Research Papers

Design and Preliminary Field Validation of a Fully Passive Prosthetic Knee Mechanism for Users With Transfemoral Amputation in India

[+] Author and Article Information
V. N. Murthy Arelekatti

Department of Mechanical Engineering,
Massachusetts Institute of Technology,
Cambridge, MA 02139
e-mail: murthya@mit.edu

Amos G. Winter, V

Department of Mechanical Engineering,
Massachusetts Institute of Technology,
Cambridge, MA 02139
e-mail: awinter@mit.edu

Contributed by the Mechanisms and Robotics Committee of ASME for publication in the JOURNAL OF MECHANISMS AND ROBOTICS. Manuscript received September 20, 2015; final manuscript received December 27, 2017; published online April 5, 2018. Assoc. Editor: James Schmiedeler.

J. Mechanisms Robotics 10(3), 031007 (Apr 05, 2018) (8 pages) Paper No: JMR-15-1274; doi: 10.1115/1.4039222 History: Received September 20, 2015; Revised December 27, 2017

An estimated 230,000 above-knee amputees in India are currently in need of prosthetic devices, a majority of them facing severe socio-economic constraints. However, only a few passive prosthetic knee devices in the market have been designed for facilitation of normative gait kinematics and for meeting the specific daily life needs of above-knee amputees in the developing world. Based on the results of our past studies, this paper establishes a framework for designing a potentially low-cost, fully passive prosthetic knee device, which aims to facilitate able-bodied kinematics at a low metabolic cost. Based on a comprehensive set of functional requirements and biomechanical analysis from our past work, we present an early prototype mechanism for the prosthetic knee joint that is primarily focused on enabling able-bodied kinematics. The mechanism is implemented using two functional modules: an automatic early stance lock for stability and a differential friction damping system for late stance and swing control. For preliminary, qualitative validation of the knee mechanism, we carried out a field trial on four above-knee amputees in India, which showed satisfactory performance of the early stance lock. The prototype enabled smooth stance-to-swing transition by timely initiation of late stance flexion. Possible methods of incorporating an additional spring module for further refinement of the design are also discussed, which can enable flexion-extension during the early-stance phase of the gait cycle and potentially reduce the metabolic energy expenditure of the user further.

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Grahic Jump Location
Fig. 1

Different Prosthetic knees available in the developing and developed world markets and their selling prices: (a) BMVSS (Jaipur-foot) manual-locking knee, shown fully extended and at full flexion [22]. (b) The International Committee of the Red Cross manual locking, single-axis knee, (c) Jaipur-Stanford four-bar knee joint, also used by BMVSS [3,22], (d) LCKnee designed by Andrysek et al. [13], with an automatic locking mechanism, and (e) the popular Ottobock range of quasi-passive and active, microprocessor-controlled prosthetic knees: C-leg and Genium Microprocessor-controlled knees have been widely adopted in the developed world markets and they can enable a wide range of activities and motions [12].

Grahic Jump Location
Fig. 2

Determination of optimal mechanical component coefficients for replicating able-bodied knee moment: (a) Narang et al. [15] used a rigid body model comprising the foot, ankle joint, lower leg, knee joint, and upper leg, (b) Using inverse dynamics, they predicted the spring stiffness coefficient (Kstance) and the frictional damping coefficients (Bflex and Bext) required at the knee joint for replicating able-bodied moment with R2 = 0.90 [14], and (c) the engagement-disengagement points during each gait cycle were also established as a part of this analysis for one spring and two friction dampers. Increase in the positive value of the knee angle denotes flexion (and decreasing positive value denotes extension).

Grahic Jump Location
Fig. 3

Relative position of the GRF vector and the knee. The GRF vector is posterior in early stance and late stance causing a flexion moment at the knee (clockwise direction, with respect to the upper leg frame). During mid-stance, the vector is anterior to the knee. The curved arrow depicts the direction of the net resultant moment at the knee during each stage because of the GRF vector, inertial forces, and the hip moment. The moment exerted by hip muscles and the inertial forces are not shown.

Grahic Jump Location
Fig. 4

Architecture and function of the prototype mechanism. During early stance, GRF direction (Fig. 3) causes a flexion moment at the locking axis while the lock is engaged. During mid-stance, the extension moment at the locking axis disengages the lock (as the locking element and rest of the lower leg assembly is mounted about the locking axis). During late stance, when the GRF vector passes posterior to the knee axis, late stance flexion at the unlocked knee joint can take place. During late stance flexion and early swing phase, the cam surface of the knee rotates about the knee axis and slips against the stationary brake lining, resulting in large damping torque (Bflex). During late swing extension, the brake, which is mounted on a one-way roller-clutch, also rotates along with the cam surface and provides a much lesser damping torque (Bext).

Grahic Jump Location
Fig. 5

Preliminary field evaluation: (a) subject 1 using the prototype for the 2 min walk test, (b) subject 2 during the 2 min walk test, late stance flexion of up to 40 deg can be seen, and (c) subject 2 walking comfortably outdoors on a relatively flat, muddy terrain

Grahic Jump Location
Fig. 6

The movement of the COP on the foot during stance phase of gait (as a function of time) has been determined in past studies [24]. The magnitude and direction of the GRF vector are also known through the stance phase [24]. This provides complete information about the physical location of the GRF vector as a function of time during stance phase of gait. The positioning of the locking axis (Fig. 4) is optimized in 2D space (the sagittal plane) to achieve the following: the GRF vector originating from the COP is posterior to the locking axis during early stance, keeping the knee locked. During mid-stance, the COP advances, moving the GRF vector anterior to the knee and locking axis, releasing the latch. During late stance just before toe off, the latch remains disengaged (Fig. 4), as the GRF vector moves posterior to the knee axis. This strategy can also be potentially used to enable ESF and extension.

Grahic Jump Location
Fig. 7

By incorporating an ESF axis, about which a spring is mounted for elastic early stance flexion–extension (Fig. 2), an additional module could be added to the proposed architecture of the prosthetic knee mechanism (Fig. 4). Illustration adapted with permission [29].



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