scholarly journals Optimization of Prosthetic Foot Stiffness to Reduce Metabolic Cost and Intact Knee Loading During Below-Knee Amputee Walking: A Theoretical Study

2012 ◽  
Vol 134 (11) ◽  
Author(s):  
Nicholas P. Fey ◽  
Glenn K. Klute ◽  
Richard R. Neptune
Keyword(s):  
Metabolic Cost ◽  
Contact Forces ◽  
Joint Loading ◽  
Prosthetic Foot ◽  
Abnormal Gait ◽  
Foot Function ◽  
Prosthetic Feet ◽  
Body Support ◽  
Intact Knee

Unilateral below-knee amputees develop abnormal gait characteristics that include bilateral asymmetries and an elevated metabolic cost relative to non-amputees. In addition, long-term prosthesis use has been linked to an increased prevalence of joint pain and osteoarthritis in the intact leg knee. To improve amputee mobility, prosthetic feet that utilize elastic energy storage and return (ESAR) have been designed, which perform important biomechanical functions such as providing body support and forward propulsion. However, the prescription of appropriate design characteristics (e.g., stiffness) is not well-defined since its influence on foot function and important in vivo biomechanical quantities such as metabolic cost and joint loading remain unclear. The design of feet that improve these quantities could provide considerable advancements in amputee care. Therefore, the purpose of this study was to couple design optimization with dynamic simulations of amputee walking to identify the optimal foot stiffness that minimizes metabolic cost and intact knee joint loading. A musculoskeletal model and distributed stiffness ESAR prosthetic foot model were developed to generate muscle-actuated forward dynamics simulations of amputee walking. Dynamic optimization was used to solve for the optimal muscle excitation patterns and foot stiffness profile that produced simulations that tracked experimental amputee walking data while minimizing metabolic cost and intact leg internal knee contact forces. Muscle and foot function were evaluated by calculating their contributions to the important walking subtasks of body support, forward propulsion and leg swing. The analyses showed that altering a nominal prosthetic foot stiffness distribution by stiffening the toe and mid-foot while making the ankle and heel less stiff improved ESAR foot performance by offloading the intact knee during early to mid-stance of the intact leg and reducing metabolic cost. The optimal design also provided moderate braking and body support during the first half of residual leg stance, while increasing the prosthesis contributions to forward propulsion and body support during the second half of residual leg stance. Future work will be directed at experimentally validating these results, which have important implications for future designs of prosthetic feet that could significantly improve amputee care.

scholarly journals Foot stiffening during the push-off phase of human walking is linked to active muscle contraction, and not the windlass mechanism

2020 ◽  
Vol 17 (168) ◽  
pp. 20200208
Author(s):  
Dominic James Farris ◽  
Jonathon Birch ◽  
Luke Kelly
Keyword(s):  
Primary Source ◽  
Muscular Contraction ◽  
Contact Forces ◽  
Bipedal Walking ◽  
Plantar Flexors ◽  
Plantar Aponeurosis ◽  
Human Foot ◽  
Plantar Aspect ◽  
Foot Function

The rigidity of the human foot is often described as a feature of our evolution for upright walking and is bolstered by a thick plantar aponeurosis that connects the heel to the toes. Previous descriptions of human foot function consider stretch of the plantar aponeurosis via toe extension (windlass mechanism) to stiffen the foot as it is levered against the ground for push-off during walking. In this study, we applied controlled loading to human feet in vivo , and studied foot function during the push-off phase of walking, with the aim of carefully testing how the foot is tensioned during contact with the ground. Both experimental paradigms revealed that plantar aponeurosis strain via the ‘windlass mechanism' could not explain the tensioning and stiffening of the foot that is observed with increased foot-ground contact forces and push-off effort. Instead, electromyographic recordings suggested that active contractions of ankle plantar flexors provide the source of tension in the plantar aponeurosis. Furthermore, plantar intrinsic foot muscles were also contributing to the developed tension along the plantar aspect of the foot. We conclude that active muscular contraction, not the passive windlass mechanism, is the foot's primary source of rigidity for push-off against the ground during bipedal walking.

scholarly journals Design and Testing of a Prosthetic Foot With Interchangeable Custom Springs for Evaluating Lower Leg Trajectory Error, an Optimization Metric for Prosthetic Feet

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Victor Prost ◽  
Kathryn M. Olesnavage ◽  
W. Brett Johnson ◽  
Matthew J. Major ◽  
Amos G. Winter
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Large Scale ◽  
Joint Stiffness ◽  
Lower Leg ◽  
Trajectory Error ◽  
Prosthetic Foot ◽  
Design Variables ◽  
Prosthetic Feet

An experimental prosthetic foot intended for evaluating a novel design objective is presented. This objective, called the lower leg trajectory error (LLTE), enables the optimization of passive prosthetic feet by modeling the trajectory of the shank during single support for a given prosthetic foot and selecting design variables that minimize the error between this trajectory and able-bodied kinematics. A light-weight, fully characterized test foot with variable ankle joint stiffness was designed to evaluate the LLTE. The test foot can replicate the range of motion of a physiological ankle over a range of different ankle joint stiffnesses. The test foot consists of a rotational ankle joint machined from acetal resin, interchangeable U-shaped nylon springs that range from 1.5 N · m/deg to 24 N · m/deg, and a flexible nylon forefoot with a bending stiffness of 16 N · m2. The U-shaped springs were designed to support a constant moment along their length to maximize strain energy density; this feature was critical in creating a high-stiffness and high-range of motion ankle. The design performed as predicted during mechanical and in vivo testing, and its modularity allowed us to rapidly vary the ankle joint stiffness. Qualitative feedback from preliminary testing showed that this design is ready for use in large scale clinical trials to further evaluate the use of the LLTE as an optimization objective for passive prosthetic feet.

scholarly journals Characterisation of prosthetic feet used in low-income countries

2004 ◽  
Vol 28 (2) ◽  
pp. 132-140 ◽  
Author(s):  
M. Sam ◽  
A. H. Hansen ◽  
D. S. Childress
Keyword(s):  
Low Income ◽  
Dynamic Properties ◽  
Low Income Countries ◽  
Spatial Transformation ◽  
Contralateral Limb ◽  
Resonant Frequencies ◽  
Prosthetic Foot ◽  
Foot Function ◽  
Prosthetic Feet

Eleven kinds of prosthetic feet that were designed for use in low-income countries were mechanically characterised in this study. Masses of the different kinds of prosthetic feet varied substantially. Dynamic properties, including damping ratios and resonant frequencies, were obtained from step unloading tests of the feet while interacting with masses comparable to the human body. Data showed that for walking, the feet can be appropriately modeled using their quasistatic properties since natural frequencies were high compared to walking frequencies and since damping ratios were small. Roll-over shapes, the effective rocker (cam) geometries that the feet deform to under walking loads, were determined using a quasistatic loading technique and a spatial transformation of the ground reaction force's centre of pressure. The roll-over shapes for most of the prosthetic feet studied were similar to the roll-over shape of the SACH (solid-ankle cushioned heel) prosthetic foot. All roll-over shapes showed a lack of forefoot support, which may cause a “drop-off experience at the end of single limb stance and shorter step lengths of the contralateral limb. The roll-over shapes of prosthetic feet appear useful in characterization of foot function.

In Vivo Tibiofemoral Contact Kinematics and Contact Forces During Dynamic Weight-Bearing Activities Following Total Knee Arthroplasty

2008 ◽  
Author(s):  
Kartik M. Varadarajan ◽  
Angela Moynihan ◽  
Darryl D’Lima ◽  
Clifford W. Colwell ◽  
Harry E. Rubash ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Computational Models ◽  
Imaging System ◽  
Weight Bearing ◽  
Contact Forces ◽  
Inverse Dynamic ◽  
Contact Kinematics ◽  
Total Knee

Accurate knowledge of in vivo articular contact kinematics and contact forces is required to quantitatively understand factors limiting life of total knee arthroplasty (TKA) implants, such as polyethylene component wear and implant loosening [1]. Determination of in vivo tibiofemoral contact forces has been a challenging issue in biomechanics. Historically, instrumented tibial implants have been used to measure tibiofemoral forces in vitro [2] and computational models involving inverse dynamic optimization have been used to estimate joint forces in vivo [3]. Recently, D’Lima et al. reported the first in vivo measurement of 6DOF tibiofemoral forces via an instrumented implant in a TKA patient [4]. However this technique does not provide a direct estimation of tibiofemoral contact forces in the medial and lateral compartments. Recently, a dual fluoroscopic imaging system has been used to accurately determine tibiofemoral contact locations on the medial and lateral tibial polyethylene surfaces [5]. The objective of this study was to combine the dual fluoroscope technique and the instrumented TKAs to determine the dynamic 3D articular contact kinematics and contact forces on the medial and lateral tibial polyethylene surfaces during functional activities.

Characterizing adaptations of prosthetic feet in the frontal plane

2020 ◽  
Vol 44 (4) ◽  
pp. 225-233
Author(s):  
Michael Ernst ◽  
Björn Altenburg ◽  
Thomas Schmalz
Keyword(s):  
Energy Storage ◽  
Theoretical Model ◽  
Ankle Joint ◽  
Frontal Plane ◽  
Measured Data ◽  
Limb Amputation ◽  
Clinical Parameters ◽  
Mechanical Adaptation ◽  
Prosthetic Foot ◽  
Prosthetic Feet

Background: Energy-storage and return feet incorporate various design features including split toes. As a potential improvement, an energy-storage and return foot with a dedicated ankle joint was recently introduced allowing for easily accessible inversion/eversion movement. However, the adaptability of energy-storage and return feet to uneven ground and the effects on biomechanical and clinical parameters have not been investigated in detail. Objectives: To investigate the design-related ability of prosthetic feet to adapt to cross slopes and derive a theoretical model. Study design: Mechanical testing and characterization. Methods: Mechanical adaptation to cross slopes was investigated for six prosthetic feet measured by a motion capture system. A theoretical model linking the measured data with adaptations is proposed. Results: The type and degree of adaptation depends on the foot design, for example, stiffness, split toe or continuous carbon forefoot, and additional ankle joint. The model used shows high correlations with the measured data for all feet. Conclusions: The ability of prosthetic feet to adapt to uneven ground is design-dependent. The split-toe feet adapted better to cross slopes than those with continuous carbon forefeet. Joints enhance this further by allowing for additional inversion and eversion. The influence on biomechanical and clinical parameters should be assessed in future studies. Clinical relevance Knowing foot-specific ability to adapt to uneven ground may help in selecting an appropriate prosthetic foot for persons with a lower limb amputation. Faster and more comprehensive adaptations to uneven ground may lower the need for compensations and therefore increase user safety.

scholarly journals A Systematic Review of the Associations Between Inverse Dynamics and Musculoskeletal Modeling to Investigate Joint Loading in a Clinical Environment

2020 ◽  
Vol 8 ◽  
Author(s):  
Jana Holder ◽  
Ursula Trinler ◽  
Andrea Meurer ◽  
Felix Stief
Keyword(s):  
Knee Joint ◽  
Clinical Decision Making ◽  
Inverse Dynamics ◽  
Clinical Decision ◽  
Contact Forces ◽  
Musculoskeletal Modeling ◽  
Joint Loading ◽  
Joint Moments ◽  
Internal Joint ◽  
Joint Contact

The assessment of knee or hip joint loading by external joint moments is mainly used to draw conclusions on clinical decision making. However, the correlation between internal and external loads has not been systematically analyzed. This systematic review aims, therefore, to clarify the relationship between external and internal joint loading measures during gait. A systematic database search was performed to identify appropriate studies for inclusion. In total, 4,554 articles were identified, while 17 articles were finally included in data extraction. External joint loading parameters were calculated using the inverse dynamics approach and internal joint loading parameters by musculoskeletal modeling or instrumented prosthesis. It was found that the medial and total knee joint contact forces as well as hip joint contact forces in the first half of stance can be well predicted using external joint moments in the frontal plane, which is further improved by including the sagittal joint moment. Worse correlations were found for the peak in the second half of stance as well as for internal lateral knee joint contact forces. The estimation of external joint moments is useful for a general statement about the peak in the first half of stance or for the maximal loading. Nevertheless, when investigating diseases as valgus malalignment, the estimation of lateral knee joint contact forces is necessary for clinical decision making because external joint moments could not predict the lateral knee joint loading sufficient enough. Dependent on the clinical question, either estimating the external joint moments by inverse dynamics or internal joint contact forces by musculoskeletal modeling should be used.

scholarly journals Concurrent Prediction of Muscle and Tibiofemoral Contact Forces During Treadmill Gait

2014 ◽  
Vol 136 (2) ◽  
Author(s):  
Trent M. Guess ◽  
Antonis P. Stylianou ◽  
Mohammad Kia
Keyword(s):  
Femoral Component ◽  
Gait Cycle ◽  
Musculoskeletal Model ◽  
Contact Forces ◽  
Grand Challenge ◽  
Subject Specific ◽  
The Right ◽  
Anterior Posterior ◽  
Rms Errors

Detailed knowledge of knee kinematics and dynamic loading is essential for improving the design and outcomes of surgical procedures, tissue engineering applications, prosthetics design, and rehabilitation. This study used publicly available data provided by the “Grand Challenge Competition to Predict in-vivo Knee Loads” for the 2013 American Society of Mechanical Engineers Summer Bioengineering Conference (Fregly et al., 2012, “Grand Challenge Competition to Predict in vivo Knee Loads,” J. Orthop. Res., 30, pp. 503–513) to develop a full body, musculoskeletal model with subject specific right leg geometries that can concurrently predict muscle forces, ligament forces, and knee and ground contact forces. The model includes representation of foot/floor interactions and predicted tibiofemoral joint loads were compared to measured tibial loads for two different cycles of treadmill gait. The model used anthropometric data (height and weight) to scale the joint center locations and mass properties of a generic model and then used subject bone geometries to more accurately position the hip and ankle. The musculoskeletal model included 44 muscles on the right leg, and subject specific geometries were used to create a 12 degrees-of-freedom anatomical right knee that included both patellofemoral and tibiofemoral articulations. Tibiofemoral motion was constrained by deformable contacts defined between the tibial insert and femoral component geometries and by ligaments. Patellofemoral motion was constrained by contact between the patellar button and femoral component geometries and the patellar tendon. Shoe geometries were added to the feet, and shoe motion was constrained by contact between three shoe segments per foot and the treadmill surface. Six-axis springs constrained motion between the feet and shoe segments. Experimental motion capture data provided input to an inverse kinematics stage, and the final forward dynamics simulations tracked joint angle errors for the left leg and upper body and tracked muscle length errors for the right leg. The one cycle RMS errors between the predicted and measured tibia contact were 178 N and 168 N for the medial and lateral sides for the first gait cycle and 209 N and 228 N for the medial and lateral sides for the faster second gait cycle. One cycle RMS errors between predicted and measured ground reaction forces were 12 N, 13 N, and 65 N in the anterior-posterior, medial-lateral, and vertical directions for the first gait cycle and 43 N, 15 N, and 96 N in the anterior-posterior, medial-lateral, and vertical directions for the second gait cycle.

Elastic ankle exoskeletons reduce soleus muscle force but not work in human hopping

2013 ◽  
Vol 115 (5) ◽  
pp. 579-585 ◽  
Author(s):  
Dominic James Farris ◽  
Benjamin D. Robertson ◽  
Gregory S. Sawicki
Keyword(s):  
Inverse Dynamics ◽  
Average Rate ◽  
Plantar Flexion ◽  
Metabolic Cost ◽  
Whole Body ◽  
Negative Consequences ◽  
Metabolic Power ◽  
Force Peak ◽  
Inverse Dynamics Analysis

Inspired by elastic energy storage and return in tendons of human leg muscle-tendon units (MTU), exoskeletons often place a spring in parallel with an MTU to assist the MTU. However, this might perturb the normally efficient MTU mechanics and actually increase active muscle mechanical work. This study tested the effects of elastic parallel assistance on MTU mechanics. Participants hopped with and without spring-loaded ankle exoskeletons that assisted plantar flexion. An inverse dynamics analysis, combined with in vivo ultrasound imaging of soleus fascicles and surface electromyography, was used to determine muscle-tendon mechanics and activations. Whole body net metabolic power was obtained from indirect calorimetry. When hopping with spring-loaded exoskeletons, soleus activation was reduced (30–70%) and so was the magnitude of soleus force (peak force reduced by 30%) and the average rate of soleus force generation (by 50%). Although forces were lower, average positive fascicle power remained unchanged, owing to increased fascicle excursion (+4–5 mm). Net metabolic power was reduced with exoskeleton assistance (19%). These findings highlighted that parallel assistance to a muscle with appreciable series elasticity may have some negative consequences, and that the metabolic cost associated with generating force may be more pronounced than the cost of doing work for these muscles.

The influence of footwear on knee joint loading during walking — in vivo load measurements with instrumented knee implants

2013 ◽  
Vol 46 (4) ◽  
pp. 796-800 ◽  
Author(s):  
Ines Kutzner ◽  
Daniel Stephan ◽  
Jörn Dymke ◽  
Alwina Bender ◽  
Friedmar Graichen ◽  
...  
Keyword(s):  
Knee Joint ◽  
Joint Loading ◽  
Knee Joint Loading

Parametric Evaluation of Hindfoot and Forefoot Properties and Their Effect on the Angular Stiffness of Prosthetic Feet

2012 ◽  
Author(s):  
Peter G. Adamczyk ◽  
Michelle Roland ◽  
Michael E. Hahn
Keyword(s):  
Stance Phase ◽  
Direct Calculation ◽  
Future Studies ◽  
Prosthetic Foot ◽  
Moment Arms ◽  
Walking Performance ◽  
Deformation Mechanics ◽  
Prosthetic Feet ◽  
Stiffness Characteristics ◽  
Parametric Adjustment

Prosthetic foot stiffness has been recognized as an important factor in optimizing the walking performance of amputees [1–3]. Commercial feet are available in a range of stiffness categories and geometries. The stiffness of linear displacements of the hindfoot and forefoot for several commercially available feet have been reported to be within a range of 27–68 N/mm [4] and 28–76 N/mm [5], respectively, but these values are most relevant only to the earliest and latest portions of stance phase, when linear compression or rebound naturally occur. In contrast, mid-stance kinetics are more related to the angular stiffness of the foot, which describes the ankle torque produced by angular progression of the lower limb over the foot during this phase. Little data is available regarding the angular stiffness of any commercially available feet. The variety of geometries between manufacturers and models of prosthetic feet makes a direct calculation of effective angular stiffness challenging due to changes in moment arms based on loading condition, intricacies of deformation mechanics of the structural components, and mechanical interaction between hindfoot and forefoot components. Thus, modeling the interaction between hindfoot stiffness, forefoot stiffness, and keel geometries and their combined effect on the angular stiffness of the foot may be a useful tool for correlating functional outcomes with stiffness characteristics of various feet. To understand how each of these factors affects angular stiffness, we developed a foot that can parametrically adjust each of these factors independently. The objective of this study was to mathematically model, design, and experimentally validate a prosthetic foot that has independent hindfoot and forefoot components, allowing for parametric adjustment of stiffness characteristics and keel geometry in future studies of amputee gait.

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