Biomechanical and energetic effects of knee flexion control during incline walking for users of the Power Knee

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-03-19 DOI:10.1016/j.clinbiomech.2025.106499

Sixu Zhou , Hanjun Kim , Jairo Maldonado-Contreras , Atli Örn Sverrisson , David Langlois , Kinsey Herrin , Aaron Young

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引用次数: 0

Abstract

Background

Individuals with transfemoral amputation often report difficulty with ambulating on inclined surfaces. Conventional prosthetic control strategies typically apply a level walking controller in incline walking modes, which may not be biomechanically optimal. Able-bodied individuals modulate knee stance pre-flexion substantially during incline walking, which is absent in most prosthetic level walking controllers. However, the biomechanical effects of stance pre-flexion for users with robotic microprocessor-controlled knees are not well-explored during inclines.

Methods

In this study (n = 10), we investigated the joint kinematics/kinetics/power, biological joint level work and metabolic energy cost to evaluate the biomechanical effects of stance pre-flexion on a 7.5^o incline walking using a commercially available robotic prosthetic knee, the Össur Power Knee, and a passive foot, the Össur Pro-Flex LP. We ran a Bradley-Terry model to rank user preferences on stance pre-flexion conditions.

Findings

We found that a 16.7 % reduction on the contralateral biological ankle joint positive work during stance phase when stance pre-flexion increased (p < 0.01). However, there was no significant difference in metabolic energy cost. Survey data revealed participants preferred higher stance pre-flexion angles (12^o -18^o) compared to lower angles (0^o - 6^o), indicating consistent preference towards increased stance pre-flexion on inclines.

Interpretation

Our results indicate that reduction in biological joint work associated with stance pre-flexion emphasizes the need to implement stance pre-flexion adjustments in prosthesis controllers, as opposed to using a level-walking controller.

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力量膝使用者倾斜行走时膝关节屈曲控制的生物力学和能量效应

背景：经股骨截肢患者常报告在倾斜表面行走困难。传统的假肢控制策略通常在倾斜行走模式下使用水平行走控制器，这可能不是生物力学最优的。健全人在倾斜行走时可以调节膝关节站立前屈，这在大多数假肢水平行走控制器中是不存在的。然而，对于机器人微处理器控制的膝关节使用者来说，在倾斜过程中，站立前屈的生物力学效应还没有得到很好的探索。在这项研究中（n = 10），我们研究了关节运动学/动力学/功率，生物关节水平功和代谢能量成本，以评估站立前屈在7.5度倾斜行走中的生物力学效果，使用市售的机器人假膝Össur power knee和被动足Össur Pro-Flex LP。我们使用Bradley-Terry模型对用户在姿态前屈条件下的偏好进行排序。我们发现，当站立前屈曲增加时，站立阶段对侧生物踝关节正功减少16.7% (p <；0.01)。然而，代谢能量消耗没有显著差异。调查数据显示，与较低的角度（100 - 60度）相比，参与者更喜欢较高的姿势预屈角度（120 - 180度），这表明在倾斜时对增加姿势预屈的偏好一致。解释：我们的研究结果表明，与站立前屈相关的生物关节工作减少，强调了在假体控制器中实施站立前屈调整的必要性，而不是使用水平行走控制器。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.