A Clinical Tuning Framework for Continuous Kinematic and Impedance Control of a Powered Knee-Ankle Prosthesis

<bold>Objective:</bold> Configuring a prosthetic leg is an integral part of the fitting process, but the personalization of a multi-modal powered knee-ankle prosthesis is often too complex to realize in a clinical environment. This paper develops both the technical means to individualize...

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Bibliographic Details
Main Authors: Emma Reznick, T. Kevin Best, Robert D. Gregg
Format: Article
Language:English
Published: IEEE 2025-01-01
Series:IEEE Journal of Translational Engineering in Health and Medicine
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Online Access:https://ieeexplore.ieee.org/document/10990182/
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Summary:<bold>Objective:</bold> Configuring a prosthetic leg is an integral part of the fitting process, but the personalization of a multi-modal powered knee-ankle prosthesis is often too complex to realize in a clinical environment. This paper develops both the technical means to individualize a hybrid kinematic-impedance controller for variable-incline walking and sit-stand transitions, and an intuitive Clinical Tuning Interface (CTI) that allows prosthetists to directly modify the controller behavior. <bold>Methods and procedures:</bold> Utilizing an established method for predicting kinematic gait individuality alongside a new parallel approach for kinetic individuality, we personalize continuous-phase/task models of joint impedance (during stance) and kinematics (during swing) using tuned characteristics exclusively from level-ground walking. To take advantage of this method, we developed a CTI that translates common clinical tuning parameters into model adjustments for the walking and sit-stand controllers. We then conducted a case study where a prosthetist iteratively tuned the powered prosthesis to an above-knee amputee participant in a simulated clinical session involving sit-stand transitions and level walking, from which incline/decline walking features were automatically calibrated. <bold>Results:</bold> The prosthetist fully tuned the multi-activity prosthesis controller in under 20 min. Each iteration of tuning (i.e., observation, parameter adjustment, and model reprocessing) took 2 min on average for walking and 1 min on average for sit-stand. The tuned behavior changes were appropriately manifested in the commanded prosthesis torques, both at the manually tuned tasks and automatically tuned tasks (inclines). <bold>Conclusion:</bold> The CTI leveraged able-bodied trends to efficiently personalize a wide array of walking tasks and sit-stand transitions, demonstrating the efficiency necessary for powered knee-ankle prostheses to become clinically viable. <bold>Clinical impact:</bold> This paper introduces a clinical tuning interface that simplifies the tuning process for multimodal robotic prosthetic legs, reducing the time required from several hours to just 20 minutes thus improving clinical feasibility.
ISSN:2168-2372