title: Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes.
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.
authors.affiliation: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois, United States of America; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, United States of America.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Simon
authors.affiliation: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois, United States of America.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Ingraham
authors.affiliation: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois, United States of America; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, United States of America.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Fey
authors.affiliation: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois, United States of America.
authors.forename: Suzanne B
authors.initials: SB
authors.lastname: Finucane
authors.affiliation: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois, United States of America; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, United States of America.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Lipschutz
authors.affiliation: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois, United States of America; Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, United States of America.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Young
authors.affiliation: Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, Illinois, United States of America; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, United States of America.
authors.forename: Levi J
authors.initials: LJ
authors.lastname: Hargrove
mesh_terms: D000328:Adult; D000674:Amputees / Q000534:rehabilitation*; D000843:Ankle Joint / Q000502:physiology*; D001696:Biomechanical Phenomena / Q000502:physiology; D017097:Electric Impedance; D005269:Femur / Q000601:surgery*; D006040:Goals; D006801:Humans; D007595:Joint Prosthesis; D007719:Knee Joint / Q000502:physiology*; D008875:Middle Aged; D013997:Time Factors; D016138:Walking / Q000502:physiology*; D055815:Young Adult