Stair ascent and descent at different inclinations
TL;DR: Findings suggest that there is a certain inclination angle or angular range where subjects do switch between a level walking and a stair walking gait pattern, and no definite signs could be found indicating thatthere is an adaptation or shift in the motor patterns when moving from level to stair walking.
About: This article is published in Gait & Posture.The article was published on 2002-02-01. It has received 738 citations till now. The article focuses on the topics: Stair climbing & Poison control.
Citations
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TL;DR: This work reviews the state-of-the-art techniques for controlling portable active lower limb prosthetic and orthotic P/O devices in the context of locomotive activities of daily living (ADL), and considers how these can be interfaced with the user’s sensory-motor control system.
Abstract: Technological advancements have led to the development of numerous wearable robotic devices for the physical assistance and restoration of human locomotion. While many challenges remain with respect to the mechanical design of such devices, it is at least equally challenging and important to develop strategies to control them in concert with the intentions of the user. This work reviews the state-of-the-art techniques for controlling portable active lower limb prosthetic and orthotic (P/O) devices in the context of locomotive activities of daily living (ADL), and considers how these can be interfaced with the user’s sensory-motor control system. This review underscores the practical challenges and opportunities associated with P/O control, which can be used to accelerate future developments in this field. Furthermore, this work provides a classification scheme for the comparison of the various control strategies. As a novel contribution, a general framework for the control of portable gait-assistance devices is proposed. This framework accounts for the physical and informatic interactions between the controller, the user, the environment, and the mechanical device itself. Such a treatment of P/Os – not as independent devices, but as actors within an ecosystem – is suggested to be necessary to structure the next generation of intelligent and multifunctional controllers. Each element of the proposed framework is discussed with respect to the role that it plays in the assistance of locomotion, along with how its states can be sensed as inputs to the controller. The reviewed controllers are shown to fit within different levels of a hierarchical scheme, which loosely resembles the structure and functionality of the nominal human central nervous system (CNS). Active and passive safety mechanisms are considered to be central aspects underlying all of P/O design and control, and are shown to be critical for regulatory approval of such devices for real-world use. The works discussed herein provide evidence that, while we are getting ever closer, significant challenges still exist for the development of controllers for portable powered P/O devices that can seamlessly integrate with the user’s neuromusculoskeletal system and are practical for use in locomotive ADL.
853 citations
Cites background from "Stair ascent and descent at differe..."
...It is duly noted that the power output characteristics vary substantially betw een the hip, knee, and ankle during a given activity [18]....
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...Each of these environmental properties have a great influence on the stability, balance, d nergy consumption of the device and of the user [18] and thus should be considered in the overall control scheme....
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TL;DR: Experimental results are shown that demonstrate the promise of the active prosthesis and control approach in restoring fully powered level walking to the user.
Abstract: The paper describes the design and control of a transfemoral prosthesis with powered knee and ankle joints. The initial prototype is a pneumatically actuated powered-tethered device, which is intended to serve as a laboratory test bed for a subsequent self-powered version. The prosthesis design is described, including its kinematic optimization and the design of a three-axis socket load cell that measures the forces and moments of interaction between the socket and prosthesis. A gait controller is proposed based on the use of passive impedance functions that coordinates the motion of the prosthesis with the user during level walking. The control approach is implemented on the prosthesis prototype and experimental results are shown that demonstrate the promise of the active prosthesis and control approach in restoring fully powered level walking to the user.
591 citations
Cites methods from "Stair ascent and descent at differe..."
...The active joint torque specifications for the prosthesis were based on the torque/angle phase space required for a 75 kg user for fast walking and stair climbing, as derived from body-mass-normalized data from Winter (1991) and Riener et al. (2002), respectively....
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...The maximum torque envelope of the resulting knee and ankle actuator configurations are shown graphically in Figure 2, along with the data for a 75 kg normal human for slow and fast cadence and stair climbing (Winter 1991 Riener et al. 2002)....
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...Based on the data presented in Winter (1991) and Riener et al. (2002), the required range of measurement for the load cell was determined to be 1000 N of axial force (i.e. along the socket) and 100 Nm of sagittal and frontal plane moments....
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TL;DR: A myoelectric-driven, finite state controller for a powered ankle-foot prosthesis that modulates both impedance and power output during stance is developed and evaluated, finding that the amputee can robustly transition between the finite state controllers through direct muscle activation, allowing rapid transitioning from level-ground to stair walking patterns.
508 citations
Cites background from "Stair ascent and descent at differe..."
...For stair-descent ambulation, a normal human ankle behaves as a damper to absorb a significant amount of potential energy during the early stance period (Gates, 2004; McFadyen & Winter, 1988; Riener et al., 2002)....
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...Thus, CD1 mechanics have been modeled as a variable damper (Gates, 2004; McFadyen &Winter, 1988; Riener et al., 2002)....
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TL;DR: To minimize prosthesis cost of transport and motor or transmission size, a parallel stiffness is selected that supplies the necessary ankle stiffness during early stance period dorsiflexion, eliminating the need for SEA during that gait phase.
Abstract: The minimum level of series compliance that adequately protects the transmission from damage during foot collision fails to satisfy bandwidth requirements. As a resolution to this difficulty, parallel motor elasticity is used to lower the forces borne by the SEA, enhancing system force bandwidth. To minimize prosthesis cost of transport (COT) and motor or transmission size, we select a parallel stiffness that supplies the necessary ankle stiffness during early stance period dorsiflexion, eliminating the need for SEA during that gait phase. In future investigations, we hope to apply the ankle-foot design to robotic, orthotic, and exoskeletal applications. In the design of biomimetic ankle-foot systems, we feel both series and parallel motor elasticity are of paramount importance.
393 citations
TL;DR: Kinematic postural changes were consistent with the need to raise the limb for toe clearance and heel strike and to lift the body during upslope walking, and to control the descent of theBody during downslope Walking, suggesting these three tasks are not governed by the same control strategy.
365 citations
References
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TL;DR: When going up and down stairs large moments are present about weight-bearing joints, but descending movements produce the largest moments, which are considerably higher than those produced during level walking.
Abstract: The motions, forces, and moments at the major joints of the lower limbs of ten men ascending and descending stairs were analyzed using an optoelectronic system, a force-plate, and electromyography. The mean values for the maximum sagittalplane motions of the hip, knee, and ankle were 42, 88, and 27 degrees, respectively. The mean maximum net flexion-extension moments were: at the hip, 123.9 newton-meters going up and 112.5 newton-meters going down stairs; at the knee, 57.1 newton-meters going up and 146.6 newton-meters going down stairs; and at the ankle, 137.2 newton-meters going up and 107.5 newton-meters going down stairs. When going up and down stairs large moments are present about weight-bearing joints, but descending movements produce the largest moments. The magnitudes of these moments are considerably higher than those produced during level walking.
757 citations
"Stair ascent and descent at differe..." refers background or result in this paper
...Several studies were performed to investigate normal human stair ascent and descent [1–3]....
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...Our kinematic and kinetic data obtained at normal inclination correspond well with patterns described in the literature [1–5]....
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TL;DR: The extensor muscles about the knee played a dominant role in progression from one step to the next in both modes coupled with the ankle plantar flexors, and the total lower limb extensor pattern, called the support moment, was highly correlated between subjects and to level walking.
676 citations
"Stair ascent and descent at differe..." refers background or result in this paper
...The higher variability in the hip joint is in agreement with observations from Mc-Fadyen and Winter [ 2 ]....
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...A fundamental consideration, already pointed out in the work of McFadyen and Winter [ 2 ], is that the ascending task consists primarily of a transfer of muscle energy into potential (gravitational) energy of the body, whereas during descent, the potential energy has to be dissipated (absorbed) by the muscles....
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...A direct consequence is that during the loading response phase (also called ‘pull up’ phase [ 2 ]) the ground reaction forces are considerably higher during descent than during ascent (Fig. 3). In contrast, during ascent the main phase of energy production takes place at the ‘push-up’ phase, where the ground reaction forces are higher than during descent....
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...Considerable differences were also observed when comparing joint angles during stair ascent and descent (Fig. 2), which is in agreement with previous studies [ 2 ]....
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TL;DR: It appears that patients with less constrained cruciate-retaining designs of total knee replacement have a more normal gait during stairclimbing than patients with more constrained cruCIate-sacrificing designs.
Abstract: The relationship between gait and prosthetic design was studied during level walking and stair-climbing for twenty-six asymptomatic patients after total knee replacement. An age-matched group of fourteen control subjects was also studied. Five designs of total knee replacement Geomedic, Gunston, total condylar, duopatellar, and Cloutier were used. Differences in gait could be identified on the basis of prosthetic design. The more stressful stair-climbing test produced more clearly differentiated function among the different designs. Patients who were treated with the least-constrained cruciate-retaining (Cloutier) design of prosthesis were the only group that had a normal range of motion during climbing up and down stairs. Two groups of patients with semiconstrained (total condylar and Geomedic) designs had a lower than normal range of knee fiexion while descending stairs. Patients with the other designs of prosthesis had a normal range of knee motion on stair-climbing. Kinematic and anatomical differences among the five designs did not have as great an influence on function during level walking as they did during stair-climbing. The results of this study indicate that after total knee replacement even asymptomatic patients with excellent clinical results have an abnormality of gait. The features of the abnormality were common to most of the patients in the series, and consisted of a shorter than normal stride length, reduced mid-stance knee flexion, and abnormal patterns of external flexion-extension moment of the knee. Although an explanation of these abnormalities of gait is not completely possible at this time, they appear to be related to the interaction of the kinematics of the knee and surrounding soft tissues. CLINICAL RELEVANCE: It appears that patients with less constrained cruciate-retaining designs of total knee replacement have a more normal gait during stairclimbing than patients with more constrained cruciate-sacrificing designs. During level walking, patients with five quite different designs all had abnormalities of gait in spite of a successful clinical result. There is currently a great deal of controversy regarding which type of total knee prosthesis provides better Funded in part by National Institutes of Health Grants KO4AMO()493 and ROIAM2O7O2 and by the Arthritis Foundation. 1 Department of Orthopedic Surgery . Rush-Presbyterian-St. Luke’s N’lcdical Center. 753 Wcst Congress Parkway, Chicago. Illinois 60612. gait. An improved understanding of gait and the variables associated with total knee designs is essential in addressing this controversy. Quantitative studies of gait during activities of daily living are needed to generate this information, and will be useful for the evaluation of total kneereplacement devices and for providing understanding of the loading patterns that may occur during normal activity. Several studies have evaluated gait in patients with knee disease. These investigations included kinematic analyses I .6.7.9.I i.2I , time-distance measurements, and force-plate measurements. There have also been several kinetic and force-analysis studies of function in normal subjects and in patients after treatment for knee disabilitiesaIa14l7ao. The common finding of these studies was that patients who appear to be clinically asymptomatic after joint replacement have abnormal gait patterns. Currently, little is known about the nature of the gait abnormality in patients after total knee replacement or its relationship to total knee-replacement design. The purpose of this study was to evaluate the relationship between gait and total knee-replacement design. The prosthetic knees that were selected for this study were considered to be representative of cruciate-sacrificing and sparing designs with varying amounts of constraint. The parameters ofgait that we observed included time-distance patterns and motion and moments of the knee joint. The gait of patients who had received one of five different designs of total knee replacement was evaluated and cornpared with that of control subjects. Materials and Methods Twenty-six patients. in five experimental groups. were studied during level walking and stair-climbing. Patients were grouped according to which of five total knee designs they had received. The five implants selected for this study were the Geomedic, Gunston, total condylar. duopatellar, and Cloutier designs. The five designs of prosthesis were selected to represent varying shapes of the articular surfaces and the retention of one, both, or neither cruciate ligament. The Geomedic prosthesis has fairly congruous articular surfaces. requires removal of the anterior cruciate ligament, permits retention of the ps)sterior cruciate ligament. and does not include a patellar flange or resurfacing. The Gunston prosthesis consists of two separate semicircular runners that articulate with two independent tibial components, permits retention of both cruciate ligaments. and does not include patellar resurfacing or a patellar flange. The total condylar design requires the sacrifice of both cruciate ligaments. with anterior-posterior stability provided by the conformity of the tibial articulating surfaces; all patients with this design had patellar resurfacing. The duopatellar prosthesis permits retention of the posterior cruciate ligament. includes a patellar flange. and allows patellar resurfacing, which was performed in all of the patients whom we examined. The Cloutier prosthesis allows retention of both cruciate ligaments and the femoral condyles are asymmetneal, diverge. and have varying radii of curvature. The tibial component of the Cloutier device consists of flat articular surfaces supported on a metal retainer, and the design has a patellar flange. but patellar resurfacing was not performed in our patients. The patients selected for this study were matched according to postoperative pain. function, passive range of motion, and joint stability. A point system based on The Hospital for Special Surgery knee.rating system was used to quantitate
653 citations
"Stair ascent and descent at differe..." refers background in this paper
...Some studies also exist that investigate stair climbing of patients with knee [8] and hip [9] implants, amputees with artificial limbs [10,11] or athletes with anterior cruciate ligament deficiencies [12]....
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01 Jan 1983
626 citations
"Stair ascent and descent at differe..." refers methods in this paper
...Anthropometric parameters, such as mass, centre of gravity and moments of inertia of thigh, shank and foot, were estimated by regression equations provided by Zatsiorsky and Seluyanov [23]....
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TL;DR: The system illustrated in this paper has been designed and developed particularly for automatic and reliable analysis of body movement in various conditions and environments and is based on real-time processing of the TV images to recognize multiple passive markers and compute their coordinates.
Abstract: The system illustrated in this paper has been designed and developed particularly for automatic and reliable analysis of body movement in various conditions and environments. It is based on real-time processing of the TV images to recognize multiple passive markers and compute their coordinates. This performance is achieved by using a special algorithm allowing the recognition of markers only if their shape matches a predetermined "mask." The main feature of the system is a two-level processing architecture, the first of which includes a dedicated peripheral fast processor for shape recognition (FPSR), designed and implemented by using fast VLSI chips. The second level consists of a general purpose computer and provides the overall system with high flexibility. The main characteristics are: no restriction on the number of markers, resolution of one part in 2500, and a 50 Hz sampling rate independent of the number of markers detected. The prototype has been fully developed, and preliminary results obtained from the analysis of several movements are illustrated.
477 citations
"Stair ascent and descent at differe..." refers background in this paper
...[19]) recorded the spatial positions of 15 mm hemispherical retro-reflective markers attached to both legs at the foot (fifth metatarsal head), ankle (lateral malleolus), knee (lateral femoral condyle), hip (greater trochanter) and pelvis (upper iliac crest)....
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