Benefits of a microprocessor-controlled prosthetic foot for ascending and descending slopes.

BACKGROUND: Prosthetic feet are prescribed for persons with a lower-limb amputation to restore lost mobility. However, due to limited adaptability of their ankles and springs, situations like walking on slopes or uneven ground remain challenging. This study investigated to what extent a microprocessor-controlled prosthetic foot (MPF) facilitates walking on slopes. METHODS: Seven persons each with a unilateral transtibial amputation (TTA) and unilateral transfemoral amputation (TFA) as well as ten able-bodied subjects participated. Participants were studied while using a MPF and their prescribed standard feet with fixed ankle attachments. The study investigated ascending and descending a 10° slope. Kinematic and kinetic data were recorded with a motion capture system. Biomechanical parameters, in particular leg joint angles, shank orientation and external joint moments of the prosthetics side were calculated. RESULTS: Prosthetic feet- and subject group-dependent joint angle and moment characteristics were observed for both situations. The MPF showed a larger and situation-dependent ankle range of motion compared to the standard feet. Furthermore, it remained in a dorsiflexed position during swing. While ascending, the MPF adapted the dorsiflexion moment and reduced the knee extension moment. At vertical shank orientation, it reduced the knee extension moment by 26% for TFA and 49% for TTA compared to the standard feet. For descending, differences between feet in the biomechanical knee characteristics were found for the TTA group, but not for the TFA group. At the vertical shank angle during slope descent, TTA demonstrated a behavior of the ankle moment similar to able-bodied controls when using the MPF. CONCLUSIONS: The studied MPF facilitated walking on slopes by adapting instantaneously to inclinations and, thus, easing the forward rotation of the leg over the prosthetic foot compared to standard feet with a fixed ankle attachment with amputation-level dependent effect sizes. It assumed a dorsiflexed ankle angle during swing, enabled a larger ankle range of motion and reduced the moments acting on the residual knee of TTA compared to the prescribed prosthetic standard feet. For individuals with TFA, the prosthetic knee joint seems to play a more crucial role for walking on ramps than the foot.

Standing on slopes - how current microprocessor-controlled prosthetic feet support transtibial and transfemoral amputees in an everyday task.

BACKGROUND: Conventional prosthetic feet like energy storage and return feet provide only a limited range of ankle motion compared to human ones. In order to overcome the poor rotational adaptability, prosthetic manufacturers developed different prosthetic feet with an additional rotational joint and implemented active control in different states. It was the aim of the study to investigate to what extent these commercially available microprocessor-controlled prosthetic feet support a natural posture while standing on inclines and which concept is most beneficial for lower limb amputees. METHODS: Four unilateral transtibial and four unilateral transfemoral amputees participated in the study. Each of the subjects wore five different microprocessor-controlled prosthetic feet in addition to their everyday feet. The subjects were asked to stand on slopes of different inclinations (level ground, upward slope of 10°, and downward slope of -10°). Vertical ground reaction forces, joint torques and joint angles in the sagittal plane were measured for both legs separately for the different situations and compared to a non-amputee reference group. RESULTS: Differences in the biomechanical parameters were observed between the different prosthetic feet and compared to the reference group for the investigated situations. They were most prominent while standing on a downward slope. For example, on the prosthetic side, the vertical ground reaction force is reduced by about 20%, and the torque about the knee acts to flex the joint for feet that are not capable of a full adaptation to the downward slope. In contrast, fully adaptable feet with an auto-adaptive dorsiflexion stop show no changes in vertical ground reaction forces and knee extending torques. CONCLUSIONS: A prosthetic foot that provides both, an auto-adaptive dorsiflexion stop and a sufficient range of motion for fully adapting to inclinations appears to be the key element in the prosthetic fitting for standing on inclinations in lower limb amputees. In such situations, this prosthetic concept appears superior to both, conventional feet with passive structures as well as feet that solely provide a sufficient range of motion. The results also indicate that both, transfemoral and transtibial amputees benefit from such a foot.

Using mobile eye tracking to measure cognitive load through gaze behavior during walking in lower limb prosthesis users: A preliminary assessment.

BACKGROUND: Lower limb amputation does not affect only physical and psychological functioning but the use of a prosthetic device can also lead to increased cognitive demands. Measuring cognitive load objectively is challenging, and therefore, most studies use questionnaires that are easy to apply but can suffer from subjective bias. Motivated by this, the present study investigated whether a mobile eye tracker can be used to objectively measure cognitive load by monitoring gaze behavior during a set of motor tasks. METHODS: Five prosthetic users and eight able-bodied controls participated in this study. Eye tracking data and kinematics were recorded during a set of motor tasks (level ground walking, walking on uneven terrain, obstacle avoidance, stairs up and ramp down, as well as ramp up and stairs down) while the participants were asked to focus their gaze on a visual target for as long as possible. Target fixation times and increase in pupil diameters were determined and correlated to subjective ratings of cognitive load. FINDINGS: Overall, target fixation time and pupil diameter showed strong negative and positive correlations, respectively, to the subjective rating of cognitive load in the able-bodied controls (-0.75 and 0.80, respectively). However, the individual correlation strength, and in some cases, even the sign, was different across participants. A similar trend could be observed in prosthetic users. INTERPRETATION: The results of this study showed that a mobile eye tracker may be used to estimate cognitive load in prosthesis users during locomotor tasks. This paves the way to establish a new approach to assessing cognitive load, which is objective and yet practical and simple to administer. Nevertheless, future studies should corroborate these results by comparing them to other objective measures as well as focus on translating the proposed approach outside of a laboratory.

Synthesis, NMR spectroscopic characterization and structure of a divinyldisilazane-(triphenylphosphine)platinum(0) complex: observation of isotope-induced chemical shifts (1)Δ(12/13)C((195)Pt).

Tetramethyldivinyldisilazane-(triphenylphosphine)platinum(0) was prepared, characterized in solid state by X-ray crystallography and in solution by multinuclear magnetic resonance spectroscopy ((1)H, (13)C, (15)N, (29)Si, (31)P and (195)Pt NMR). Numerous signs of spin-spin coupling constants were determined by two-dimensional heteronuclear shift correlations (HETCOR) and two-dimensional (1)H/(1)H COSY experiments. Isotope-induced chemical shifts (1)Δ(12/13)C((195)Pt) were measured from (195)Pt NMR spectra of the title compound as well as of other Pt(0), Pt(II) and Pt(IV) compounds for comparison. In contrast to other heavy nuclei such as (199)Hg or (207)Pb, the "normal" shifts of the heavy isotopomers to low frequencies are found, covering a range of >500 ppb.

Polymer derived non-oxide ceramics modified with late transition metals.

This tutorial review highlights the methods for the preparation of metal modified precursor derived ceramics (PDCs) and concentrates on the rare non-oxide systems enhanced with late transition metals. In addition to the main synthetic strategies for modified SiC and SiCN ceramics, an overview of the morphologies, structures and compositions of both, ceramic materials and metal (nano) particles, is presented. Potential magnetic and catalytic applications have been discussed for the so manufactured metal containing non-oxide ceramics.

Force transmission capacity of the lower limb during walking of amputees with bone-anchored prostheses compared with socket prostheses and persons with hip replacements.

BACKGROUND: Restoring the ability to walk with a prosthesis is considered a fundamental rehabilitation goal after transfemoral amputation. An essential prerequisite for achieving this goal is adequate force transmission between the prosthesis and the body. Does bone anchorage of an artificial limb permit a more normal force transmission? METHODS: Data of 15 healthy subjects, nine amputees fitted with bone-anchored prostheses, nine amputees using socket prostheses, and 18 patients with a total hip replacement were included in this multicenter, observational study. Ground reaction force was measured using Kistler force plates. Kinematics was recorded with 12 Vicon Bonita cameras. Subjects were instructed to walk at three different speeds: first at their self-selected, then at slow, and finally at fast speed. FINDINGS: Self-selected walking speeds of subject groups were significantly different, osseointegrated amputees walked the slowest. The lowest ground reaction force was measured for osseointegrated amputees on the prosthetic side, who also showed the highest force on their contralateral side. Patients with hip replacements showed values similar as healthy subjects. The vertical center of gravity movement was specific for each subject group. INTERPRETATION: The force transmission capacity of the bone-anchored prosthetic leg is limited during walking and is lower than both in socket prostheses users without symptoms and patients with total hip replacement. Therefore, active amputees well fitted with a socket prosthesis who consider a transition to bone-anchorage should be advised that their walking speed may decrease with high probability, and that their self-selected walking speed may even be slower than 3 km/h.

Using embedded prosthesis sensors for clinical gait analyses in people with lower limb amputation: A feasibility study.

BACKGROUND: Biomechanical gait analyses are typically performed in laboratory settings, and are associated with limitations due to space, marker placement, and tasks that are not representative of the real-world usage of lower limb prostheses. Therefore, the purpose of this study was to investigate the possibility of accurately measuring gait parameters using embedded sensors in a microprocessor-controlled knee joint. METHODS: Ten participants were recruited for this study and equipped with a Genium X3 prosthetic knee joint. They performed level walking, stair/ramp descent, and ascent. During these tasks, kinematics and kinetics (sagittal knee and thigh segment angle, and knee moment) were recorded using an optical motion capture system and force plates (gold standard), as well as the prosthesis-embedded sensors. Root mean square errors, relative errors, correlation coefficients, and discrete outcome variables of clinical relevance were calculated and compared between the gold standard and the embedded sensors. FINDINGS: The average root mean square errors were found to be 0.6°, 5.3°, and 0.08 Nm/kg, for the knee angle, thigh angle, and knee moment, respectively. The average relative errors were 0.75% for the knee angle, 11.67% for the thigh angle, and 9.66%, for the knee moment. The discrete outcome variables showed small but significant differences between the two measurement systems for a number of tasks (higher differences only at the thigh). INTERPRETATION: The findings highlight the potential of prosthesis-embedded sensors to accurately measure gait parameters across a wide range of tasks. This paves the way for assessing prosthesis performance in realistic environments outside the lab.

Novel 1,4-Dihydropyridines as Specific Binders and Activators of SIRT3 Impair Cell Viability and Clonogenicity and Downregulate Hypoxia-Induced Targets in Cancer Cells.

The mitochondrial SIRT3 modulates several biological pathways such as cancer, metabolism, and hypoxia-related diseases. Recently, we discovered new 1,4-dihydropyridines, compounds 2 and 3, the latter being a SIRT3-specific activator. In the present work, a novel 2- and 3-related small series of compounds have been developed, with 3c displaying the strongest SIRT3 binding and activation, with a KD of 29 µM and 387% of enzyme activation. Differently, 3d was the best in enhancing glutamate dehydrogenase activity and deacetylating K68- and K122-acMnSOD in triple-negative MDA-MB-231 breast cancer cells. Tested in CAL-62 thyroid cancer and MDA-MB-231 cells, 3d displayed the strongest time- and dose-dependent reduction of cell viability and clonogenicity at a single-digit micromolar level, along with cell death, in both normoxia and hypoxia conditions. Moreover, 3d downregulated not only hypoxia-induced factors, such as HIF-1α, EPAS-1, and CA-IX, but also epithelial-mesenchymal transition master regulators and extracellular matrix components such as SNAIL1, ZEB1, SLUG, COL1A2, MMP2, and MMP9, markedly hampering MDA-MB-231 cell migration.

Immediate effects of a new microprocessor-controlled prosthetic knee joint: a comparative biomechanical evaluation.

OBJECTIVE: To investigate the immediate biomechanical effects after transition to a new microprocessor-controlled prosthetic knee joint. DESIGN: Intervention cross-over study with repeated measures. Only prosthetic knee joints were changed. SETTING: Motion analysis laboratory. PARTICIPANTS: Men (N=11; mean age ± SD, 36.7±10.2y; Medicare functional classification level, 3-4) with unilateral transfemoral amputation. INTERVENTIONS: Two microprocessor-controlled prosthetic knee joints: C-Leg and a new prosthetic knee joint, Genium. MAIN OUTCOME MEASURES: Static prosthetic alignment, time-distance parameters, kinematic and kinetic parameters, and center of pressure. RESULTS: After a half-day training and an additional half-day accommodation, improved biomechanical outcomes were demonstrated by the Genium: lower ground reaction forces at weight acceptance during level walking at various velocities, increased swing phase flexion angles during walking on a ramp, and level walking with small steps. Maximum knee flexion angle during swing phase at various velocities was nearly equal for Genium. Step-over-step stair ascent with the Genium knee was more physiologic as demonstrated by a more equal load distribution between the prosthetic and contralateral sides and a more natural gait pattern. When descending stairs and ramps, knee flexion moments with the Genium tended to increase. During quiet stance on a decline, subjects using Genium accepted higher loading of the prosthetic side knee joint, thus reducing same side hip joint loading as well as postural sway. CONCLUSIONS: In comparision to the C-Leg, the Genium demonstrated immediate biomechanical advantages during various daily ambulatory activities, which may lead to an increase in range and diversity of activity of people with above-knee amputations. Results showed that use of the Genium facilitated more natural gait biomechanics and load distribution throughout the affected and sound musculoskeletal structure. This was observed during quiet stance on a decline, walking on level ground, and walking up and down ramps and stairs.

How does ankle power on the prosthetic side influence loading parameters on the sound side during level walking of persons with transfemoral amputation?

BACKGROUND: Increased ankle power on the prosthetic side seems to decrease biomechanical loading parameters on the sound side. This assumption is based on biomechanical comparisons of different foot constructions. However, such study designs could not show whether the amount of ankle power solely influences the sound side. OBJECTIVE: To analyze the influence of divergent ankle power, resulting from different foot constructions and from different ankle power settings, on the sound side loading parameters. STUDY DESIGN: Interventional cross sectional study. METHODS: Level walking of transfemoral amputees with a microprocessor knee joint and Solid Ankle Cushioned Heel (SACH), energy storing and returning (ESR) and powered foot (PF) was analyzed. The PF was adapted in three configurations: without power (np), low power (lp), and optimal power (op). An optoelectronic camera system with 12 cameras and two force plates were used. RESULTS: The ankle power on the prosthetic side shows significant differences about foot types and different settings of the PF. The knee adduction moment, the knee flexion moment, and the vertical ground reaction forces on the sound side were significantly reduced with PF_op and ESR in comparison to SACH. When analyzing these parameters for the different PF configurations, only some show significant results at normal velocity. CONCLUSIONS: The additional positive mechanical work for an active push off in the PF tends to have a relieving effect. The biomechanical sound side loading parameters are reduced with PF_op in comparison to SACH and ESR, resulting in a relief of the sound side of lower limb amputees.

Limited trunk motion and posterior pelvic tilting in ambulatory children treated with bilateral rib to pelvis implants for spinal deformity control.

In young children, growth-friendly spinal implants with bilateral rib to pelvis fixation are used to control progressive spinal deformity. Whereas curve progression, complications and side-effects have been extensively studied in this patient population, no data are available on gait pattern changes and postural body adjustments. Our study evaluates whether gait pattern changed for ambulatory children treated with bilateral rib to pelvis implants compared to age-matched healthy children. In this small cohort study, gait analysis was performed using spatiotemporal and kinematic parameters of four ambulatory children with severe scoliosis and growth-friendly spinal implants using the bilateral rib to pelvis fixation. Data were statistically analyzed and compared to seven healthy age-matched children. Between both groups, no differences were seen in walking speed, cadence and stride length. The treated patients showed a lower range of motion of the pelvic obliquity and of the trunk obliquity and rotation, but a higher knee flexion. Growth-friendly spinal implants with bilateral rib to pelvis fixation are commonly used in wheelchair children and rarely indicated in ambulatory patients. The presented data show reduced trunk and pelvis motion using this implant construct. These findings help to understand body postural adjustments and add valuable information for families and care providers when considering this surgery. Level of evidence: Therapeutic level IV.

A Passive Back-Support Exoskeleton for Manual Materials Handling: Reduction of Low Back Loading and Metabolic Effort during Repetitive Lifting.

OCCUPATIONAL APPLICATIONSGlobalization and eCommerce continue to fuel unprecedented growth in the logistics and warehousing markets. Simultaneously, the biggest bottleneck for these industries is their human capital. Where automation and robotic solutions fail to deliver a return on investment, humans frequently take over handling tasks that place harmful loads and strains on the body. Occupational exoskeletons can reduce fatigue and strain by supporting the lower spine and are designed to prevent work-related musculoskeletal disorders and other injuries. They are a mid- to long-term investment for industries to improve ergonomic conditions in workplaces, with the potential for reducing absences from work, sick days logged, and workers compensation claims. To examine the effectiveness of the newly introduced Paexo Back exoskeleton, a study was completed with 10 participants who completed manual load handling tasks with and without the exoskeleton. Key findings include significant reductions in metabolic effort and low back loading when the exoskeleton is worn.

TECHNICAL ABSTRACTBackground: Work-related low back pain is a major threat to workers and society. Some new commercial and prototype exoskeletons are designed to specifically control the development of such disorders. Some beneficial effects of these exoskeletons have been reported earlier. Purpose: Determine the potential benefits of a newly introduced exoskeleton, Paexo Back, which is designed to reduce low back loading during lifting tasks. Methods: Ten healthy subjects participated in this study. To replicate a typical workplace situation, a repetitive lifting task with and without the exoskeleton was performed. For 5-min periods, the participants repeatedly lifted a 10-kg box from the floor onto a table and then placed it back on the floor. Effects of exoskeleton use were assessed using a diverse set of outcomes. Oxygen uptake and heart rate were measured using a wireless spiroergometry system. Activation levels of back, abdominal, and thigh muscles were also measured using a wireless electromyographic system. Kinematic data were recorded using an optoelectronic device, and ground reaction forces were measured with two force plates. Joint compression forces in the lower spine (L4/L5 and L5/S1) were estimated using the AnyBody™ Modeling System during the upward lifting portion of the lifting task (bringing the box to the table). Results: Using the exoskeleton resulted in significant reductions in oxygen rate (9%), activation of the back and thigh muscles (up to 18%), and peak and mean compression forces at L4/L5 (21%) and L5/S1 (20%). Conclusions: These results show that using the tested exoskeleton for a lifting task contributes to an increased metabolic efficiency, a reduction in the back muscle activation required to conduct the task, and a reduction in low back loading.

A distance-dependent parameterization of the extended Hubbard model for conjugated and aromatic hydrocarbons derived from stretched ethene.

The Hubbard model, which is widely used in physics but is mostly unfamiliar to chemists, provides an attractive yet simple model for chemistry beyond the self consistent field molecular orbital approximation. The Hubbard model adds an effective electron-electron repulsion when two electrons occupy the same atomic orbital to the familiar Hückel Hamiltonian. Thus it breaks the degeneracy between excited singlet and triplet states and allows an explicit treatment of electron correlation. We show how to evaluate the parameters of the model from high-level ab initio calculations on two-atom fragments and then to transfer the parameters to large molecules and polymers where accurate ab initio calculations are difficult or impossible. The recently developed MS-RASPT2 method is used to generate accurate potential energy curves for ethene as a function of carbon-carbon bond length, which are used to parameterize the model for conjugated hydrocarbons. Test applications to several conjugated/aromatic molecules show that even though the model is very simple, it is capable of reasonably accurate predictions for bond lengths, and predicts molecular excitation energies in reasonable agreement with those from the MS-RASPT2 method.

Copper-containing SiCN precursor ceramics (Cu@SiCN) as selective hydrocarbon oxidation catalysts using air as an oxidant.

A molecular approach to metal-containing ceramics and their application as selective heterogeneous oxidation catalysts is presented. The aminopyridinato copper complex [Cu(2)(Ap(TMS))(2)] (Ap(TMS)H=(4-methylpyridin-2-yl)trimethylsilanylamine) reacts with poly(organosilazanes) via aminopyridine elimination, as shown for the commercially available ceramic precursor HTT 1800. The reaction was studied by (1)H and (13)C NMR spectroscopy. The liberation of the free, protonated ligand Ap(TMS)H is indicative of the copper polycarbosilazane binding. Crosslinking of the copper-modified poly(organosilazane) and subsequent pyrolysis lead to the copper-containing ceramics. The copper is reduced to copper metal during the pyrolysis step up to 1000 degrees C, as observed by solid-state (65)Cu NMR spectroscopy, SEM images, and energy-dispersive spectroscopy (EDS). Powder diffraction experiments verified the presence of crystalline copper. All Cu@SiCN ceramics show catalytic activity towards the oxidation of cycloalkanes using air as oxidant. The selectivity of the reaction increases with increasing copper content. The catalysts are recyclable. This study proves the feasibility of this molecular approach to metal-containing SiCN precursor ceramics by using silylaminopyridinato complexes. Furthermore, the catalytic results confirm the applicability of this new class of metal-containing ceramics as catalysts.

Comparative biomechanical analysis of current microprocessor-controlled prosthetic knee joints.

OBJECTIVE: To investigate and identify functional differences of 4 microprocessor-controlled prosthetic knee joints (C-Leg, Hybrid Knee [also called Energy Knee], Rheo Knee, Adaptive 2). DESIGN: Tested situations were walking on level ground, on stairs and ramps; additionally, the fall prevention potentials for each design were examined. The measuring technology used included an optoelectronic camera system combined with 2 forceplates as well as a mobile spiroergometric system. SETTING: The study was conducted in a gait laboratory. PARTICIPANTS: Subjects with unilateral transfemoral amputations (N=9; mobility grade, 3-4; age, 22-49y) were tested. INTERVENTIONS: Participants were fitted and tested with 4 different microprocessor-controlled knee joints. MAIN OUTCOME MEASURES: Static prosthetic alignment, time distance parameters, kinematic and kinetic data and metabolic energy consumption. RESULTS: Compared with the Hybrid Knee and the Adaptive 2, the C-Leg offers clear advantages in the provision of adequate swing phase flexion resistances and terminal extension damping during level walking at various speeds, especially at higher walking speeds. The Rheo Knee provides sufficient terminal extension; however, swing phase flexion resistances seem to be too low. The values for metabolic energy consumption show only slight differences during level walking. The joint resistances generated for descending stairs and ramps relieve the contralateral side to varying degrees. When walking on stairs, safety-relevant technical differences between the investigated joint types can be observed. Designs with adequate internal resistances offer stability advantages when the foot is positioned on the step. Stumble recovery tests reveal that the different knee joint designs vary in their effectiveness in preventing the patient from falling. CONCLUSIONS: The patient benefits provided by the investigated electronic prosthetic knee joints differ considerably. The C-Leg appears to offer the amputee greater functional and safety-related advantages than the other tested knee joints. Reduced loading of the contralateral side has been demonstrated during ramp and stair descent. Metabolic energy consumption does not vary significantly between the tested knees. Hence, this parameter seems not to be a suitable criterion for assessing microprocessor-controlled knee components.

Characterizing adaptations of prosthetic feet in the frontal plane.

BACKGROUND: Energy-storage and return feet incorporate various design features including split toes. As a potential improvement, an energy-storage and return foot with a dedicated ankle joint was recently introduced allowing for easily accessible inversion/eversion movement. However, the adaptability of energy-storage and return feet to uneven ground and the effects on biomechanical and clinical parameters have not been investigated in detail. OBJECTIVES: To investigate the design-related ability of prosthetic feet to adapt to cross slopes and derive a theoretical model. STUDY DESIGN: Mechanical testing and characterization. METHODS: Mechanical adaptation to cross slopes was investigated for six prosthetic feet measured by a motion capture system. A theoretical model linking the measured data with adaptations is proposed. RESULTS: The type and degree of adaptation depends on the foot design, for example, stiffness, split toe or continuous carbon forefoot, and additional ankle joint. The model used shows high correlations with the measured data for all feet. CONCLUSIONS: The ability of prosthetic feet to adapt to uneven ground is design-dependent. The split-toe feet adapted better to cross slopes than those with continuous carbon forefeet. Joints enhance this further by allowing for additional inversion and eversion. The influence on biomechanical and clinical parameters should be assessed in future studies. CLINICAL RELEVANCE: Knowing foot-specific ability to adapt to uneven ground may help in selecting an appropriate prosthetic foot for persons with a lower limb amputation. Faster and more comprehensive adaptations to uneven ground may lower the need for compensations and therefore increase user safety.

Comparative biomechanical evaluation of two technologically different microprocessor-controlled prosthetic knee joints in safety-relevant daily-life situations.

Safety-relevant gait situations (walking on stairs and slopes, walking backwards, walking with small steps, simulated perturbations of swing phase extension) were investigated in a motion analysis laboratory with six unilateral transfemoral amputees using two different microprocessor-controlled prosthetic knee joints (Rheo Knee XC, C-Leg). A randomized crossover design was chosen. The study results imply that the performance and safety potential of a microprocessor-controlled knee joint can be associated with the individual control algorithms and the technological concepts that are implemented to generate motion resistances for controlling flexion and extension movements. When walking with small steps, advantages of the "default swing" concept used in the Rheo Knee XC were identified due to a highly reproducible swing phase release. However, when walking backwards, this concept may lead to an uncontrolled knee flexion which partly resulted in falls. When walking down stairs, walking on slopes or while recovering from a stumble after perturbations of the swing phase extension, the C-Leg demonstrated a reliable prosthetic side load-bearing capacity resulting in reduced loading on the residual body. In contrast, the Rheo Knee XC required increased compensatory movements of the remaining locomotor system in order to compensate for reduced load-bearing and safety reserves.

Lower limb amputee gait characteristics on a specifically designed test ramp: Preliminary results of a biomechanical comparison of two prosthetic foot concepts.

BACKGROUND: For demanding activities in daily life, such as negotiating stairs, ramps and uneven ground, the functionality of conventional prosthetic feet ("Daily Life Feet" - DLF) is often limited. With the introduction of microprocessor-controlled feet (MPF) it was expected that the functional limitations of DLF might be reduced. The purpose of the present study was to investigate biomechanical gait parameters with DLF and MPF when walking on a specifically designed ramp involving abruptly changing inclination angles as a scenario reflecting typical situations related to walking on uneven ground. RESEARCH QUESTION: The specific aim of the study was to answer the research question if the advanced adaptability of MPF to different ground slopes would lead to more natural motion patterns and reduced joint loading compared with DLF feet. METHODS: A specifically designed ramp was installed within a gait lab. During downward motion on this ramp biomechanical parameters - ground reaction forces, joint moments and joint angles were obtained both with DLF and MPF used by four transtibial amputees. A control group of 10 non-amputees (NA) was measured with for comparison. RESULTS: The NA group managed the ramp element with the abruptly changing inclination with a specific ankle joint adaptation. Compared to DLF the MPF considerably improved the ankle adaptation to the abruptly changing inclination which was reflected by a significantly increased stance phase dorsiflexion which was comparable to the NA group. The peak value of the knee extension moment on the prosthetic side was significantly increased with DLF, whereas it was almost normal with MPF (DLF: 0.71 ±â€¯0.13 Nm/kg, MPF: 0.42 ±â€¯0.12 Nm/kg, NA: 0.36 ±â€¯0.07 Nm/kg, p < 0.05 and p < 0.01). The external knee adduction moment was generally reduced for the transtibial amputees and did not show differences between foot designs. SIGNIFICANCE: The adaptable ankle joint motion of the MPF is a crucial requirement for a more natural motion pattern and leads to a reduction of sagittal knee joint loading on the prosthetic side.

Biomechanical and Metabolic Effectiveness of an Industrial Exoskeleton for Overhead Work.

Overhead work activities can lead to shoulder pain and serious musculoskeletal disorders (WMSD), such as rotator cuff injury and degeneration. Recently developed exoskeletons show promising results in supporting workers in such activities. In this study, a novel exoskeleton was investigated for two different overhead tasks with twelve participants. To investigate the effects of the device, electromyographic (EMG) signals of different shoulder and adjacent muscles as well as kinematic and metabolic parameters were analyzed with and without the exoskeleton. The mean EMG amplitude of all evaluated muscles was significantly reduced when the exoskeleton was used for the overhead tasks. This was accompanied by a reduction in both heart rate and oxygen rate. The kinematic analysis revealed small changes in the joint positions during the tasks. This study demonstrated the biomechanical and metabolic benefits of an exoskeleton designed to support overhead work activities. The results suggest improved physiological conditions and an unloading effect on the shoulder joint and muscles which are promising indicators that the exoskeleton may be a good solution to reduce shoulder WMSD among workers who carry out overhead tasks on a regular basis.

A Support Vector Regression Approach for Continuous Prediction of Ankle Angle and Moment During Walking: An Implication for Developing a Control Strategy for Active Ankle Prostheses.

Lower limb amputations impair normal locomotion. This calls for the use of prosthetic devices to restore the lost or disabled functionality. Most of the commercially available prostheses offer only passive assistance with limited capacity. On the other hand, active prostheses may better restore movement, by supporting missing muscle function with additional motor power. The control algorithms of such embedded motors must understand the users locomotive intention to produce the required locomotion similar to that of an able-bodied individual. For individuals with transtibial amputation, the control algorithm should produce the desired locomotion by controlling an active ankle joint to generate appropriate ankle angle and ankle moment. In this paper, a strategy is proposed for the continuous estimation of ankle angle and ankle moment during walking using a support vector regression approach. Experimentally obtained hip and knee joint motion data were provided as the inputs to the support vector regression model. It is shown that, for level ground walking at self-selected speed, the proposed method could predict the ankle angle and moment with high accuracy (mean R2 value of 0.98 for ankle angle and 0.97 for ankle moment).