ◽  
Author(s):  
Cody L. McDonald ◽  
Patricia A. Kramer ◽  
Sara J. Morgan ◽  
Elizabeth G. Halsne ◽  
Sarah M. Cheever ◽  
...  

1989 ◽  
Vol 79 (4) ◽  
pp. 1177-1193
Author(s):  
Jacques Talandier ◽  
Emile A. Okal

Abstract We have developed a new magnitude scale, Mm, based on the measurement of mantle Rayleigh-wave energy in the 50 to 300 sec period range, and directly related to the seismic moment through Mm = log10M0 − 20. Measurements are taken on the first passage of Rayleigh waves, recorded on-scale on broadband instruments with adequate dynamical range. This allows estimation of the moment of an event within minutes of the arrival of the Rayleigh wave, and with a standard deviation of ±0.2 magnitude units. In turn, the knowledge of the seismic moment allows computation of an estimate of the high-seas amplitude of a range of expectable tsunami heights. The latter, combined with complementary data from T-wave duration and historical references, have been integrated into an automated procedure of tsunami warning by the Centre Polynésien de Prévention des Tsunamis (CPPT), in Papeete, Tahiti.


2021 ◽  
Vol 11 (1) ◽  
pp. 114-123
Author(s):  
Zakia Azkia ◽  
Rahmi Setiyani ◽  
Lita Heni Kusumawardani

Background: Falls are a significant health problem and the most common cause of injuries in older people. Different types of exercise have been recommended to prevent falls, including balance exercise and range of motion. However, there is a lack of evidence to compare the effect of the two exercises.Purpose: This study aimed to compare the effect of Balance Strategy Exercise (BSE) and Lower Limb-Range of Motion (ROM) exercise on reducing the risk of falls among older people living in long-term care facilities. Methods: This was a quasi-experimental study using a pre-post design without a control group. A total of 30 older adults from two nursing homes who met the inclusion and exclusion criteria participated in the study. A cluster randomization technique was used to assign the older people into either BSE or Lower-Limb ROM groups evenly. Treatment was given for 30 minutes per session, three sessions per week for three weeks. The risk of falls was measured using the Timed Up and Go (TUG) test. The paired t-test, Wilcoxon and Mann-Whitney U-test were used to analyze the data. Results: Results showed significant differences in the TUG scores before and after the intervention within both the BSE (p=0.001) and the Lower Limb-ROM group (p=0.001). However, the Lower Limb-ROM group demonstrated a significantly higher reduction in TUG score than the BSE group after the intervention (p=0.008).Conclusion: Lower Limb-ROM exercise is better to reduce the risk of falls among older people living in institutional care than BSE. This exercise can be applied as part of a fall prevention program in nursing homes.


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