PhD candidate, Massachussets Institute of Technology
In India alone, there are about one million people with lower limb amputation who require significantly more effort to walk, and are subject to social stigmas preventing them from employment and independent living, by using limbs that do not facilitate able-bodied walking motions. There is a gap between the high performance prosthetic feet in the United States that come at a cost of thousands of dollars and the affordable prosthesis in the developing world that lack quality, durability and performance.
The aim of this study is to design a high performance, mass-manufacturable passive prosthetic foot for Indian amputees that complies with international standards at an affordable cost. Through a novel quantitative method, developed in our group, called Lower Leg Trajectory Error (LLTE) which maps the mechanical design of a prosthetic foot to its biomechanical performance, we can optimize the shape and material properties of the passive prosthesis to replicate natural gait and loading on the foot using affordable materials such as injection molding plastics. This exact same design tool (LLTE) can also be used to create highly customized prosthetic feet for high end markets.
By validating this design tool through clinical testing, it will enable us to create a tailored compliant structures that deform under the amputee's weight allowing him to walk in a natural fashion.
Abstract: The Shape&Roll Prosthetic Foot (patent pending) is an artificial foot designed for use in low-income countries, and may also be useful in industrialised nations. Its design is based on the theory that the roll-over shape of a prosthetic foot should mimic that of the non-disabled physiological foot-ankle complex during walking. This article presents the S&R foot including the unique features incorporated into its design. The results of mechanical tests indicate that the roll-over shape of the foot closely mimics the roll-over shape of the non-disabled ankle-foot complex and an expensive 'high-performance' prosthetic foot. The fatigue testing process for the S&R foot is also described. The foot has been shown to be durable according to the International Organization for Standardization (ISO) standards, with more than five samples tested to date. The Shape&Roll Foot is low in cost, simple to fabricate, light in weight, low in profile, and is highly functional for walking in respect of roll-over characteristics.
Pub.: 04 Feb '05, Pinned: 30 Jun '17
Abstract: Decreased push-off power by the prosthetic foot and inadequate roll-over shape of the foot have been shown to increase the energy dissipated during the step-to-step transition in human walking. The aim of this study was to determine whether energy storage and return (ESAR) feet are able to reduce the mechanical energy dissipated during the step-to-step transition. Fifteen males with a unilateral lower-limb amputation walked with their prescribed ESAR foot (Vari-Flex, Ossur; Reykjavik, Iceland) and with a solid-ankle cushioned heel foot (SACH) (1D10, Ottobock; Duderstadt, Germany), while ground reaction forces and kinematics were recorded. The positive mechanical work on the center of mass performed by the trailing prosthetic limb was larger (33%, p = 0.01) and the negative work performed by the leading intact limb was lower (13%, p = 0.04) when walking with the ESAR foot compared with the SACH foot. The reduced step-to-step transition cost coincided with a higher mechanical push-off power generated by the ESAR foot and an extended forward progression of the center of pressure under the prosthetic ESAR foot. Results can explain the proposed improvement in walking economy with this kind of energy storing and return prosthetic foot.
Pub.: 01 Jan '14, Pinned: 30 Jun '17
Abstract: The purpose of this article is to provide an overview of our previous work on roll-over shapes, which are the effective rocker shapes that the lower limb systems conform to during walking.This article is a summary of several recently published articles from the Northwestern University Prosthetics Research Laboratory and Rehabilitation Engineering Research Program on the topic of roll-over shapes. The roll-over shape is a measurement of centre of pressure of the ground reaction force in body-based coordinates. This measurement is interpreted as the effective rocker shape created by lower limb systems during walking.Our studies have shown that roll-over shapes in able-bodied subjects do not change appreciably for conditions of level ground walking, including walking at different speeds, while carrying different amounts of weight, while wearing shoes of different heel heights, or when wearing shoes with different rocker radii. In fact, results suggest that able-bodied humans will actively change their ankle movements to maintain the same roll-over shapes.The consistency of the roll-over shapes to level surface walking conditions has provided insight for design, alignment and evaluation of lower limb prostheses and orthoses. Changes to ankle-foot and knee-ankle-foot roll-over shapes for ramp walking conditions have suggested biomimetic (i.e. mimicking biology) strategies for adaptable ankle-foot prostheses and orthoses.
Pub.: 16 Jul '10, Pinned: 30 Jun '17
Abstract: The use of rocker models to understand functional tasks of the human lower limb is attractive because of their simplicity. Recent studies have determined a consistent feature of able-bodied walking termed the roll-over shape (ROS), which is the effective rocker shape that the lower limb system conforms to between initial contact and contralateral initial contact during walking. However, it is unclear what effective rocker shapes are used for fore-aft swaying. A better understanding of these shapes could be used to develop improved prostheses for this task, perhaps improving balance and balance confidence, and reducing the occurrence of falling in lower limb prosthesis users. We measured effective rocker shapes used by 11 able-bodied persons during walking and fore-aft swaying. We hypothesized that the curvature of the swaying shapes would be smaller (radius larger) than that of the walking shapes, providing a more stable interface with the ground during swaying. The radius (measured as the inverse of the curvature of the shape) was found to be about 1/3 of the leg length for walking, but over two times the leg length for swaying. A model examining the effective ankle stiffness necessary to achieve these curvatures suggests that the stiffness of a biomimetic prosthetic ankle would need to be over three times higher for fore-aft swaying than for walking. These results suggest that two separate modes would be needed in an ankle-foot prosthesis to mimic the physiologic system for walking and swaying.
Pub.: 18 May '10, Pinned: 30 Jun '17
Abstract: A few investigators have described the movement of the center of pressure (COP) of the ground reaction force and the activation patterns of the lower limb muscles during gait initiation and termination. This study examines the effective rocker (roll-over shape) behavior of the knee-ankle-foot (KAF) system during gait initiation, steady-state walking (i.e. constant speed gait), and gait termination. The KAF roll-over shapes were characterized by transforming COP data of 10 able-bodied subjects from a laboratory-based coordinate system into a leg-based coordinate system. The resulting roll-over shapes (effective rockers) were characterized using a circular arc model. The KAF roll-over shapes exhibit an overall "flexed" orientation during the first step of gait initiation and an "extended" orientation during the last step of gait termination. Understanding the behavior of the anatomical KAF system during gait initiation and termination may aid in the design of prosthetic components, i.e. mechanical devices that replace complete anatomical structures. Prostheses that intend to mimic the overall behavior of physiological KAF systems (biomimetic designs) could be manufactured using approaches that are much simpler than attempting to reconstruct the complexity of the lower limb.
Pub.: 05 Jun '07, Pinned: 30 Jun '17
Abstract: Roll-over characteristics of able-bodied human subjects walking on ramped surfaces were examined in this study. Ten subjects walked at their normal self-selected speed on a level surface, a 5-deg ramp, and a 10-deg ramped surface. Ramps were designed such that ground reaction forces and center of pressure of the ground reaction forces could be measured on their surfaces. This set-up facilitated calculation of the effective rockers that the ankle-foot (AF) and knee-ankle-foot (KAF) systems conformed to during single-limb stance (contralateral toe off to contralateral heel contact). Since our original "roll-over shapes" were characterized between heel contact and opposite heel contact, we label the shapes found during single-limb stance as "truncated roll-over shapes". We hypothesized that the ankle-foot system would adapt to the various surfaces, creating a roll-over shape that would change in orientation with different levels of inclination. The truncated AF roll-over shapes supported this hypothesis for uphill walking but did not support the hypothesis for downhill walking. However, truncated roll-over shapes of the KAF system did adjust their orientation to match both the positive and negative levels of surface inclination. In general, the ankle appears to be the main adapting joint when walking up inclined surfaces while the knee becomes important for the overall adaptation in downhill walking. Knowledge of physiological lower-limb roll-over characteristics on ramped surfaces may help in the development of biomimetic prostheses and orthoses that will automatically adapt to changes in walking surface inclination.
Pub.: 25 Jan '05, Pinned: 30 Jun '17
Abstract: Modern passive prosthetic foot/ankles cannot adapt to variations in ground slope. The lack of active adaptation significantly compromises an amputee's balance and stability on uneven terrains. To address this deficit, this paper proposes an ankle prosthesis that uses semi-active damping as a mechanism to provide active slope adaptation. The conceptual ankle prosthesis consists of a modulated damper in series with a spring foot that allows the foot to conform to the angle of the surface in the sagittal plane. In support of this approach, biomechanics data is presented showing unilateral transtibial amputees stepping on a wedge with their daily-use passive prosthesis. Based on this data, a simulation of the ankle prosthesis with semi-active damping is developed. The model shows the kinematic adaptation of the prosthesis to sudden changes in ground slope. The results show the potential of an ankle prosthesis with semi-active damping to actively adapt to the ground slope at each step.
Pub.: 19 Jan '12, Pinned: 30 Jun '17
Abstract: This article describes the development of a prototype prosthetic ankle-foot system that passively adapts to surface slopes on each step of walking. Engineering analyses were performed to design the cam clutch and clutch engagement and disengagement mechanism. The prototype was tested by a veteran with a unilateral transtibial amputation. Kinematic and kinetic data were recorded while the subject walked on a treadmill at slopes ranging from -10 degrees to +10 degrees. After each slope condition, the subject rated his level of exertion and socket comfort. The subject reported increased comfort and reduced exertion for downhill slopes when using the prototype compared with his usual prosthesis. The subject also expressed that when walking downhill on the prototype, it was the most comfortable he has ever been in a prosthesis. The prosthetic ankle torque-angle relationship shifted toward dorsiflexion for uphill and toward plantar flexion for downhill slopes when using the prototype, indicating slope adaptation, but this effect did not occur when the subject walked with his usual prosthesis. The prototype also demonstrated late-stance plantar flexion, suggesting the potential for storing and returning more energy than standard lower-limb prostheses.
Pub.: 22 Oct '14, Pinned: 30 Jun '17
Abstract: The majority of commercially available passive prosthetic feet are not capable of providing joint mechanics that match that of the intact human ankle. Due to their cantilever design, their stiffness characteristics contrast with what has been observed in the biological ankle; namely, an increase in stiffness during the stance phase of walking. In this study, we introduce the design and control of a pneumatic foot-ankle prosthesis that attempts to provide biomimetic mechanics. The prosthesis is comprised of a pneumatic cylinder in series with a fiberglass leaf spring, and a solenoid valve to control the flow of air between the two sides of the cylinder. The solenoid valve acts as a mechanical clutch, enabling resetting of the ankle's equilibrium position. By adjusting the pressure inside the cylinder, the prosthesis can be customized to provide a range of ankle mechanics. A mechanical testing machine is used to compare the torque-angle curve of the pneumatic prosthesis to a low-profile passive prosthetic foot. Finally, data are presented of one transtibial amputee walking with the prosthesis at 1.2 m/s. The testing shows that the pneumatic prosthesis is capable of providing an appropriate range of motion as well a maximum torque of 94 Nm, while returning approximately 11.5 J of energy.
Pub.: 04 May '17, Pinned: 30 Jun '17
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