Swing-phase Motion Research Articles

The effects of swing assistance in a microprocessor-controlled transfemoral prosthesis on walking at varying speeds and grades.

This article proposes, describes, and tests a swing-assist walking controller for a stance-controlled, swing-assisted knee prosthesis that aims to combine benefits of passive swing mechanics (e.g., quiet operation, biomimetic function, and low power requirements) with benefits of powered swing assistance (e.g., increased robustness of swing-phase motion and specifically increased toe clearance). A three-participant, multislope, multispeed treadmill walking study was performed using the swing-assist prosthesis and controller, as well as using the participants' prescribed microprocessor knee devices. The swing-assist device and approach were found to improve user minimum foot clearance during walking at slopes and speeds, and also to improve symmetry of knee motion. Hip power inputs from stance knee release to heel strike indicated that, on average, less hip power was required when using the swing-assist prosthesis, indicating that the observed benefits were likely the result of the knee device and its control methodology, rather than a result of increased hip joint effort.

Design of a Semi-Powered Stance-Control Swing-Assist Transfemoral Prosthesis.

This paper describes the design of a new type of knee prosthesis called a stance-control, swing-assist (SCSA) knee prosthesis. The device is motivated by the recognition that energetically-passive stance-controlled microprocessor-controlled knees (SCMPKs) offer many desirable characteristics, such as quiet operation, low weight, high-impedance stance support, and an inertially-driven swing-phase motion. Due to the latter, however, SCMPKs are also highly susceptible to swing-phase perturbations, which can increase the likelihood of falling. The SCSA prosthesis supplements the behavior of an SCMPK with a small motor that maintains the low output impedance of the SCMPK swing state, while adding a supplemental closed-loop controller around it. This paper elaborates upon the motivation for the SCSA prosthesis, describes the design of a prosthesis prototype, and provides human-subject testing data that demonstrates potential device benefits relative to an SCMPK during both non-perturbed and perturbed walking.

M-Mode Ultrasound Reveals Earlier Gluteus Minimus Activity in Individuals With Chronic Hip Pain During a Step-down Task.

Controlled laboratory study. The hip abductor muscles are important hip joint stabilizers. Hip joint pain may alter muscle recruitment. Motion-mode (M-mode) ultrasound enables noninvasive measurements of the onset of deep and superficial muscle motion, which is associated with activation onset. To compare (1) the onset of superficial and deep gluteus medius and gluteus minimus muscle motion relative to the instant of peak ground reaction force and (2) the level of swing-phase muscle motion during step-down between subjects with chronic hip pain and controls using M-mode ultrasound. Thirty-five subjects with anterior, nontraumatic hip pain for more than 6 months (mean ± SD age, 54 ± 9 years) and 35 controls (age, 57 ± 7 years) were scanned on the lateral hip of the leading leg during frontal step-down onto a force platform using M-mode ultrasound. Computerized motion detection with the Teager-Kaiser energy operator was applied on the gluteus minimus and the deep and superficial gluteus medius to determine the time lag between muscle motion onset and instant of peak ground reaction force and the level of gluteus minimus motion during the swing phase. Time lags and motion levels were averaged per subject, and t tests were used to determine between-group differences. In participants with hip pain, gluteus minimus motion onset was 103 milliseconds earlier (P = .002) and superficial gluteus medius motion was 70 milliseconds earlier (P = .047) than those in healthy control participants. The level of gluteus minimus swing-phase motion was higher with pain (P = .006). Increased gluteus minimus motion during the swing phase and earlier gluteus minimus and superficial gluteus medius motion in individuals with hip pain suggest an overall increase of muscle activity, possibly a protective behavior.

A Computer Model to Simulate the Swing Phase of a Transfemoral Prosthesis

For amputees to perform an everyday task, or to participate in physical exercise, it is crucial that they have an appropriately designed and functional prosthesis. Past studies of transfemoral amputee gait have identified several limitations in the performance of amputees and in their prosthesis when compared with able-bodied walking, such as asymmetrical gait, slower walking speed, and higher energy demands. In particular the different inertial characteristics of the prosthesis relative to the sound limb results in a longer swing time for the prosthesis. The aim of this study was to determine whether this longer swing time could be addressed by modifying the alignment of the prosthesis. The following hypothesis was tested: Can the inertial characteristics of the prosthesis be improved by lowering the prosthetic knee joint, thereby producing a faster swing time? To test this hypothesis, a simple 2-D mathematical model was developed to simulate the swing-phase motion of the prosthetic leg. The model applies forward dynamics to the measured hip moment of the amputee in conjunction with the inertial characteristics of prosthetic components to predict the swing-phase motion. To evaluate the model and measure any change in prosthetic function, we conducted a kinematic analysis on four Paralympic runners as they ran. When evaluated, there was no significant difference (p> 0.05) between predicted and measured swing time. Of particular interest was how swing time was affected by changes in the position of the prosthetic knee axis. The model suggested that lowering the axis of the prosthetic knee could reduce the longer swing time. This hypothesis was confirmed when tested on the amputee runners.

Kinematic behavior of the ankle following malleolar fracture repair in a high-fidelity cadaver model.

Previous studies involving axially loaded ankle cadaver specimens undergoing a passive range of motion after fracture have demonstrated rotatory instability patterns consisting of excessive external rotation during plantar flexion. The present study was designed to expand these studies by using a model in which ankle motion is controlled by physiologically accurate motor forces generated through phasic force-couples attached to the muscle-tendon units. Eight right unembalmed cadaver feet were tested in a dynamic gait simulator that reproduces the sagittal kinematics of the tibia while applying physiological muscle forces to the tendons of the major extrinsic muscles of the foot. Six-degrees-of-freedom kinematics of the tibia and talus were measured with use of a VICON motion-analysis system. The experimental conditions included all combinations of lateral and medial injury to reproduce the clinical classifications of ankle fracture. Statistical analysis was performed with repeated-measures analyses of variance. The talus of the intact ankles demonstrated coupled external rotation and inversion relative to the tibia as the ankle plantar flexed. Osteotomy of the fibula, simulating a lateral ankle fracture, slightly but significantly increased external rotation and inversion of the talus (p < 0.001), whereas disruption of either the superficial or the deep deltoid ligament increased talar eversion (p < 0.003) and disruption of the deep deltoid ligament increased internal rotation (p < 0.0001). The aberrant motions were corrected by repair of the injured structure. The predominant coupled rotation of the talus is external rotation associated with plantar flexion. Following progressive ankle destabilization, talar external rotation and inversion increased. The clinical decision-making process regarding the treatment of ankle fractures centers on determination of whether the injury is expected to result in abnormal motion, which is thought to predispose to the development of arthritis. The present study demonstrated a remarkable degree of ankle stability during stance phase even when there was severe disruption of medial and lateral structures. This finding suggests that a main determinant of clinical outcome after ankle fracture may be ankle motion during swing phase, when ankle stability is not augmented by the combination of axial loading and active motor control of motion. If swing-phase motion is abnormal, then the ankle may be in a vulnerable position at the point of heel-strike.

Mathematical modelling and field trials of an inexpensive endoskeletal above-knee prosthesis.

The swing-phase motion of the shank of an above-knee prosthesis has been modelled mathematically. An inexpensive endoskeletal prosthesis was designed using the Jaipur foot and conduit pipes with a hinge joint for the knee. Results of field trials and the modelling indicate that a very simple above-knee prosthesis can give near normal gait at "normal" walking speeds on flat surfaces. The swing of the shank is most sensitive to the timing of toe-off.

Changes in knee function associated with treadmill ambulation

A comparison of level walking, on a walkway and on a treadmill, was performed using ten normal subjects. Motion about the knee was measured using a triaxial electrogoniometer, and foot-floor contact patterns were recorded by means of four foot switches attached to the sole of each shoe. On the walkway, the data were collected with the subject moving at a comfortable walking speed. The treadmill was then set at the average velocity obtained on the walkway. Knee joint rotation in the coronal and transverse planes did not change significantly between the walkway and the treadmill. In the sagittal plane, significant differences were found for total motion ( p < 0.01), swing phase motion ( p < 0.01), knee position at heel strike ( p < 0.05), and maximum swing phase extension ( p < 0.01). A comparison of the foot-floor contact patterns between walkway and treadmill ambulation revealed reduced heel contact time, with an increase in toe contact while on the treadmill. It was concluded that sagittal plane knee kinematics during level treadmill walking differ significantly from level overground walking.