Lower-Limb Myoelectric Calibration Postures for Transtibial Prostheses.

The use of an agonist-antagonist muscle pair for myoelectric control of a transtibial prosthesis requires normalizing the myoelectric signals and identifying their co-contraction signature. Extensive literature has explored the relationship between body posture and lower-limb muscle activation level using surface electromyography (EMG), but it is unknown how these relationships hold after amputation. Using a virtual tracking task, this study compares the effect of three different calibration postures (seated, standing, dynamic) on user tracking ability while in two tracking postures (seated, standing) for 18 able-bodied (AB) subjects and 9 subjects with transtibial (TT) amputation. As expected, AB subjects produced statistically significant differences in muscle activation for gastrocnemius (GAS) when seated vs. standing during calibration (p = 8.8e-4), but not for tibialis anterior (TA) (p = 0.76). TT subjects, however, showed no significant differences in GAS or TA between seated and standing (p = 0.90, 0.60 respectively). It was also determined that normalizing EMG by the global maximum signal observed (standard in biomechanic analysis) is undesirable for myoelectric control. For best general results with this framework, calibration in both seated and dynamic postures is recommended, taking the normalization information from the seated posture and the narrowest co-contraction slopes from the two.

Finite-State Impedance and Direct Myoelectric Control for Robotic Ankle Prostheses: Comparing Their Performance and Exploring Their Combination.

Non-volitional control, such as finite-state machine (FSM) impedance control, does not directly incorporate user intent signals, while volitional control, like direct myoelectric control (DMC), relies on these signals. This paper compares the performance, capabilities, and perception of FSM impedance control to DMC on a robotic prosthesis for subjects with and without transtibial amputation. It then explores, using the same metrics, the feasibility and performance of the combination of FSM impedance control and DMC across the full gait cycle, termed Hybrid Volitional Control (HVC). After calibration and acclimation with each controller, subjects walked for two minutes, explored the control capabilities, and completed a questionnaire. FSM impedance control produced larger average peak torque (1.15 Nm/kg) and power (2.05 W/kg) than DMC (0.88 Nm/kg and 0.94 W/kg). The discrete FSM, however, caused non-standard kinetic and kinematic trajectories, while DMC yielded trajectories qualitatively more similar to able-bodied biomechanics. While walking with HVC, all subjects successfully achieved ankle push-off and were able to modulate the magnitude of push-off via the volitional input. Unexpectedly, however, HVC behaved either more similarly to FSM impedance control or to DMC alone, rather than in combination. Both DMC and HVC, but not FSM impedance control, allowed subjects to achieve unique activities such as tip-toe standing, foot tapping, side-stepping, and backward walking. Able-bodied subject (N=6) preferences were split amongst the controllers, while all transtibial subjects (N=3) preferred DMC. Desired performance and ease of use showed the highest correlations with overall satisfaction (0.81 and 0.82, respectively).

Design of a segmented custom ankle foot orthosis with custom-made metal strut and 3D-printed footplate and calf shell.

BACKGROUND: 3D-printing is a potential manufacturing process for optimizing the design and manufacture of ankle foot orthosis (AFOs). The feasibility of an AFO with interchangeable strut that is suitable for 3D-printing is created and evaluated. OBJECTIVE: A segmented AFO with 3D-printed custom footplate and calf shell connected by a custom-made strut is studied. STUDY DESIGN: The duration of a healthy subject wearing the 3D-printed segmented AFO in daily activities is used to evaluate the feasibility and durability to integrate 3D-printed AFOs into orthotics practice. TECHNIQUE: The 3D-scanning of a patient's leg is first conducted. The scanned 3D surface is modified by creating the clearance around bony prominences and trimlines for the footplate and calf shell. The footplate has a custom-shaped inside to match with the foot and a standard shape outside at the top to match and connect with the strut. For the calf shell, the inside shape is custom fit with the shank and the outside shape is standard to connect with the strut. Material extrusion is the 3D-printing process selected. Tree-like support structures are used to avoid the use of soluble support material and to eliminate the risk of residual chemical solvent in the orthosis. RESULTS: The segmented AFO with material extrusion footplate and calf shell was tested in a healthy subject with an active lifestyle, offering comfort, and stability for over 4 months without breakage. CONCLUSIONS: This segmented AFO is durable, requires short 3D-printing time, and enables the quick adjustment of bending stiffness via an interchangeable strut design.