Rehabilitation Devices and Systems

Improving lower-limb prostheses is important to enhance the mobility of amputees. The purpose of this paper is to introduce an impedance-based control strategy (consisting of four novel algorithms) for an active knee and ankle prosthesis and test its generalizability across multiple walking speeds, walking surfaces, and users. The four algorithms increased ankle stiffness throughout stance, decreased knee stiffness during terminal stance, as well as provided powered ankle plantarflexion and knee swing initiation through modifications of equilibrium positions of the ankle and knee, respectively. Seven amputees (knee disarticulation and transfemoral levels) walked at slow, comfortable, and hurried speeds on level and inclined (10) surfaces. The prosthesis was tuned at their comfortable level ground walking speed. We further quantified trends in prosthetic knee and ankle kinematics, and kinetics across conditions. Subjects modulated their walking speed by ±25% (average) from their comfortable speeds. As speed increased, increasing ankle angles and velocities as well as stance phase ankle power and plantarflexion torque were observed. At slow and comfortable speeds, plantarflexion torque was increased on the incline. At slow and comfortable speeds, stance phase positive knee power was increased and knee torque more flexor on the incline. As speed increased, knee torque became less flexor on the incline. These algorithms were shown to generalize well across speed, produce gait mechanics that compare favorably with non-amputee data, and display evidence of scalable device function. They have the potential to reduce the challenge of clinically configuring such devices and increase their viability during daily use. INDEX TERMS Biomechanics, gait, transfemoral amputee, powered knee and ankle prosthesis, sloped surface, walking speed.