A systematic review on design technology and application of polycentric prosthetic knee in amputee rehabilitation

Mohanty, Rajesh Kumar; Mohanty, Ramesh Chandra; Sabut, Sukanta

doi:10.1007/s13246-020-00882-3

Cited by 33 publications

(14 citation statements)

References 71 publications

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“…In this scenario, quantifying and characterizing the gait of persons with a prosthesis is an essential element to improve the development of new and ergonomic prosthetic devices, and to optimize the rehabilitation programs ( 33 – 36 ). Nevertheless, the heterogeneous variety of methodologies used to assess prosthetic gait limits the comparison of results from different studies and complicates the definition of shared guidelines.…”

Section: Introductionmentioning

confidence: 99%

Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective

Marchis

Ranaldi

Varrecchia

et al. 2022

Front. Rehabilit. Sci.

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Prosthetic gait implies the use of compensatory motor strategies, including alterations in gait biomechanics and adaptations in the neural control mechanisms adopted by the central nervous system. Despite the constant technological advancements in prostheses design that led to a reduction in compensatory movements and an increased acceptance by the users, a deep comprehension of the numerous factors that influence prosthetic gait is still needed. The quantitative prosthetic gait analysis is an essential step in the development of new and ergonomic devices and to optimize the rehabilitation therapies. Nevertheless, the assessment of prosthetic gait is still carried out by a heterogeneous variety of methodologies, and this limits the comparison of results from different studies, complicating the definition of shared and well-accepted guidelines among clinicians, therapists, physicians, and engineers. This perspective article starts from the results of a project funded by the Italian Worker's Compensation Authority (INAIL) that led to the generation of an extended dataset of measurements involving kinematic, kinetic, and electrophysiological recordings in subjects with different types of amputation and prosthetic components. By encompassing different studies published along the project activities, we discuss the specific information that can be extracted by different kinds of measurements, and we here provide a methodological perspective related to multimodal prosthetic gait assessment, highlighting how, for designing improved prostheses and more effective therapies for patients, it is of critical importance to analyze movement neural control and its mechanical actuation as a whole, without limiting the focus to one specific aspect.

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Section: Introductionmentioning

confidence: 99%

Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective

Marchis

Ranaldi

Varrecchia

et al. 2022

Front. Rehabilit. Sci.

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“…In addition, with the help of a microprocessor controller, the so called single-axis intelligent knees can adjust the knee joint damping for amputees' daily activities [2], e.g., Ottobock C-leg, Ossur Rheo Knee. To obtain more stability and functions, passive knees with a polycentric structure are showing up and are popular among the amputees due to their high cost-performance [3]- [5], such as Ossur Total Knee and Blatchford KX06. Moreover, a new passive polycentric knee was proposed in [6], which was designed by a method for performance comparison of commercial knees.…”

Section: Introductionmentioning

confidence: 99%

Design, Control, and Validation of a Polycentric Hybrid Knee Prosthesis

Wang

Zhang

Liang

et al. 2023

IEEE Trans. Ind. Electron.

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This paper presents a novel polycentric hybrid knee prosthesis (PHKP) by enabling a multi-bar linkage to work for high-torque activities in active mode and for lowtorque activities in passive mode. The mode transition is implemented by a servo-controlled telescopic slide rails. Distinguished from the single-axis hybrid knee prostheses, the PHKP Knee provides geometric stability in stance and notably increases toe clearance in swing by using an optimally designed instantaneous center of rotation (ICR) trajectory. In active mode, the PHKP Knee provides high transmission ratio and continuous peak torque offering sufficient support for torque-demanding activities. Impedance control was employed to regulate joint torque as a response to knee motion in the active mode. It was found that due to the inherent geometric stability of the polycentric mechanism in stance, the damping coefficient of the controller can be tuned much smoother than the single-axis knees leading to more compliant and comfortable interactions among the wearer, the prosthesis and the ground. The stair ascent tests showed that the joint angle and torque profiles of the PHKP Knee are similar to those of the able-bodied by demonstrating a step-over-step pattern with a peak angle of 73°and a maximum torque of 0.92 Nm/Kg.

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“…Review articles about passive knees concentrate on polycentric mechanisms and structure optimization. The design, modeling, kinematics, and stability of a knee that was based on a four-bar linkage have been a main topic of prosthesis research for the past decade ( Andrysek, 2010 ; Amador et al, 2011 ; Anand and Sujatha, 2017 ; Andrysek et al, 2019 ; Mohanty et al, 2020 ; Soriano et al, 2020 ). Microprocessor-controlled knees (MPKs) can automatically adjust damping characteristics through external sensors and servo valves, which provide a wider range of self-selected speeds and augmented stability.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms and component design of prosthetic knees: A review from a biomechanical function perspective

Liang

Qian

Chen

et al. 2022

Front. Bioeng. Biotechnol.

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Prosthetic knees are state-of-the-art medical devices that use mechanical mechanisms and components to simulate the normal biological knee function for individuals with transfemoral amputation. A large variety of complicated mechanical mechanisms and components have been employed; however, they lack clear relevance to the walking biomechanics of users in the design process. This article aims to bridge this knowledge gap by providing a review of prosthetic knees from a biomechanical perspective and includes stance stability, early-stance flexion and swing resistance, which directly relate the mechanical mechanisms to the perceived walking performance, i.e., fall avoidance, shock absorption, and gait symmetry. The prescription criteria and selection of prosthetic knees depend on the interaction between the user and prosthesis, which includes five functional levels from K0 to K4. Misunderstood functions and the improper adjustment of knee prostheses may lead to reduced stability, restricted stance flexion, and unnatural gait for users. Our review identifies current commercial and recent studied prosthetic knees to provide a new paradigm for prosthetic knee analysis and facilitates the standardization and optimization of prosthetic knee design. This may also enable the design of functional mechanisms and components tailored to regaining lost functions of a specific person, hence providing individualized product design.

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A systematic review on design technology and application of polycentric prosthetic knee in amputee rehabilitation

Cited by 33 publications

References 71 publications

Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective

Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective

Design, Control, and Validation of a Polycentric Hybrid Knee Prosthesis

Mechanisms and component design of prosthetic knees: A review from a biomechanical function perspective

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