Professional Documents
Culture Documents
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- prosthetic limb. Sutherland et al.5 performed kinetic evalu-
merous factors involved in the gait cycle have been ation of two different prosthetic knee joints.
investigated. Researchers examined the effects of dif- Models have been developed to represent and simulate
ferent prosthetic designs in search of optimum prosthetic conditions that occur in reality. Modeling human gait is an
performance and evaluated the kinematics of the knee joint extremely difficult task because many factors and unknowns
in response to various prosthetic design conditions. Stein and play significant roles in the behavior and control of the limbs.
Flowers1 investigated the effects of knee controller perfor- To minimize the complexity, researchers often model a spe-
mance on amputee gait during stance phase. Van Der Linden cific event of gait rather than the entire process. Several
et al.2 studied the effect of various prosthetic feet on the models of the lower limbs have been developed to increase
biomechanics of transfemoral amputee gait. Blumentritt et understanding of gait. However, very few amputee gait mod-
al.3 performed a biomechanical study on seven transfemoral els have been created and validated. To date, the majority of
amputees who utilized rotary hydraulic prosthetic knees. transfemoral amputee modeling has focused on the swing
Kinetic gait analysis focuses on the internal and external phase of gait. Mohan et al.6 developed a mathematical model
forces that cause the motion. Previous transfemoral amputee of the transfemoral prosthesis during swing phase to deter-
kinetic gait research has investigated the impact of different mine the optimal location for the center of gravity of the
prosthetic designs on the ground reaction force (GRF) pro- prosthesis. Bach et al.7,8 also investigated the swing phase of
file. Van Der Linden et al.2 used three force plates to capture the transfemoral amputee gait with the use of computer
the GRFs and moments of one complete stride and observed simulations. The study developed a ballistic model of swing
that the vertical GRF profile of the prosthetic limb never phase to determine the optimal inertial loading for a trans-
attained full body weight during stance phase. Gitter et al.4 femoral prosthesis.
evaluated kinetic gait information of eight transfemoral am- The majority of previous research on transfemoral ampu-
putees using a single force plate to capture GRFs of the
tee gait has been almost exclusively dedicated to evaluating
new prosthetic components and concepts to improve gait.
C. DUNDASS is affiliated with Forensic Dynamics Inc., Kamloops, While this is extremely valuable and necessary for enhance-
British Columbia, Canada. ments in component technology, the long term performance
G. Z. YAO is affiliated with the Department of Mechanical Engineer- and, specifically, the reliability of current and older prosthet-
ing, Queen’s University, Kingston, Ontario, Canada. ics still being used by amputees have received little attention.
C. K. MECHEFSKE is affiliated with the Department of Mechanical No previous study has been conducted that attempts to eval-
Engineering, Queen’s University, Kingston, Ontario, Canada. uate the relationship between component deterioration and
Copyright 娀2003 American Academy of Orthotists and Prosthetists. gait. This apparent gap is the motivation for conducting the
Prof. Chris Mechefske, Department of Mechanical Engineering, knee controller deterioration experiments in this paper.
Queen’s University, McLaughlin Hall, Kingston, Ontario, Canada Computational models developed for able-bodied subjects
K7L 3N6; 1-613-5333148; fax: 1-613-5336489. E-mail: chrism@me. show the usefulness for the simulation of gait kinematics and
queensu.ca kinetics. The motivation for the development of a dynamic
model that appropriately models transfemoral amputee gait is enabling the user to set different resistance levels for knee
clear from the absence of such a model in the literature. flexion and extension. A Greissenger multi-axle prosthetic
foot was attached to the shank (Otto Bock, Duderstadt, Ger-
EXPERIMENTAL PROCEDURE AND DATA ANALYSIS many). The geometric and physical properties of the Ohio
One male unilateral transfemoral amputee participated in the Willow Wood limb were measured for the purposes of mod-
study. The subject was 24 years of age and considered to be in eling. The approximate location of the center of mass of the
excellent physical condition. He had a body mass of approx- foot and shank was determined by balancing them on a
imately 76 kg at the time of the experiments. His left leg was straight edge. The inertia of each segment was calculated
amputated at approximately 30 cm distal to the greater tro- using the pendulum technique as described by Chandler et
chanter. Prior to testing, the subject signed an informed al.9
consent conforming to the policies of the University of West- The knee controller deterioration experiments were de-
ern Ontario Ethics Review Committee. signed to investigate the effects of hydraulic knee deteriora-
The kinematic and kinetic data were collected at the Oc- tion on gait. The study involved interchanging the subject’s
cupational Therapy Gait Laboratory at The University of Catech knee controller unit with artificially deteriorated Ca-
Western Ontario. The facility consisted of an elevated walking tech knee controllers. The gait laboratory knee controller
platform approximately seven meters in length. The walking experiments were performed in conjunction with a series of
platform contained two force plates (see Figure 1) that were mechanical life cycle tests that were performed on the Catech
aligned perpendicular to a kinematic camera unit. The first knee controller units.10 The research involved cycling five
force plate (Advanced Mechanical Technology Inc., AMTI knee controllers at 1 Hz in a life cycle test machine to
model #OR6-5-1000, Watertown, MA) recorded the GRF of simulate wear that would occur under normal use. The man-
the prosthetic limb. The second force plate (Kistler model ufacturer of the knee controller estimates that the useful life
#9261A, Amherst, NY) measured the GRF of the sound limb. of the unit is approximately 2,000,000 cycles (typically 2 years
The output from the AMTI force plate was fed through an for an average transfemoral amputee). In this study,
AMTI Strain Gage Amplifier System. The output from the 2,000,000 cycles corresponded to 100% deterioration.
Kistler force plate was fed into a Kistler 9261A electronic During laboratory testing of gait, the five knee controllers
unit. The kinematic data were collected using an Optotrack ranged in condition from 0% to 100% deterioration at con-
3010 System made by Northern Digital Inc. (Waterloo, On- stant intervals of 25%. The study involved five separate days
tario, Canada). The system uses three optical sensors capable of testing so that each knee controller was tested at every
of recording infrared light that is actively emitted from IRED level of deterioration from 0% to 100%. Each day of gait
markers attached to the limb. The 3D kinematic data and testing, the subject performed a baseline test consisting of
force plate data were simultaneously collected with the Op- three walking trials at a self-selected comfortable speed with
totrak Data Acquisition unit (Northern Digital, Inc.). The data his own knee controller unit. Subsequent tests (also consist-
files were recorded and stored on line with a 486 IBM com- ing of three walking trials at a self-selected speed) were
puter (White Plains, NY). performed with each deteriorated knee controller. The knee
During the set of experiments on knee controller deteri- controller units were interchanged without removal of the
oration, the subject wore a quadrilateral socket with an Ohio prosthesis. The subject was given the opportunity to famil-
Willow Wood Model 90 Knee (Mt. Sterling, OH) controlled by iarize himself with each new controller. The gait data were
a Catech hydraulic knee controller (Catech Systems, Toronto, recorded once the subject reported that he was comfortable
Canada). The Catech controller consists of a piston and cyl- with the prosthesis. The subject walked in a straight line,
inder configuration accompanied by a compression spring. completing 1.5 strides before contacting the two force plates
The level of viscous damping can be manually adjusted, 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.
Figure 1. Subject and data collection area. The kinematic data were analyzed for periods when the
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
Figure 6. Prosthetic knee angle for three levels of deterioration. Figure 8. Average baseline vertical GRF for each day.
ACKNOWLEDGMENTS
Figure 11. Predicted vertical GRF compared with experimental re-
sults. 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-
model has proved its merit and future potential, this model sored by the National Sciences and Engineering Research Council of
has been evaluated only with the characteristics of a single Canada.
subject transfemoral amputee. Only more testing of other
transfemoral amputees can provide a solid evaluation of the REFERENCES
comprehensiveness of the model.
1. Stein JL, Flowers WC. Stance phase control of above-knee
prostheses: knee control versus sach foot design. J Biomech
CONCLUSIONS 1987;20:19 –28.
From a series of gait experiments, the kinematics and kinet- 2. Van Der Linden ML, Solomonidis SE, Spence WD, Li Ning, Paul
ics of an above-knee prosthetic limb were analyzed for any JP. A methodology for studying the effects of various types of
substantial knee controller deterioration trends. All gait pa- prosthetic feet on the biomechanics of transfemoral amputee
rameters investigated showed only weak association with gait. J Biomech 1999;32:877– 889.
3. Blumentritt S, Werner Scherer H, Michael JW, Schmalz T. 9. Chandler RF, Clauser CE, McConville JT, Reynolds HM, and
Transfemoral amputees walking on a rotary hydraulic prosthetic Young JW. Investigation of inertial properties of the human
knee mechanism: a preliminary report. J Prosthet Orthot 1998; body. Aerospace Medical Research Laboratories, Wright-
10:61–70. Patterson Air Force Base, Ohio, 1975; AMRL-TR-74 –137, AD-
A016 – 485. DOT-HS-801– 430.
4. Gitter A, Czerniecki J, Meinders M. Effect of prosthetic mass on
swing phase work during above-knee amputee ambulation. Am J 10. Mechefske CK, Yang Y. Failure diagnosis of a type of hydraulic
Phys Med Rehab 1997;76:114 –121. knee joint controller. Prosthet Orthot Int 2001;25:148 –153.
5. Sutherland JL, Sutherland DH, Kaufman KR, Teel M. Case study 11. Winter DA, Sidwall HG, Hobson DA. Measurement and reduc-
forum: gait comparison of two prosthetic knee units. J Prosthet tion of noise in kinematics of locomotion. J Biomech 1974;7:
Orthot 1997;9:168 –173. 157–159.
6. Mohan D, Sethi PK, Ravi R. Mathematical modeling and field 12. Winter DA. Biomechanics and motor control of human move-
trials of an inexpensive endoskeletal above-knee prosthesis. ment. 2nd Ed. Hoboken, NJ: Wiley, 1990.
Prosthet Orthot Int 1992;16:118 –123.
13. Zahedi MS, Spence WD, Solomonidis SE, Paul JP. Repeatabiliy
7. Bach TM, Barnes LJ, Evans OM, Robinson IG. Optimization of of kinetic and kinematic measurements in gait studies of the
inertia characteristics of transfemoral limb prosthesis using a lower limb amputee. Prosthet Orthot Int 1997;11:55– 64.
computer simulation of human walking. Proceedings of the
14. Winter DA. The biomechanics and motor control of human gait.
Canadian Society for Biomechanics Eighth Biennial Confer-
Waterloo, Ontario: University of Waterloo Press, 1987.
ence, Calgary, Canada, 1994;212–213.
15. Kaplan ML, Heegaard JH. Energy-conserving impact algo-
8. Bach TM, Barnes LJ, Evans OM, Robinson IG. Optimization of
rithm for the heel-strike phase of gait. J Biomech 2000;33:
inertia characteristics of transfemoral limb prostheses: tests of
771–775.
predictions of a computer simulation. Proceedings of the Cana-
dian Society for Biomechanics Eighth Biennial Conference, 16. Gilchrist LA, Winter DA. A two-part, viscoelastic foot model for
Calgary, Canada 1994;124 –125. use in gait simulations. J Biomech 1996;29:795–798.