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ABSTRACT Objective Methods Results Conclusions The clinical management of partial bone defects in lower limbs, particularly those resulting from osteomyelitis, remains a significant challenge. This study aimed to systematically evaluate the effectiveness of 3D‐printed porous Ti6Al4V prostheses in addressing osteomyelitis‐induced partial bone defects.We established a comprehensive protocol for utilizing 3D‐printed prostheses for bone defect repair, encompassing 3D simulation of prosthesis implantation and internal fixation, finite element analysis (FEA), and clinical implementation. Mimics software facilitated simulation of fixation patterns and screw lengths. FEA modeled bone defects in the distal metaphyseal femur and distal diaphyseal tibia to assess changes in stress conduction pre‐ and post‐prosthesis implantation. The clinical study involved eight patients (average age: 56.3 years) with an average defect length of 14.9 cm. Postoperative outcomes were evaluated using X‐rays and the Lower Extremity Functional Scale (LEFS).FEA demonstrated that the implanted prostheses effectively shared stress and reduced the load on residual bone in both models, thus lowering the risk of fractures under external forces. The average follow‐up period was 24.5 months, with patients initiating weight‐bearing activities on average 7.8 days post‐surgery. Serial postoperative X‐rays demonstrated long‐term stability of the prostheses, with progressive bone regeneration around and integration with the prostheses. While two patients experienced infection recurrence requiring prosthesis removal and debridement, the remaining six showed significant improvement in LEFS scores, increasing from 31.5 preoperatively to 61.0 at the last follow‐up.3D‐printed porous Ti6Al4V prostheses effectively restore anatomical integrity and optimize stress conduction in lower limbs, resulting in substantial functional recovery. This innovative approach shows promise for wider clinical adoption and warrants further investigation in medical practice. [ABSTRACT FROM AUTHOR]

Amputees often experience high temperatures between the amputated limb and the prosthetic socket, necessitating the use of cooling devices to mitigate this issue. However, challenges arise with the location and size of conventional heat sinks. This research proposes a novel heat sink utilising a phase change material (PCM) to dissipate heat. The leg was chosen as the site for the heat sink, designed in a cylindrical shape. Coolant flow pipes were arranged in a branched configuration inspired by constructal theory, constrained by the dimensions of the artificial leg. The degrees of freedom for the constructal design are branches akin to arterial and venous branching, aiming to minimise pressure drop. Four heat sinks with varying degrees of branching were compared based on temperature reduction, heat dissipation, pressure drop, phase change material melting capacity, and operational efficiency. The cylindrical heat sink measures 50 mm in diameter and 300 mm in length. Ice was employed as the PCM, with water served as the working fluid. The working fluid's temperature and flow rate were maintained at 40 °C and 0.2 L/min, respectively. The experimental work was prepared to validate the theoretical model. The study revealed that the proposed heat sink design, with increased branching, led to a significant temperature reduction, achieving up to 39.62%. Moreover, heat dissipation increased by 236% compared to a single-tube heat sink. The use of branched pipes resulted in a manageable increase in pressure drop, peaking at 39.9 Pa, well within pump specifications, while markedly enhancing heat dissipation. The melting time of the PCM and the melting area increased as the number of branches of the heat sink increased. Ultimately, applying constructal theory in heat sink design for PCM demonstrated its superior performance within spatial constraints, providing a promising solution for prosthetic cooling. [ABSTRACT FROM AUTHOR]

i points beyond itself as it stylizes the ambiguity inherent in all things that are made: their capacity to include I and i exclude, protect I and i harm, create I and i destroy. Heaton's I Zen Men i are lumped together; in one we can just about make out a thinker's pose, while the other merely slouches. i (2007, see Figure 1) by Southport- and London-based sculptor and performance artist Tony Heaton, we first encounter an uninviting fortress made from the same stone as St Paul's Cathedral, Buckingham Palace, and the Bank of England. The original blue (which, Heaton notes, became derogatively known as spaz blue) turns into lamé, a shimmering fabric, which is a play on the word I lame i , indicating the fickle balance between ability and disability. [Extracted from the article]

The hip joint plays an important role in providing stability to the human body. Factors such as aging, wear, and tear, make the hip joint degenerate and, in such cases, the same to be replaced through hip arthroplasty surgeries. The background of this study aims to investigate the contact consequence between the artificial femoral head and the acetabular cup for different bearing couples during one-leg stance and standing up from a chair, utilizing the finite element method. The three-dimensional finite dynamic contact model has been developed with different material combinations. The results obtained by the present finite element model align well with the previously available literature. The parameters investigated include maximum von Mises stress, maximum contact pressure and deformation for different material combinations. The results reveal that the pair i.e., Alumina on Ultra-high molecular weight polyethylene (UHMWPE) exhibits lower contact pressure, von Mises Stress and deformation. Therefore, the material pair i.e., Alumina on UHMWPE can be employed in the Total hip replacement (THR) to mitigate contact consequences under both static and dynamic loading conditions, thereby enhancing the durability of the artificial joints. [ABSTRACT FROM AUTHOR]

Active lower limb prostheses show large potential to offer energetic, balance, and versatility improvements to users when compared to passive and semi-active devices. Still, their control remains a major development challenge, with many different approaches existing. This perspective aims at illustrating a future leg prosthesis control approach to improve the everyday life of prosthesis users, while providing a research road map for getting there. Reviewing research on the needs and challenges faced by prosthesis users, we argue for the development of versatile control architectures for lower limb prosthetic devices that grant the wearer full volitional control at all times. To this end, existing control approaches for active lower limb prostheses are divided based on their consideration of volitional user input. The presented methods are discussed in regard to their suitability for universal everyday control involving user volition. Novel combinations of established methods are proposed. This involves the combination of feed-forward motor control signals with simulated feedback loops in prosthesis control, as well as online optimization techniques to individualize the system parameters. To provide more context, developments related to volitional control design are touched on. [ABSTRACT FROM AUTHOR]

Similar to nonamputees, female athletes with unilateral transtibial amputation (TTA) using running-specific leg prostheses (RSPs) may have worse running economy and higher rates of running-related injury than male athletes. Optimizing RSP configuration for female athletes could improve running economy and minimize biomechanical asymmetry, which has been associated with running-related injury. Nine females with a TTA ran at 2.5 m/s while we measured metabolic rates and ground reaction forces. Subjects used an RSP with a manufacturer-recommended stiffness category, one category less stiff and two categories less stiff than recommended. Use of an RSP two categories less stiff resulted in 3.0% lower net metabolic power (P = 0.04), 7.8% lower affected leg stiffness (P = 6.01 × 10−4), increased contact time asymmetry (P = 0.04), and decreased stance average vertical ground reaction force asymmetry (P = 0.04) compared with a recommended stiffness category RSP. Lower RSP stiffness (kN/m) values were associated with lower net metabolic power (P = 0.02), lower affected leg stiffness (P = 1.36 × 10−4), longer affected leg contact time (P = 1.46 × 10−4), and similar affected leg peak and stance-average vertical ground reaction force compared with higher RSP stiffness values. Subjects then used the RSP stiffness category that elicited the lowest net metabolic power with 100 g, 200 g, and 300 g added distally. We found no significant effects of added mass on net metabolic power, biomechanics, or asymmetry. These results suggest that female runners with a TTA could decrease metabolic power during running while minimizing biomechanical asymmetries, which have been associated with running-related injury, by using an RSP two categories less stiff than manufacturer recommended. NEW & NOTEWORTHY: Females with unilateral transtibial amputation can improve running performance through reductions in net metabolic power by using a running-specific prosthesis (RSP) that is less stiff than manufacturer-recommended. Lower RSP stiffness values are associated with greater leg stiffness and contact time asymmetry, and lower stance-average vertical ground reaction force asymmetry. However, we found that adding mass to the RSP did not affect net metabolic power and stance-phase biomechanical asymmetries during running. [ABSTRACT FROM AUTHOR]

Brain–computer interfaces (BCIs) allow information to be transmitted directly from the human brain to a computer, enhancing the ability of human brain activity to interact with the environment. In particular, BCI-based control systems are highly desirable because they can control equipment used by people with disabilities, such as wheelchairs and prosthetic legs. BCIs make use of electroencephalograms (EEGs) to decode the human brain's status. This paper presents an EEG-based facial gesture recognition method based on a self-organizing map (SOM). The proposed facial gesture recognition uses α , β , and θ power bands of the EEG signals as the features of the gesture. The SOM-Hebb classifier is utilized to classify the feature vectors. We utilized the proposed method to develop an online facial gesture recognition system. The facial gestures were defined by combining facial movements that are easy to detect in EEG signals. The recognition accuracy of the system was examined through experiments. The recognition accuracy of the system ranged from 76.90% to 97.57% depending on the number of gestures recognized. The lowest accuracy (76.90%) occurred when recognizing seven gestures, though this is still quite accurate when compared to other EEG-based recognition systems. The implemented online recognition system was developed using MATLAB, and the system took 5.7 s to complete the recognition flow. [ABSTRACT FROM AUTHOR]

Robotic lower-limb prostheses, with their actively powered joints, may significantly improve amputee users' mobility and enable them to obtain healthy-like gait in various modes of locomotion in daily life. However, timely recognition of the amputee users' locomotive mode and mode transition still remains a major challenge in robotic lower-limb prosthesis control. In the paper, the authors present a new multi-dimensional dynamic time warping (mDTW)- based intent recognizer to provide high-accuracy recognition of the locomotion mode/mode transition sufficiently early in the swing phase, such that the prosthesis'joint-level motion controller can operate in the correct locomotive mode and assist the user to complete the desired (and often power-demanding) motion in the stance phase. To support the intent recognizer development, the authors conducted a multi-modal gait data collection study to obtain the related sensor signal data in various modes of locomotion. The collected data were then segmented into individual cycles, generating the templates used in the mDTW classifier. Considering the large number of sensor signals available, we conducted feature selection to identify the most useful sensor signals as the input to the mDTW classifier. We also augmented the standard mDTW algorithm with a voting mechanism to make full use of the data generated from the multiple subjects. To validate the proposed intent recognizer, we characterized its performance using the data cumulated at different percentages of progression into the gait cycle (starting from the beginning of the swing phase). It was shown that the mDTW classifier was able to recognize three locomotive mode/mode transitions (walking, walking to stair climbing, and walking to stair descending) with 99.08% accuracy at 30% progression into the gait cycle, well before the stance phase starts. With its high performance, low computational load, and easy personalization (through individual template generation), the proposed mDTW intent recognizer may become a highly useful building block of a prosthesis control system to facilitate the robotic prostheses' real-world use among lower-limb amputees. [ABSTRACT FROM AUTHOR]

Background: Advanced prosthetic hands may embed nanosensors and microelectronics in their cosmetic skin. Heat influx may cause damage to these delicate structures. Protecting the integrity of the prosthetic hand becomes critical and necessary to ensure sustainable function. This study aims to mimic the sensorimotor control strategy of the human hand in perceiving nociceptive stimuli and triggering self-protective mechanisms and to investigate how similar neuromorphic mechanisms implemented in prosthetic hand can allow amputees to both volitionally release a hot object upon a nociceptive warning and achieve reinforced release via a bionic withdrawal reflex. Methods: A steady-state temperature prediction algorithm was proposed to shorten the long response time of a thermosensitive temperature sensor. A hybrid sensory strategy for transmitting force and a nociceptive temperature warning using transcutaneous electrical nerve stimulation based on evoked tactile sensations was designed to reconstruct the nociceptive sensory loop for amputees. A bionic withdrawal reflex using neuromorphic muscle control technology was used so that the prosthetic hand reflexively opened when a harmful temperature was detected. Four able-bodied subjects and two forearm amputees randomly grasped a tube at the different temperatures based on these strategies. Results: The average prediction error of temperature prediction algorithm was 8.30 ± 6.00%. The average success rate of six subjects in perceiving force and nociceptive temperature warnings was 86.90 and 94.30%, respectively. Under the reinforcement control mode in Test 2, the median reaction time of all subjects was 1.39 s, which was significantly faster than the median reaction time of 1.93 s in Test 1, in which two able-bodied subjects and two amputees participated. Results demonstrated the effectiveness of the integration of nociceptive sensory strategy and withdrawal reflex control strategy in a closed loop and also showed that amputees restored the warning of nociceptive sensation while also being able to withdraw from thermal danger through both voluntary and reflexive protection. Conclusion: This study demonstrated that it is feasible to restore the sensorimotor ability of amputees to warn and react against thermal nociceptive stimuli. Results further showed that the voluntary release and withdrawal reflex can work together to reinforce heat protection. Nevertheless, fusing voluntary and reflex functions for prosthetic performance in activities of daily living awaits a more cogent strategy in sensorimotor control. [ABSTRACT FROM AUTHOR]

Human–robot walking with prosthetic legs and exoskeletons, especially over complex terrains, such as stairs, remains a significant challenge. Egocentric vision has the unique potential to detect the walking environment prior to physical interactions, which can improve transitions to and from stairs. This motivated us to develop the StairNet initiative to support the development of new deep learning models for visual perception of real-world stair environments. In this study, we present a comprehensive overview of the StairNet initiative and key research to date. First, we summarize the development of our large-scale data set with over 515,000 manually labeled images. We then provide a summary and detailed comparison of the performances achieved with different algorithms (i.e., 2D and 3D CNN, hybrid CNN and LSTM, and ViT networks), training methods (i.e., supervised learning with and without temporal data, and semi-supervised learning with unlabeled images), and deployment methods (i.e., mobile and embedded computing), using the StairNet data set. Finally, we discuss the challenges and future directions. To date, our StairNet models have consistently achieved high classification accuracy (i.e., up to 98.8%) with different designs, offering trade-offs between model accuracy and size. When deployed on mobile devices with GPU and NPU accelerators, our deep learning models achieved inference speeds up to 2.8 ms. In comparison, when deployed on our custom-designed CPU-powered smart glasses, our models yielded slower inference speeds of 1.5 s, presenting a trade-off between human-centered design and performance. Overall, the results of numerous experiments presented herein provide consistent evidence that StairNet can be an effective platform to develop and study new deep learning models for visual perception of human–robot walking environments, with an emphasis on stair recognition. This research aims to support the development of next-generation vision-based control systems for robotic prosthetic legs, exoskeletons, and other mobility assistive technologies. [ABSTRACT FROM AUTHOR]

Humans can generate and sustain a wide range of walking velocities while optimizing their energy efficiency. Understanding the intricate mechanisms governing human walking will contribute to the engineering applications such as energy-efficient biped robots and walking assistive devices. Reflex-based control mechanisms, which generate motor patterns in response to sensory feedback, have shown promise in generating human-like walking in musculoskeletal models. However, the precise regulation of velocity remains a major challenge. This limitation makes it difficult to identify the essential reflex circuits for energy-efficient walking. To explore the reflex control mechanism and gain a better understanding of its energy-efficient maintenance mechanism, we extend the reflex-based control system to enable controlled walking velocities based on target speeds. We developed a novel performance-weighted least squares (PWLS) method to design a parameter modulator that optimizes walking efficiency while maintaining target velocity for the reflex-based bipedal system. We have successfully generated walking gaits from 0.7 to 1.6 m/s in a two-dimensional musculoskeletal model based on an input target velocity in the simulation environment. Our detailed analysis of the parameter modulator in a reflex-based system revealed two key reflex circuits that have a significant impact on energy efficiency. Furthermore, this finding was confirmed to be not influenced by setting parameters, i.e., leg length, sensory time delay, and weight coefficients in the objective cost function. These findings provide a powerful tool for exploring the neural bases of locomotion control while shedding light on the intricate mechanisms underlying human walking and hold significant potential for practical engineering applications. Author summary: Previous reflex-based control systems face significant limitations in accurately regulating walking velocity owing to the vast number of control parameters involved. This hinders identifying essential reflex circuits that have a significant impact on energy-efficient walking across a wide range of speeds. Our research tackles this challenge by developing a reflex-based control framework that precisely regulates the velocities of the bipedal model through the performance-weighted least squares (PWLS) method that optimizes the control parameter values while considering energy efficiency. Through a detailed analysis, we identify two key reflex circuits essential for generating energy-efficient walking over a wide range of velocities. We hope that our research will inspire future investigations into reflex mechanisms and facilitate the development of advanced walking control systems for practical applications, such as gait-assisted exoskeletons and prosthetic legs, and robot control. [ABSTRACT FROM AUTHOR]

The study discussed in this paper focuses on additive manufacturing (AM) of intricate geometrically structured components of a prosthetic leg. The objective is to optimize the original design to reduce the need for support structures while maximizing stiffness and reducing weight. Making a prosthetic leg lighter can improve the mobility of a person and reduce the energy required to climb stairs, enhancing their quality of life and independence. Traditional manufacturing methods, such as injection molding and computerized numerical control (CNC) machining, have limitations in terms of design flexibility. The study used Selective Laser Melting (SLM) technology with 316L-A stainless steel powder. The optimization process focused on the knee, upper leg, lower leg, hydraulic, and oil support system. The workflow procedure for additive manufacturing was discussed. Overall, the study successfully reduced the weight of the prosthetic leg by 50% from the original model. [ABSTRACT FROM AUTHOR]

Intelligent transfemoral prostheses, which have recently been studied, are equipped with a microcontroller, providing appropriate motion functions for their walking environments. Thus, studies have been conducted to estimate user intentions in locomotion movements by applying biomechanical sensors inside the socket. Among them, a pressure sensor is used to determine the intentions of locomotion movements through changes in the internal pressure of the prosthetic socket. However, existing studies have a problem in that the reproducibility of pressure change data is degraded due to the non-detection and saturation of the pressure measurement value. Accordingly, this study proposes a fabrication method for a wide and flexible pressure sensor that can solve this problem and a method for the identification of user intentions in locomotion movements using it. The proposed system was fabricated with Velostat film, which has a smaller noise impact and can be fabricated in various sizes and shapes. The fabricated sensor was attached to four points inside the socket, confirming the possibility of detecting the intention of six movements according to the multi-critical detection method. The proposed pressure-sensor-based intention detection system can be applied individually by prosthetic users through simple tasks. Moreover, it will be universally applicable for commercialization. [ABSTRACT FROM AUTHOR]

Background and Objectives: Total knee arthroplasty (TKA) has become the treatment of choice for advanced osteoarthritis. The aim of this paper was to show the possibilities of optimizing the Perth CT protocol, which is highly effective for preoperative planning and postoperative assessment of alignment. Materials and Methods: The cross-sectional study comprised 16 patients for preoperative planning or postoperative evaluation of TKA. All patients were examined with the standard and optimized Perth CT protocol using advance techniques, including automatic exposure control (AEC), iterative image reconstruction (IR), as well as a single-energy projection-based metal artifact reduction algorithm for eliminating prosthesis artifacts. The effective radiation dose (E) was determined based on the dose report. Imaging quality is determined according to subjective and objective (values of signal to noise ratio (SdNR) and figure of merit (FOM)) criteria. Results: The effective radiation dose with the optimized protocol was significantly lower compared to the standard protocol (p < 0.001), while in patients with the knee prosthesis, E increased significantly less with the optimized protocol compared to the standard protocol. No significant difference was observed in the subjective evaluation of image quality between protocols (p > 0.05). Analyzing the objective criteria for image quality optimized protocols resulted in lower SdNR values and higher FOM values. No significant difference of image quality was determined using the SdNR and FOM as per the specified protocols and parts of extremities, and for the presence of prothesis. Conclusions: Retrospecting the ALARA ('As Low As Reasonably Achievable') principles, it is possible to optimize the Perth CT protocol by reducing the kV and mAs values and by changing the collimation and increasing the pitch factor. Advanced IR techniques were used in both protocols, and AEC was used in the optimized protocol. The effective dose of radiation can be reduced five times, and the image quality will be satisfactory. [ABSTRACT FROM AUTHOR]

Background: Agreement between the activities-specific balance confidence scale (ABC) and center of pressure (CoP) in prosthesis users is still very much unknown. The purpose of this study was to investigate the agreement between ABC and CoP in lower-limb prosthesis users. Methods: Twenty-one individuals with lower-limb prostheses were recruited. Participants were provided with the ABC scale and performed static balance tasks during eyes opened (EO) and eyes closed (EC) conditions whilst standing on a force platform. Pearson product moment coefficients between CoP displacements and ABC scores were performed. Participants were also stratified by those who had better (≥80 on ABC scale) and less (<80 on ABC scale) perceived balance confidence. Displacement was compared using an independent t-test with Cohen's d to estimate effect size with alpha set at 0.05 for these tests. Results: There was a significant inverse moderate relationship between eyes opened displacement (EOD) (18.3 ± 12.5 cm) and ABC (75.1 ± 18.3%), r = (19)−0.58, p = 0.006, as well as eyes closed displacement (ECD) (37.7 ± 22.1 cm) and ABC, r = (19)−0.56, p = 0.008. No significant difference in EOD (t(19) = 1.36, p = 0.189, d = 0.61) and ECD (t(19) = 1.47, p = 0.156, d = 0.66) was seen between those with greater and less balance confidence. Conclusions: Self-report and performance-based balance outcome measures are recommended when assessing lower-limb prostheses users. [ABSTRACT FROM AUTHOR]

In recent years, technical innovations have made artificial limbs much more comfortable, but not patient satisfaction. In this work, an artificial bio-composite prosthesis is designed and developed. Further, the concept of cloning the movement action of the anatomical leg and feeding it to the prosthetic leg is achieved through an accelerometer sensor and microcontroller. Results demonstrate that the efficiency of the proposed device depends on the angle suspension, hinge lubrication and the prosthetic material, which should be sufficient to sustain the development and application of technological solutions. The proposed sensor-based technology plays an important role in rehabilitation field. It has been proven from this work that the data transfer from the normal leg to the prosthetic leg is quick and data loss is reduced. The design of the prototype could mimic various gestures and motions to make things feel much better for amputees. A prototype mimicking the functions of the human leg was successfully designed, bringing out various gestures and motions for the betterment of the amputees. This sensor-based technology gives a great solution for amputees to make life better like a normal person. As the sockets are made up of jute fiber reinforced epoxy biocomposite material, the skin irritation is reduced for the above-knee amputee patients. Through this proposed prosthetic leg, the patients can perform the normal actions of the leg as a healthy person. Also, the proposed mechanism is highly suitable for disabled patients for their better gait movement. [ABSTRACT FROM AUTHOR]

In recent years, significant improvements in the design of leg blade prosthetics have been carried out. After several advances in material and topological optimisations, sport-purpose feet prosthetics have reached high-level performances, allowing athletes with limb loss to participate in various sport activities at a competitive level. Since the knowledge of prosthetic mechanical behaviour is crucial for its optimal design, specific studies are required to meet the anthropometric characteristics of the athlete. This research work is focused on investigating the dynamic behaviour of a running blade prosthetic and developing a validated prosthetic model, placing particular emphasis on the definition of suitable material properties. An experimental modal analysis is performed on the Cheetah Xcel, Össur lower limb prosthetic. In contrast with what has already been presented in the literature, a roving hummer test under free–free conditions is proposed here to avoid the uncertainties due to constraint conditions. For the first time, blade prosthetic dynamic characteristics in free–free conditions are presented. Additionally, a novel Finite Element model of the prosthetic is developed and tuned on the basis of the experimental results. The modal assurance criterion index is exploited to compare experimental and numerical mode shapes. Starting from frequency response functions, the first six mode shapes are experimentally identified in the frequency range up to 750 Hz, including both bending and torsion. As expected, the bending in the vertical plane constitutes the primary mode shape: this kind of flexion enhances energy storage, enabling athletes to achieve an optimal running gait. This study shows the dynamic modal behaviour of a lower limb prosthetic in free–free conditions and demonstrates that a traditional isotropic material is not suitable in describing its dynamic features. The development of a model that exploits orthotropic material properties improves the alignment between experimental and numerical outcomes. This result is in agreement with the material composition of the prosthetic, which consists of carbon fibre layers. [ABSTRACT FROM AUTHOR]

Introduction: Gait analysis is one of the most important components of functional outcome evaluation in patients with lower-extremity tumors. Disparities between operated limbs when compared with non-operated limbs and healthy populations based on gait parameters have rarely been studied. In the present study, we attempted to analyze the gait difference and its impacts on daily life. Methods: The gait parameters of distal femoral tumor-resected patients were collected from PubMed, CNKI, MEDLINE, Embase, Cochrane, and Google Scholar till September 30, 2022, by strictly following the inclusion and exclusion criteria. Differences between gait parameters in the operated and non-operated limbs or healthy limbs of distal femoral tumor patients were analyzed based on stance phase, swing phase, cadence, and velocity. The fixed-effects and random-effects models were used to conduct a meta-analysis. Results: Six studies were included according to the selection criteria. There were 224 patients in total in these studies. Standard mean differences were calculated for all of our outcomes. Our results showed that there was a minimal difference in the standard mean difference of gait parameters between operated and non-operated limbs and healthy limbs. Conclusion: Distal femoral tumor resections have been associated with deficient muscle function and strength and impaired gait parameters. Minimal differences in the gait parameters highlighted the advantage of distal femoral resection when replaced with a prosthesis. [ABSTRACT FROM AUTHOR]

Background: Prosthetic legs help individuals with an amputation regain locomotion. Recently, deep neural network (DNN)-based control methods, which take advantage of the end-to-end learning capability of the network, have been proposed. One prominent challenge for these learning-based approaches is obtaining data for the training, particularly for the training of a mid-level controller. In this study, we propose a method for generating synthetic gait patterns (vertical load and lower limb joint angles) using a generative adversarial network (GAN). This approach enables a mid-level controller to execute ambulation modes that are not included in the training datasets. Methods: The conditional GAN is trained on benchmark datasets that contain the gait data of individuals without amputation; synthetic gait patterns are generated from the user input. Further, a DNN-based controller for the generation of impedance parameters is trained using the synthetic gait pattern and the corresponding synthetic stiffness and damping coefficients. Results: The trained GAN generated synthetic gait patterns with a coefficient of determination of 0.97 and a structural similarity index of 0.94 relative to benchmark data that were not included in the training datasets. We trained a DNN-based controller using the GAN-generated synthetic gait patterns for level-ground walking, standing-to-sitting motion, and sitting-to-standing motion. Four individuals without amputation participated in bypass testing and demonstrated the ambulation modes. The model successfully generated control parameters for the knee and ankle based on thigh angle and vertical load. Conclusions: This study demonstrates that synthetic gait patterns can be used to train DNN models for impedance control. We believe a conditional GAN trained on benchmark datasets can provide reliable gait data for ambulation modes that are not included in its training datasets. Thus, designing gait data using a conditional GAN could facilitate the efficient and effective training of controllers for prosthetic legs. [ABSTRACT FROM AUTHOR]

The purpose of prosthetic devices is to reproduce the angular-torque profile of a healthy human during locomotion. A lightweight and energy-efficient joint is capable of decreasing the peak actuator power and/or power consumption per gait cycle, while adequately meeting profile-matching constraints. The aim of this study was to highlight the dynamic characteristics of a bionic leg with electric actuators with rotational movement. Three-dimensional (3D)-printing technology was used to create the leg, and servomotors were used for the joints. A stepper motor was used for horizontal movement. For better numerical simulation of the printed model, three mechanical tests were carried out (tension, compression, and bending), based on which the main mechanical characteristics necessary for the numerical simulation were obtained. For the experimental model made, the dynamic stresses could be determined, which highlights the fact that, under the conditions given for the experimental model, the prosthesis resists. [ABSTRACT FROM AUTHOR]

Lower limb prostheses can replace missing parts of the body and improve a patient's quality of life. The 3D printing technique can be used to make prosthesis sockets from recycled PA2200 powder, but the mechanical properties of these printed materials have not been studied in detail. Tensile and bending tests were performed, and the results obtained did not show statistically significant differences. An improperly fitted prosthesis affects the biomechanics of gait. The posture and gait analysis of a person wearing a prosthesis was performed using the "Qualisys", "AMTI" force plates and "Zebris" systems, and the results showed differences between the prosthetic and the healthy leg. [ABSTRACT FROM AUTHOR]

The study proposes a novel computational approach for customizing sustainable knee disarticulation prostheses, aimed at improving the quality of life for users. A specialized calculation technique for assessing the loads and moments on the prosthesis was formulated, leveraging MATLAB for solving kinematic equations, Solidworks for motion analysis, and ANSYS Workbench for material and static analysis. The integration of these tools enabled the validation of the design and analytical outcomes. The kinematic solutions accounted for individual and prosthesis weights, analyzing linear and angular dynamics over a motion range pertinent to the prosthetic leg's function. Static analysis was executed to determine maximum force impact on the prosthesis. The study's results were conducive to identifying the most suitable prosthesis characteristics for individuals aged 20 to 80, with a height of 160-190 cm and a weight of 80-120 kg. The prosthetic design promoted ease of movement in activities requiring a range of motion, such as running and jumping. The prosthesis adapted swiftly to body movements, achieving readiness in approximately three seconds. The research underscores the importance of interdisciplinary collaboration between engineers and medical professionals to optimize the anatomical and kinematic aspects of prosthesis design. [ABSTRACT FROM AUTHOR]

The digitization of the design process of lower limb prosthetic sockets seems to be necessary. Using modern CAD procedures and CAM technologies, it is possible to produce functional, individual prosthetic aids that bring many benefits compared to commonly used methods. However, the disadvantage of using CAD/CAM procedures can be the input costs for production technology and software. The aim of this research is to propose a low-cost solution for individual transtibial socket design and production. Modern methods and technologies like 3D scanning, CAD design and additive manufacturing have been applied. As a result, a transtibial stump positive and custom socket design methodology is proposed. In conclusions a total value of a custom transtibial socket design and production was calculated. [ABSTRACT FROM AUTHOR]

The aim of this review article is to appraise the design and functionality of above-knee prosthetic legs. So far, various transfemoral prosthetic legs are found to offer a stable gait to amputees but are limited to laboratories. The commercially available prosthetic legs are not reliable and comfortable enough to satisfy amputees. There is a dire need for creating a powered prosthetic knee joint that could address amputees' requirements. To pinpoint the gap in transfemoral prosthetic legs, prosthetic knee unit model designs, control frameworks, kinematics, and gait evaluations are concentrated. Ambulation exercises, ground-level walking, running, and slope walking are considered to help identify research gaps and areas where existing prostheses can be ameliorated. The results show that above-knee amputees can more effectively manage their issues with the aid of an active prosthesis, capable of reliable gait. To accomplish the necessary control, closed loop controllers and volitional control are integral parts. Future studies should consider designing a transfemoral electromechanical prosthesis based on electromyographic (EMG) signals to better predict the amputee's intent and control in accordance with that intent. [ABSTRACT FROM AUTHOR]

(1) Background: Asymmetry in gait could pose a problem for patients with transfemoral amputation, due to a higher risk for secondary comorbidities. Gait analysis during ascending and descending stairs (20 stair ascends and descends) was conducted in a patient with a unilateral transfemoral amputation and integrated neural sensory feedback (NSFB), with the aim to compare biomechanical parameters between the healthy and the prosthetic leg in conditions with and without NSFB. (2) Methods: Transversal-type research was conducted at the beginning of the patient's rehabilitation and without prior gait training in conditions with NSFB. Complete study included several months of different gait testing with and without the NSFB. Data analyzed in this study are just a small portion of the overall dataset (only one subject, one recording session, reduced amount of trials in one condition), used for showing the validity of the proposed methodology for gait analysis and proving proof of concept. The analyzed parameters included stance, time, and speed of ascending and descending stairs in conditions with and without NSFB, measured for both legs. The data were processed using statistical software (SPSS Statistics version 24), with descriptive statistics and paired-sample t-tests to determine differences in gait parameters between the healthy and the prosthetic leg. (3) Results: The results revealed statistically significant differences (p = 0.00) in all three examined parameters (stance, time, and speed) between conditions with and without NSFB. (4) Conclusions: Gait stance, time, and the speed of ascending and descending stairs can be controlled and tailored in real time using NSFB. [ABSTRACT FROM AUTHOR]

We aimed to determine a method for prescribing a standing prosthetic leg length (ProsL) that results in an equivalent running biological leg length (BioL) for athletes with unilateral (UTTA) and bilateral transtibial amputations (BTTA). We measured standing leg length of ten non-amputee (NA) athletes, ten athletes with UTTA, and five athletes with BTTA. All athletes performed treadmill running trials from 3 m/s to their maximum speed. We calculated standing and running BioL and ProsL lengths and assessed the running-to-standing leg length ratio (Lratio) at three instances during ground contact: touchdown, mid-stance, and take-off. Athletes with UTTA had 2.4 cm longer standing ProsL than BioL length (p = 0.030), but their ProsL length were up to 3.3 cm shorter at touchdown and 4.1 cm shorter at mid-stance than BioL, at 3–11.5 m/s. At touchdown, mid-stance, and take-off, athletes with BTTA had 0.01–0.05 lower Lratio at 3 m/s (p < 0.001) and 0.03–0.07 lower Lratio at 10 m/s (p < 0.001) in their ProsL compared to the BioL of NA athletes. During running, ProsL were consistently shorter than BioL. To achieve equivalent running leg lengths at touchdown and take-off, athletes with UTTA should set their running-specific prosthesis height so that their standing ProsL length is 2.8–4.5% longer than their BioL length, and athletes with BTTA should set their running-specific prosthesis height so that their standing ProsL lengths are at least 2.1–3.9% longer than their presumed BioL length. Setting ProsL length to match presumed biological dimensions during standing results in shorter legs during running. [ABSTRACT FROM AUTHOR]

About 8% of the Ecuadorian population suffers some type of amputation of upper or lower limbs. Due to the high cost of a prosthesis and the fact that the salary of an average worker in the country reached 248 USD in August 2021, they experience a great labor disadvantage and only 17% of them are employed. Thanks to advances in 3D printing and the accessibility of bioelectric sensors, it is now possible to create economically accessible proposals. This work proposes the design of a hand prosthesis that uses electromyography (EMG) signals and neural networks for real-time control. The integrated system has a mechanical and electronic design, and the latter integrates artificial intelligence for control. To train the algorithm, an experimental methodology was developed to record muscle activity in upper extremities associated with specific tasks, using three EMG surface sensors. These data were used to train a five-layer neural network. the trained model was compressed and exported using TensorflowLite. The prosthesis consisted of a gripper and a pivot base, which were designed in Fusion 360 considering the movement restrictions and the maximum loads. It was actuated in real time thanks to the design of an electronic circuit that used an ESP32 development board, which was responsible for recording, processing and classifying the EMG signals associated with a motor intention, and to actuate the hand prosthesis. As a result of this work, a database with 60 electromyographic activity records from three tasks was released. The classification algorithm was able to detect the three muscle tasks with an accuracy of 78.67% and a response time of 80 ms. Finally, the 3D printed prosthesis was able to support a weight of 500 g with a safety factor equal to 15. [ABSTRACT FROM AUTHOR]

This paper presents a microcontroller-based solution for generating real-time normal walking knee angle of a powered transfemoral prosthetic leg prototype. The proposed control algorithm was used to determine the prosthetic knee angle by utilizing seven hip angle movement features generated from only the inertia measurement unit (IMU) deployed on the prosthetic socket on the thigh of the same side. Then, a proportional–integral–derivative (PID) controller is developed to control the motor to reach the desired knee angle in real time. Furthermore, a novel parallel four-bar linkage-based master–slave validation framework combining a motion capture system was introduced to evaluate the performance of the knee angle generation on a speed-adjustable treadmill with able-bodied subjects. In the framework evaluation, 3 different walking speeds were applied to the treadmill to validate different speed adaptation capabilities of the prosthetic leg control system, precisely 50 cm/s, 60 cm/s, and 70 cm/s. Through the proposed 4-bar linkage framework, the prosthesis's movement can simulate able-bodied subjects well with maximum RMSE never exceeding 0.27° in the swing flexion phase, 4.4° to 5.8° in the stance phase, and 1.953° to 13.466° in the swing extension phase. The treadmill results showed that the prosthetic leg is able to perform a normal walking gait following different walking speeds of the subject. Finally, a corridor walking experiment with a bypass adapter was successfully performed to examine the feasibility of real prosthetic walking situations. [ABSTRACT FROM AUTHOR]

Prosthetic shank is one of the prominent parts of prosthetic leg that transfers load from prosthetic socket to the foot section. Nowadays, it is common to use composite materials for prosthetics and orthotics applications. This research aims at synthesis and characterization of properties of crystalline nanocellulose (CNC) powder and investigating its effect on the mechanical and physical properties of E-glass fiber - epoxy composite for prosthetic shank applications. Different properties including tensile, impact, flexural, water absorption, thermographic, density and surface morphology of a hybrid composite are investigated. The research further targets to test the suitability of developed composite material for prosthetic shank applications. Extraction of CNC powder is performed using chemical extraction technique which involves alkali treatment, delignification, bleaching and acid hydrolysis. Crystallinity of CNC particles is determined at 2θ values of 19.89°, 44.04°, 64.34° and 77.51°. Crystallite size of these powders is found to be 13 nm from XRD analysis. Thermal properties of CNCs are examined using thermographic analysis and the result reveals a three-stage decomposition of CNC powders in temperature ranges. The results also reveal that addition of CNC powder enhances the overall performance of the composite, and composite specimen with 8wt% CNC powder shows superior mechanical and physical properties. Further, selected composite is modeled for the prosthetic shank application using commercial finite element software, ANSYS 2022, and maximum equivalent von Mise's stress of 0.82598 MPa and deformation of 0.054065 mm are obtained Based on the overall findings and analysis, it is highly recommended to develop and use hybrid E-glass fiber - CNC - epoxy composite as a substitute material for prosthetic shank applications. [ABSTRACT FROM AUTHOR]

Intelligent lower-limb prosthesis appears in the public view due to its attractive and potential functions, which can help amputees restore mobility and return to normal life. To realize the natural transition of locomotion modes, locomotion mode classification is the top priority. There are mainly five steady-state and periodic motions, including LW (level walking), SA (stair ascent), SD (stair descent), RA (ramp ascent), and RD (ramp descent), while ST (standing) can also be regarded as one locomotion mode (at the start or end of walking). This paper mainly proposes four novel features, including TPDS (thigh phase diagram shape), KAT (knee angle trajectory), CPO (center position offset) and GRFPV (ground reaction force peak value) and designs ST classifier and artificial neural network (ANN) classifier by using a user-dependent dataset to classify six locomotion modes. Gaussian distributions are applied in those features to simulate the uncertainty and change of human gaits. An angular velocity threshold and GRFPV feature are used in the ST classifier, and the artificial neural network (ANN) classifier explores the mapping relation between our features and the locomotion modes. The results show that the proposed method can reach a high accuracy of 99.16% ± 0.38%. The proposed method can provide accurate motion intent of amputees to the controller and greatly improve the safety performance of intelligent lower-limb prostheses. The simple structure of ANN applied in this paper makes adaptive online learning algorithms possible in the future. [ABSTRACT FROM AUTHOR]

A significant number of people in the world suffer from limb losses, while prosthesis is the hopeful way to help the amputees back to normal life. Recently, the most popular control method used in intelligent prosthesis is FSM-IC (finite state machine with impedance control), which requires a significant amount of manual parameter adjustments to achieve a good model compensation in a discrete way. Taking the lower-limb prosthesis as the research object, this paper applies an LWPR (locally weighted projection regression) model to learn the dynamic model of a prosthesis in real time in order to achieve a better model compensation in a continuous way and propose scientific experimental schemes to verify the control method. First, the basic control framework of lower-limb prosthesis is given. Then, the control law is derived on the basis of model building and LWPR's addition. Finally, the proper experimental schemes are designed to carry out the control method effectively in a safe way. The experimental results show that the control law with the LWPR model can greatly improve the tracking performance during the swing phase and obtain rather good compliance during the stance phase. Moreover, the results also indicate that the LWPR model can approximate the dynamic model online. This method is hoped to be extended to more applications and fields. [ABSTRACT FROM AUTHOR]