PROSTHETIC AND ORTHOTIC SCIENCE

Initial Biomechanical Analysis and Modeling of Transfemoral

Amputee Gait
C. Dundass, MSc, G. Z. Yao, PhD, C. K. Mechefske, PhD, P ENG

ABSTRACT
The purpose of this study is to evaluate the effects of hydraulic knee controller deterioration on the gait of a single
transfemoral amputee subject. As such, this should be considered a preliminary study. A set of gait experiments was
developed and conducted to achieve this purpose. Although the subject did feel the difference between the deteriorated
hydraulic controllers, no substantial deterioration trends were isolated in the kinematic or kinetic data collected at various
stages of knee controller deterioration. A large variability was observed in the baseline gait trials that were recorded on
different days. To eliminate the variability, a dynamic model of transfemoral amputee gait was developed based on the
experimental data. The model predictions of ground reaction forces showed good agreement with experimental data. The
effectiveness of the model was validated. (J Prosthet Orthot. 2003;15:20 –26.)
KEY INDEXING TERMS: Above-knee prosthesis, ground reaction force, kinematics, knee controller deterioration,
simulation

R
esearch on human gait has a long history, and nu-
merous factors involved in the gait cycle have been
investigated. Researchers examined the effects of dif-
ferent prosthetic designs in search of optimum prosthetic
performance and evaluated the kinematics of the knee joint
in response to various prosthetic design conditions. Stein and
Flowers1 investigated the effects of knee controller perfor-
mance on amputee gait during stance phase. Van Der Linden
et al.2 studied the effect of various prosthetic feet on the
biomechanics of transfemoral amputee gait. Blumentritt et
al.3 performed a biomechanical study on seven transfemoral
amputees who utilized rotary hydraulic prosthetic knees.
Kinetic gait analysis focuses on the internal and external
forces that cause the motion. Previous transfemoral amputee
kinetic gait research has investigated the impact of different
prosthetic designs on the ground reaction force (GRF) pro-
file. Van Der Linden et al.2 used three force plates to capture
the GRFs and moments of one complete stride and observed
that the vertical GRF profile of the prosthetic limb never
attained full body weight during stance phase. Gitter et al.4
evaluated kinetic gait information of eight transfemoral am-
putees using a single force plate to capture GRFs of the
C. DUNDASS is affiliated with Forensic Dynamics Inc., Kamloops,
British Columbia, Canada.
G. Z. YAO is affiliated with the Department of Mechanical Engineer-
ing, Queen’s University, Kingston, Ontario, Canada.
C. K. MECHEFSKE is affiliated with the Department of Mechanical
Engineering, Queen’s University, Kingston, Ontario, Canada.
Copyright 娀2003 American Academy of Orthotists and Prosthetists.
Prof. Chris Mechefske, Department of Mechanical Engineering,
Queen’s University, McLaughlin Hall, Kingston, Ontario, Canada
K7L 3N6; 1-613-5333148; fax: 1-613-5336489. E-mail: chrism@me.
queensu.ca
prosthetic limb. Sutherland et al.5 performed kinetic evalu-
ation of two different prosthetic knee joints.
Models have been developed to represent and simulate
conditions that occur in reality. Modeling human gait is an
extremely difficult task because many factors and unknowns
play significant roles in the behavior and control of the limbs.
To minimize the complexity, researchers often model a spe-
cific event of gait rather than the entire process. Several
models of the lower limbs have been developed to increase
understanding of gait. However, very few amputee gait mod-
els have been created and validated. To date, the majority of
transfemoral amputee modeling has focused on the swing
phase of gait. Mohan et al.6 developed a mathematical model
of the transfemoral prosthesis during swing phase to deter-
mine the optimal location for the center of gravity of the
prosthesis. Bach et al.7,8 also investigated the swing phase of
the transfemoral amputee gait with the use of computer
simulations. The study developed a ballistic model of swing
phase to determine the optimal inertial loading for a trans-
femoral prosthesis.
The majority of previous research on transfemoral ampu-
tee gait has been almost exclusively dedicated to evaluating
new prosthetic components and concepts to improve gait.
While this is extremely valuable and necessary for enhance-
ments in component technology, the long term performance
and, specifically, the reliability of current and older prosthet-
ics still being used by amputees have received little attention.
No previous study has been conducted that attempts to eval-
uate the relationship between component deterioration and
gait. This apparent gap is the motivation for conducting the
knee controller deterioration experiments in this paper.
Computational models developed for able-bodied subjects
show the usefulness for the simulation of gait kinematics and
kinetics. The motivation for the development of a dynamic

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JPO Journal of Prosthetics and Orthotics
model that appropriately models transfemoral amputee gait is
clear from the absence of such a model in the literature.
EXPERIMENTAL PROCEDURE AND DATA ANALYSIS
One male unilateral transfemoral amputee participated in the
study. The subject was 24 years of age and considered to be in
excellent physical condition. He had a body mass of approx-
imately 76 kg at the time of the experiments. His left leg was
amputated at approximately 30 cm distal to the greater tro-
chanter. Prior to testing, the subject signed an informed
consent conforming to the policies of the University of West-
ern Ontario Ethics Review Committee.
The kinematic and kinetic data were collected at the Oc-
cupational Therapy Gait Laboratory at The University of
Western Ontario. The facility consisted of an elevated walking
platform approximately seven meters in length. The walking
platform contained two force plates (see Figure 1) that were
aligned perpendicular to a kinematic camera unit. The first
force plate (Advanced Mechanical Technology Inc., AMTI
model #OR6-5-1000, Watertown, MA) recorded the GRF of
the prosthetic limb. The second force plate (Kistler model
#9261A, Amherst, NY) measured the GRF of the sound limb.
The output from the AMTI force plate was fed through an
AMTI Strain Gage Amplifier System. The output from the
Kistler force plate was fed into a Kistler 9261A electronic
unit. The kinematic data were collected using an Optotrack
3010 System made by Northern Digital Inc. (Waterloo, On-
tario, Canada). The system uses three optical sensors capable
of recording infrared light that is actively emitted from IRED
markers attached to the limb. The 3D kinematic data and
force plate data were simultaneously collected with the Op-
totrak Data Acquisition unit (Northern Digital, Inc.). The data
files were recorded and stored on line with a 486 IBM com-
puter (White Plains, NY).
During the set of experiments on knee controller deteri-
oration, the subject wore a quadrilateral socket with an Ohio
Willow Wood Model 90 Knee (Mt. Sterling, OH) controlled by
a Catech hydraulic knee controller (Catech Systems, Toronto,
Canada). The Catech controller consists of a piston and cyl-
inder configuration accompanied by a compression spring.
The level of viscous damping can be manually adjusted,
Figure 1. Subject and data collection area.
Volume 15 • Number 1 • 2003
Analysis and Modeling of Transfemoral Amputee Gait
enabling the user to set different resistance levels for knee
flexion and extension. A Greissenger multi-axle prosthetic
foot was attached to the shank (Otto Bock, Duderstadt, Ger-
many). The geometric and physical properties of the Ohio
Willow Wood limb were measured for the purposes of mod-
eling. The approximate location of the center of mass of the
foot and shank was determined by balancing them on a
straight edge. The inertia of each segment was calculated
using the pendulum technique as described by Chandler et
al.9
The knee controller deterioration experiments were de-
signed to investigate the effects of hydraulic knee deteriora-
tion on gait. The study involved interchanging the subject’s
Catech knee controller unit with artificially deteriorated Ca-
tech knee controllers. The gait laboratory knee controller
experiments were performed in conjunction with a series of
mechanical life cycle tests that were performed on the Catech
knee controller units.10 The research involved cycling five
knee controllers at 1 Hz in a life cycle test machine to
simulate wear that would occur under normal use. The man-
ufacturer of the knee controller estimates that the useful life
of the unit is approximately 2,000,000 cycles (typically 2 years
for an average transfemoral amputee). In this study,
2,000,000 cycles corresponded to 100% deterioration.
During laboratory testing of gait, the five knee controllers
ranged in condition from 0% to 100% deterioration at con-
stant intervals of 25%. The study involved five separate days
of testing so that each knee controller was tested at every
level of deterioration from 0% to 100%. Each day of gait
testing, the subject performed a baseline test consisting of
three walking trials at a self-selected comfortable speed with
his own knee controller unit. Subsequent tests (also consist-
ing of three walking trials at a self-selected speed) were
performed with each deteriorated knee controller. The knee
controller units were interchanged without removal of the
prosthesis. The subject was given the opportunity to famil-
iarize himself with each new controller. The gait data were
recorded once the subject reported that he was comfortable
with the prosthesis. The subject walked in a straight line,
completing 1.5 strides before contacting the two force plates
with the respective feet. Only trials in which the subject
contacted both force plates with the respective feet were
retained. The kinematics of the prosthesis was also recorded
during the experiments. Three markers were attached to each
segment of the prosthesis. Five seconds of kinematics and
kinetics data were recorded at 100 Hz sampling rate for each
trial.
The kinematic and kinetic data were processed and ana-
lyzed with Matlab for Windows. The force plate data were
zeroed for each trial by averaging the first five sample points
of each trial (the subject had not initiated contact with force
plate yet) and subtracting the calculated average from re-
maining data points of each trial. The subject was considered
to be in contact with the force plate any time the vertical
force was found to be greater than or equal to five Newtons.
The kinematic data were analyzed for periods when the
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Dundass et al. JPO Journal of Prosthetics and Orthotics

sensors were in view. The periods before and after the subject It was hypothesized that high variability in the subject’s
was in view were eliminated. Any data points that were gait in the area of the first local maximum of the GRF profile
missing while the subject was in range were calculated by could have masked the emergence of any trends. Zahedi et
linear interpolation. The kinematic data were filtered with a
recursive second order Butterworth digital filter with a cut-
off frequency of 6 Hz as described in Winter et al.11 The limb
segment angles were calculated based on the conventions
outlined by Winter.12

EXPERIMENTAL RESULTS AND DISCUSSION

To successfully sample all possible deterioration trends, the
testing was carried out over 5 separate days. This allowed
deterioration trends to be evaluated through two approaches;
deterioration trends within an individual knee controller
(over different days) and trends within a single day (between
different controllers).
DETERIORATION TRENDS WITHIN A SINGLE DAY
Figure 2 illustrates the average of three trials for the vertical
GRF profile of the 0%, 50%, and 100% knee controller
deterioration levels recorded on the fourth day of testing
(25% and 75% deterioration conditions were omitted for
clarity). Similarly, Figure 3 displays the anterior/posterior Figure 3. Average A/P GRF for three levels of knee controller
deterioration.
(A/P) GRF profile for the 0%, 50%, and 100% knee controller
deterioration levels. The first set of GRF profiles (0 –50 nor-
malized time) in Figures 2 and 3 relates to the prosthetic side
and the second set of curves (40 –100 normalized time) rep-
resents the sound limb.
Figure 2 shows that the overall profiles for the vertical
GRF were not greatly influenced by the change in deteriora-
tion of the knee controller units. The only area that illus-
trated a considerable difference was the magnitude and loca-
tion of the first relative maximum on the prosthetic side.
Further analysis of all five deterioration conditions revealed
no substantial trend (R2⫽0.16) for the first relative peak of
the prosthetic vertical GRF (see Figure 4).
Figure 4. Relationship between first vertical peak and knee control-
ler deterioration.

Figure 2. Average vertical GRF for three levels of knee controller

deterioration. Figure 5. Prosthetic side vertical GRF standard deviation.

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JPO Journal of Prosthetics and Orthotics Analysis and Modeling of Transfemoral Amputee Gait

al.13 used standard deviation as a method to measure step-

to-step variation of a transfemoral amputee. A plot of stan-
dard deviation revealed that, in fact, the variation was great-
est in the first peak region of the vertical GRF. Figure 5 shows
a standard deviation envelope of the three trials representing
the baseline testing performed at the beginning. The other
knee deterioration conditions also revealed that the greatest
variation occurred in the region of the first local maximum
vertical GRF.
There was little difference among knee controller deteri-
oration in the A/P GRF profiles (Figure 3). Several other
distinguishable gait parameters of the GRF profile, such as
loading rate, maximum braking and propulsion, zero shear
point, symmetry ratio, braking impulse, propulsion impulse,
and stance time were also investigated for any evidence of
deterioration trends. All GRF parameters investigated dis-
played only weak associations with knee controller deterio-
ration. Figure 7. Prosthetic ankle angle for three levels of deterioration.
A final search for deterioration trends was conducted on
the kinematic data. Figures 6 and 7 show the average of three variation between trials on the same day. Figure 8 shows the
trials for the knee and ankle angle of the prosthetic limb for average vertical GRF profile (average of three baseline trials)
the 0%, 50%, and 100% deterioration conditions, where HS of the prosthetic limb for each day of testing. It clearly shows
denotes heel strike and TO denotes toe off. The analysis variability in the baseline testing from 1 day to another.
yielded similar results. No significant deterioration trends A standard deviation analysis of the 5 days baseline data
were isolated, presumably because of the large variation was also conducted and compared with the standard deviation
within the trials. The deterioration of the knee controller had from a single day baseline data. Figure 9 confirms that, in
no effect on the walking speed, which was self-selected by the fact, the 5 days baseline tests did reflect larger standard
subject. deviations than baseline testing from a single day. The high-
DETERIORATION TRENDS OVER FIVE DAYS est levels of variability in the 5 days data occurred in the
region of the first and second maximum peaks (approximately
Before performing a detailed analysis of the GRFs and kine- 68 N and 56 N, respectively). The highest standard deviation
matics of the 5 days testing results, a variability study was in the single day data (42 N) was also recorded near the first
conducted and compared with the single day variability. A maximum peak of stance phase. Zahedi et al.13 reported that
variability analysis within the 5 days of baseline testing illus- the largest standard deviation within the vertical GRF profile
trated higher variation than the variability within baseline of a transfemoral amputee occurred at the first maximum
testing on the same day. This result implied that the subject’s peak followed by the second maximum peak. Winter14 per-
gait varied from 1 test day to another more than typical formed repeatability studies in able-bodied subjects and re-

Figure 6. Prosthetic knee angle for three levels of deterioration. Figure 8. Average baseline vertical GRF for each day.

Volume 15 • Number 1 • 2003 23

Dundass et al.
Figure 9. Standard deviation of baseline data for 5 days versus same
day.
ported that the largest standard deviation of stance in the
vertical GRF occurred at the first and second peaks. Winter
also compared repeatability of gait between trials on the same
day with trials on different days for able-bodied subjects. He
reported that the vertical GRF coefficient of variation re-
mained constant (10%) for the two conditions. This result
contradicts the results from this study, which shows the
variability in different days increased from the same day
variability. It is not possible to speculate whether this trend
holds for the general transfemoral amputee population with-
out further testing of several amputee subjects to satisfy the
requirements of a statistically significant study. However,
Zahedi et al.13 did report that the amount of step-to-step
variation among trials on the same day increased for ampu-
tees compared with healthy subjects.
The results show a large amount of variation in gait during
different days of testing. This variability makes it difficult to
isolate any significant deterioration trends within any given
knee controller. It was hypothesized that the changes caused
by the knee controller deterioration fall within or near the
standard deviation envelope and, as such, are difficult to
isolate and distinguish from typical variation in gait. How-
ever, the gait deterioration experiments were not without
merit because much information and insight were gained
about the gait strategies used by a transfemoral amputee.
Specifically, variation among different days was found to be
substantially higher than variation within the same day. This
observation should be carefully considered for future ampu-
tee gait research that requires testing on different days.
MODEL DEVELOPMENT AND SIMULATION
RESULTS
Based on the experimental results of the amputee gait study,
a clear conclusion about the effect of knee joint controller
deterioration on various gait parameters could not be
reached. However, the subject did report that he could feel
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JPO Journal of Prosthetics and Orthotics
the change in resistance in the lower limb motion caused by
the deterioration of the knee joint controller. To precisely
capture the effect of knee joint controller deterioration on
gait, a mathematical model was developed to predict the
behavior of transfemoral amputee gait. The model developed
here could be used to study a full deterioration on transfemo-
ral amputee gait.
Modeling human gait is an extremely difficult task, be-
cause many variables are simultaneously affecting the perfor-
mance of the system. The GRF component is perhaps the
most complex component of the gait cycle to model. In this
model, the GRF component is a combination of the two
models developed by Kaplan and Heegaard15 and Gilchrist
and Winter.16 The foot was modeled as a single rigid body
connected to the shank through the ankle joint. The shank
and thigh were also modeled as rigid bodies. The knee con-
troller was modeled as a spring with two dashpots. Only one
dashpot was active at any given time depending on whether
the knee joint was flexing or extending. To appropriately
model the knee controller unit, a series of compression tests
was carried out on an Instron tensile testing machine (Can-
ton, MA) to evaluate the effective spring stiffness. The damp-
ing coefficients of the dashpots were selected through trial
and error. Figure 10 shows the complete model with the
main inputs and outputs indicated.
The model was constructed in Working Model 2D, version
4.0.1 for Windows. The software uses numerical integration
to solve for the motion and forces of the system. Working
Model uses a variable time step that is adjusted for each
animation frame if the numerical error exceeds the allowable
integration tolerance.
Simulation of gait was performed with the experimental
thigh data used as an input to the model. For verification
purposes, the GRFs were compared with experimentally ob-
tained data. Figure 11 illustrates the comparison between the
simulated and experimental results for the vertical GRF. The
comparison shows that the overall profile of the predicted
results closely track the shape of the experimental data. The
predicted magnitudes of the first and second maximum peak
and the relative minimum agree well with the experimental
data (less than 25 N difference or 4% of max GRF). The
temporal location of the relative minimum and second peak
tracked the experimental data. The predicted first maximum
peak occurred slightly earlier (0.04 seconds or 5% of stance)
in stance phase than the measured data. The region that
showed the greatest abnormality occurred in the unloading
phase during late stance. It is unclear which aspect of the
model caused this deviation. Perhaps it was related to the
non-rigid toe component of the prosthetic foot, which was
modeled as rigid. Regardless of this deviation, the stance time
is still accurately predicted.
The purpose of the modeling in this article was to develop
a model that accurately represented the behavior of the core
components of a typical transfemoral limb. It is shown
through direct evidence that the model results strongly cor-
relate with the experimental results. Although this type of
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JPO Journal of Prosthetics and Orthotics
Figure 10. Model components.
Figure 11. Predicted vertical GRF compared with experimental re-
sults.
model has proved its merit and future potential, this model
has been evaluated only with the characteristics of a single
subject transfemoral amputee. Only more testing of other
transfemoral amputees can provide a solid evaluation of the
comprehensiveness of the model.
CONCLUSIONS
From a series of gait experiments, the kinematics and kinet-
ics of an above-knee prosthetic limb were analyzed for any
substantial knee controller deterioration trends. All gait pa-
rameters investigated showed only weak association with
Volume 15 • Number 1 • 2003
Analysis and Modeling of Transfemoral Amputee Gait
knee controller deterioration. A variability study was con-
ducted to evaluate the variation of the subject’s gait within
baseline testing on the same day and over 5 days. Variability
in the subject’s GRF profile over 5 days was significantly
larger than variation within the same day. The prosthetic
limb first peak in the vertical GRF illustrated the largest
variation for both the single day and 5 days data. It was
concluded that the variability was sufficiently large to mask
any trends of knee controller deterioration.
The predicted results of the dynamic model were consis-
tent with the experimental data. The validation of the effec-
tiveness of this model in predicting the behavior of trans-
femoral amputee gait will facilitate further development for
this model to predict the behavior of full deterioration trans-
femoral prostheses.
ACKNOWLEDGMENTS
The authors thank Dr. S. Spaulding of the Occupational Therapy
Gait Laboratory at The University of Western Ontario for her assis-
tance in collecting the experimental data. This research was spon-
sored by the National Sciences and Engineering Research Council of
Canada.
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