Dual-Task Interference Effects on Lower-Extremity Muscle Activities during Gait Initiation and Steady-State Gait among Healthy Young Individuals, Measured Using Wireless Electromyography Sensors.

To maintain a healthy lifestyle, adults rely on their ability to walk while simultaneously managing multiple tasks that challenge their coordination. This study investigates the impact of cognitive dual tasks on lower-limb muscle activities in 21 healthy young adults during both gait initiation and steady-state gait. We utilized wireless electromyography sensors to measure muscle activities, along with a 3D motion capture system and force plates to detect the phases of gait initiation and steady-state gait. The participants were asked to walk at their self-selected pace, and we compared single-task and dual-task conditions. We analyzed mean muscle activation and coactivation in the biceps femoris, vastus lateralis, gastrocnemius, and tibialis anterior muscles. The findings revealed that, during gait initiation with the dual-task condition, there was a decrease in mean muscle activation and an increase in mean muscle coactivation between the swing and stance limbs compared with the single-task condition. In steady-state gait, there was also a decrease in mean muscle activation in the dual-task condition compared with the single-task condition. When participants performed dual-task activities during gait initiation, early indicators of reduced balance capability were observed. Additionally, during dual-task steady-state gait, the knee stabilizer muscles exhibited signs of altered activation, contributing to balance instability.

Effects of a Powered Knee-Ankle Prosthesis on Amputee Hip Compensations: A Case Series.

Transfemoral amputee gait often exhibits compensations due to the lack of ankle push-off power and control over swing foot position using passive prostheses. Powered prostheses can restore this functionality, but their effects on compensatory behaviors, specifically at the residual hip, are not well understood. This paper investigates residual hip compensations through walking experiments with three transfemoral amputees using a low-impedance powered knee-ankle prosthesis compared to their day-to-day passive prosthesis. The powered prosthesis used impedance control during stance for compliant interaction with the ground, a time-based push-off controller to deliver high torque and power, and phase-based trajectory tracking during swing to provide user control over foot placement. Experiments show that when subjects utilized the powered ankle push-off, less mechanical pull-off power was required from the residual hip to progress the limb forward. Overall positive work at the residual hip was reduced for 2 of 3 subjects, and negative work was reduced for all subjects. Moreover, all subjects displayed increased step length, increased propulsive impulses on the prosthetic side, and improved impulse symmetries. Hip circumduction improved for subjects who had previously exhibited this compensation on their passive prosthesis. These improvements in gait, especially reduced residual hip power and work, have the potential to reduce fatigue and overuse injuries in persons with transfemoral amputation.

A Phase Variable Approach for Improved Rhythmic and Non-Rhythmic Control of a Powered Knee-Ankle Prosthesis.

Although there has been recent progress in control of multi-joint prosthetic legs for rhythmic tasks such as walking, control of these systems for non-rhythmic motions and general real-world maneuvers is still an open problem. In this article, we develop a new controller that is capable of both rhythmic (constant-speed) walking, transitions between speeds and/or tasks, and some common volitional leg motions. We introduce a new piecewise holonomic phase variable, which, through a finite state machine, forms the basis of our controller. The phase variable is constructed by measuring the thigh angle, and the transitions in the finite state machine are formulated through sensing foot contact along with attributes of a nominal reference gait trajectory. The controller was implemented on a powered knee-ankle prosthesis and tested with a transfemoral amputee subject, who successfully performed a wide range of rhythmic and non-rhythmic tasks, including slow and fast walking, quick start and stop, backward walking, walking over obstacles, and kicking a soccer ball. Use of the powered leg resulted in clinically significant reductions in amputee compensations for rhythmic tasks (including vaulting and hip circumduction) when compared to use of the take-home passive leg. In addition, considerable improvements were also observed in the performance for non-rhythmic tasks. The proposed approach is expected to provide a better understanding of rhythmic and non-rhythmic motions in a unified framework, which in turn can lead to more reliable control of multi-joint prostheses for a wider range of real-world tasks.

Intuitive Clinician Control Interface for a Powered Knee-Ankle Prosthesis: A Case Study.

This paper presents a potential solution to the challenge of configuring powered knee-ankle prostheses in a clinical setting. Typically, powered prostheses use impedance-based control schemes that contain several independent controllers which correspond to consecutive periods along the gait cycle. This control strategy has numerous control parameters and switching rules that are generally tuned by researchers or technicians and not by a certified prosthetist. We propose an intuitive clinician control interface (CCI) in which clinicians tune a powered knee-ankle prosthesis based on a virtual constraint control scheme, which tracks desired periodic joint trajectories based on a continuous measurement of the phase (or progression) of gait. The interface derives virtual constraints from clinician-designed joint kinematic trajectories. An experiment was conducted in which a certified prosthetist used the control interface to configure a powered knee-ankle prosthesis for a transfemoral amputee subject during level-ground walking trials. While it usually takes engineers hours of tuning individual parameters by trial and error, the CCI allowed the clinician to tune the powered prosthesis controller in under 10 min. This allowed the clinician to improve several amputee gait outcome metrics, such as gait symmetry. These results suggest that the CCI can improve the clinical viability of emerging powered knee-ankle prostheses.