Split-belt adaptation and gait symmetry in transtibial amputees walking with a hybrid EMG controlled ankle-foot prosthesis

Kannape, Oliver Alan; Herr, Hugh M.

doi:10.1109/embc.2016.7591964

Cited by 18 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The loss of motor control provided through a prosthetic limb may only compound the risk for impaired adaptability. Although literature describing the effect of an amputation on locomotor adaptability is limited, recent studies provide some insight on reactive and adaptive changes when walking is perturbed using a split-belt treadmill[18, 19]. Specifically, one study suggested persons with transtibial amputation (TTA) and those without amputation were equally perturbed at the onset of the unequal walking speeds based on similar magnitude reactive accommodations in step length symmetry[18].…”

Section: Introductionmentioning

confidence: 99%

Locomotor adaptability in persons with unilateral transtibial amputation

et al. 2017

View full text Add to dashboard Cite

BackgroundLocomotor adaptation enables walkers to modify strategies when faced with challenging walking conditions. While a variety of neurological injuries can impair locomotor adaptability, the effect of a lower extremity amputation on adaptability is poorly understood.ObjectiveDetermine if locomotor adaptability is impaired in persons with unilateral transtibial amputation (TTA).MethodsThe locomotor adaptability of 10 persons with a TTA and 8 persons without an amputation was tested while walking on a split-belt treadmill with the parallel belts running at the same (tied) or different (split) speeds. In the split condition, participants walked for 15 minutes with the respective belts moving at 0.5 m/s and 1.5 m/s. Temporal spatial symmetry measures were used to evaluate reactive accommodations to the perturbation, and the adaptive/de-adaptive response.ResultsPersons with TTA and the reference group of persons without amputation both demonstrated highly symmetric walking at baseline. During the split adaptation and tied post-adaptation walking both groups responded with the expected reactive accommodations. Likewise, adaptive and de-adaptive responses were observed. The magnitude and rate of change in the adaptive and de-adaptive responses were similar for persons with TTA and those without an amputation. Furthermore, adaptability was no different based on belt assignment for the prosthetic limb during split adaptation walking.ConclusionsReactive changes and locomotor adaptation in response to a challenging and novel walking condition were similar in persons with TTA to those without an amputation. Results suggest persons with TTA have the capacity to modify locomotor strategies to meet the demands of most walking conditions despite challenges imposed by an amputation and use of a prosthetic limb.

show abstract

Section: Introductionmentioning

confidence: 99%

Locomotor adaptability in persons with unilateral transtibial amputation

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Gains β SO and β TA could be modified based on the measured GRF peaks ( Figure 4B ) or/and predicted ankle moment peak. This type of control seems more intuitive for the user ( Ortiz-Catalan et al, 2014 ; Kannape and Herr, 2016 ) since it includes a highly adaptive living system in the control of the prosthesis output.…”

Section: Discussionmentioning

confidence: 99%

“…Myoelectric signals with built-in pattern recognition algorithms enable fine motor control in arm prostheses, even without any sensory feedback ( Li et al, 2010 ; Tkach et al, 2014 ). Likewise, it might be possible to improve locomotor outcome measures (e.g., walking symmetry) by controlling a powered prosthesis or orthosis using myoelectric signals from residual or intact muscles ( Sawicki and Ferris, 2009 ; Herr and Grabowski, 2012 ; Takahashi et al, 2015 ; Kannape and Herr, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

A Prototype of a Neural, Powered, Transtibial Prosthesis for the Cat: Benchtop Characterization

et al. 2018

View full text Add to dashboard Cite

We developed a prototype of a neural, powered, transtibial prosthesis for the use in a feline model of prosthetic gait. The prosthesis was designed for attachment to a percutaneous porous titanium implant integrated with bone, skin, and residual nerves and muscles. In the benchtop testing, the prosthesis was fixed in a testing rig and subjected to rhythmic vertical displacements and interactions with the ground at a cadence corresponding to cat walking. Several prosthesis functions were evaluated. They included sensing ground contact, control of transitions between the finite states of prosthesis loading, and a closed-loop modulation of the linear actuator gain in each loading cycle. The prosthetic design parameters (prosthesis length = 55 mm, mass = 63 g, peak extension moment = 1 Nm) corresponded closely to those of the cat foot-ankle with distal shank and the peak ankle extension moment during level walking. The linear actuator operated the prosthetic ankle joint using inputs emulating myoelectric activity of residual muscles. The linear actuator gain was modulated in each cycle to minimize the difference between the peak of ground reaction forces (GRF) recorded by a ground force sensor and a target force value. The benchtop test results demonstrated a close agreement between the GRF peaks and patterns produced by the prosthesis and by cats during level walking.

show abstract

“…3 Researchers have also investigated locomotor adaptability in patient populations, including patients with cerebral vascular accident, 14 Parkinson's disease, 15 and transtibial amputation. [16][17][18] Patients with transtibial amputation were found to adapt similarly to individuals with no impairment. 17 Split-belt treadmill walking was reported as a rehabilitation intervention to correct temporal-spatial asymmetry in persons following stroke, 14 with benefits retained for at least 3 months.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Gait Symmetry and Metabolic Demand in Individuals With Unilateral Transfemoral Amputation: A Preliminary Study

et al. 2019

View full text Add to dashboard Cite

Introduction Temporal-spatial symmetry allows for optimal metabolic economy in unimpaired human gait. The gait of individuals with unilateral transfemoral amputation is characterized by temporal-spatial asymmetries and greater metabolic energy expenditure. The objective of this study was to determine whether temporal-spatial asymmetries account for greater metabolic energy expenditure in individuals with unilateral transfemoral amputation. Materials and Methods The relationship between temporal-spatial gait asymmetry and metabolic economy (metabolic power normalized by walking speed) was retrospectively examined in eighteen individuals with transfemoral amputation walking at a self-selected velocity overground. Pearson’s product-moment correlations were used to assess the relationship between: (1) step time symmetry and metabolic economy and (2) step length symmetry and metabolic economy. The retrospective analysis of this data was approved by the Walter Reed National Military Medical Center Institutional Review Board and all individuals provided written consent. Additional insights on this relationship are presented through a case series describing the temporal-spatial and metabolic responses of two individuals with transfemoral amputation who completed a split-belt treadmill walking test. Results For the cohort of individuals, there was no significant relationship between metabolic economy and either step time asymmetry or step length asymmetry. However, the case series showed a positive relationship between step length asymmetry and metabolic power as participants adapted to split-belt treadmill walking. Conclusion There is mixed evidence for the relationship between temporal-spatial asymmetries and metabolic energy expenditure. This preliminary study may suggest optimal metabolic energy expenditure in individuals with transfemoral amputation occurs at an individualized level of symmetry and resultant deviations incur a metabolic penalty. The results of this study support the idea that addressing only temporal-spatial gait asymmetries in individuals with transfemoral amputation through rehabilitation may not improve metabolic economy. Nevertheless, future prospective research is necessary to confirm these results and implications for clinical practice.

show abstract

Split-belt adaptation and gait symmetry in transtibial amputees walking with a hybrid EMG controlled ankle-foot prosthesis

Cited by 18 publications

References 17 publications

Locomotor adaptability in persons with unilateral transtibial amputation

Locomotor adaptability in persons with unilateral transtibial amputation

A Prototype of a Neural, Powered, Transtibial Prosthesis for the Cat: Benchtop Characterization

The Relationship Between Gait Symmetry and Metabolic Demand in Individuals With Unilateral Transfemoral Amputation: A Preliminary Study

Contact Info

Product

Resources

About