Browsing by Subject "Forward dynamics simulation"
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Item Compensatory mechanisms in below-knee amputee walking and their effects on knee joint loading, metabolic cost and angular momentum(2010-08) Silverman, Anne Katherine; Neptune, Richard R.; Barr, Ronald E.; Dingwell, Jonathan B.; Fernandez, Benito; Longoria, Raul G.Unilateral, below-knee amputees have altered gait mechanics, which can significantly affect mobility. For example, amputees often have asymmetric leg loading as well as higher metabolic cost and an increased risk of falling compared to non-amputees. Below-knee amputees lose the functional use of the ankle muscles, which are critical in non-amputee walking for providing body support, forward propulsion and leg-swing initiation. The ankle muscles also regulate angular momentum in non-amputees, which is important for providing body stability and preventing falls. Thus, compensatory mechanisms in amputee walking are developed to accomplish the functional tasks normally provided by the ankle muscles. In Chapters 2 and 3, three-dimensional forward dynamics simulations of amputee and non-amputee walking were generated to identify compensatory mechanisms and their effects on joint loading and metabolic cost. Results showed that the prosthesis provided body support, but did not provide sufficient body propulsion or leg-swing initiation. As a result, compensations by the residual leg gluteus maximus, gluteus medius, and hamstrings were needed. The simulations also showed the intact leg tibio-femoral joint contact impulse was greater than the residual leg and that the vasti and hamstrings were the primary contributors to the joint impulse on both the intact and residual legs. The amputee simulation had higher metabolic cost than the non-amputee simulation, which was primarily due to prolonged muscle activity from the residual leg gluteus maximus, gluteus medius, hamstrings, vasti and intact leg vasti and ankle muscles. In Chapter 4, whole-body angular momentum in amputees and non-amputees was analyzed. Reduced residual leg propulsion resulted in a smaller range of sagittal plane angular momentum in the second half of the gait cycle. Thus, to conserve angular momentum, reduced braking was needed in the first half of the gait cycle. Decreased residual leg braking appears to be an important mechanism to regulate sagittal plane angular momentum in amputee walking, but was also associated with a greater range of angular momentum that may contribute to reduced stability in amputees. These studies have provided important insight into compensatory mechanisms in below-knee amputee walking and have the potential to guide rehabilitation methods to improve amputee mobility.Item Experimental analysis and computational simulation of unilateral transtibial amputee walking to evaluate prosthetic device design characteristics and amputee gait mechanics(2010-05) Ventura, Jessica Dawn; Neptune, Richard R.; Barr, Ronald E.; Crawford, Richard H.; Fernandez, Benito R.; Abraham, Lawrence D.Over one million amputees are living in the United States with major lower limb loss (Ziegler-Graham et al. 2008). Lower limb amputation leads to the functional loss of the ankle plantar flexor muscles, which are important contributors to body support, forward propulsion, and leg swing initiation during walking (Neptune et al. 2001; Liu et al. 2006). Effective prosthetic component design is essential for successful rehabilitation of amputees to return to an active lifestyle by partially replacing the functional role of the ankle muscles. The series of experimental and computer simulation studies presented in this research showed that design characteristics of energy storage and return prosthetic ankles, specifically the elastic stiffness, significantly influence residual and intact leg ground reaction forces, knee joint moments, and muscle activity, thus affecting muscle output. These findings highlight the importance of proper prosthetic foot stiffness prescription for amputees to assure effective rehabilitation outcomes. The research also showed that the ankle muscles serve to stabilize the body during turning the center of mass. When amputees turn while supported by their prosthetic components, they rely more on gravity to redirect the center of mass than active muscle generation. This mechanism increases the risks of falling and identifies a need for prosthetic components and rehabilitation focused on increasing amputee stability during turning. A proper understanding of the effects of prosthetic components on amputee walking mechanics is critical to decreasing complications and risks that are prevalent among lower-limb amputees. The presented research is an important step towards reaching this goal.Item Mobility in individuals with traumatic lower-limb injuries : implications for device design, surgical intervention and rehabilitation therapies(2016-05) Ranz, Ellyn Cymbre; Neptune, Richard R.; Barr, Ronald E; Crawford, Richard H; Sulzer, James S; Wilken, Jason MTraumatic injuries to the extremities are commonly observed in emergency room patients and military personnel in combat. Restoring high mobility and functionality is a primary goal post-injury, which may require the use of rehabilitative devices, surgical interventions, and rehabilitation therapies. The research detailed in this dissertation investigates specific elements of these approaches through the use of experimental study and modeling and simulation. In the first study, the influence of passive-dynamic ankle-foot orthosis bending axis on the gait performance of limb salvage subjects was investigated. Bending axis location was altered by fabricating customized orthosis components using additive manufacturing and was tested in a gait laboratory. Altering bending axis location did not result in large or consistent changes in gait measures, however subjects expressed strong preferences for bending axis condition and preference was strongly related to specific gait measures. This suggests that preference and comfort are important factors guiding the prescription of bending axis location. In the second study, musculoskeletal modeling was used to examine the influence of transfemoral amputation surgical techniques on muscle capacity to generate forces and moments about the hip. Muscle reattachment tension and stabilization were shown to be critical parameters for post-amputation capacity, which supports the use of myodesis stabilization (muscle is reattached directly to bone) in amputation procedures. In the third study, a forward dynamics simulation of transfemoral amputee gait was developed and used to examine individual muscle and prosthesis contributions to walking subtasks. The residual hip muscles, and intact ankle, knee, and hip muscles worked synergistically to provide body support, anteroposterior propulsion, mediolateral control, and leg swing. Increased contributions of contralateral muscles to ipsilateral subtasks as well as increased duration of specific muscle contributions were observed in comparison to non-amputee and transtibial amputee walking. These findings can be used to help develop targeted rehabilitation therapies and improve transfemoral amputee locomotion. Through elucidating the influence of PD-AFO bending axis on gait performance as well as the influence of transfemoral amputation surgical techniques on muscle capacity and function, this research provides a foundation for improved rehabilitation outcomes, and thus mobility for individuals who have experienced traumatic lower-limb injuries.Item A theoretical analysis of the influence of wheelchair seat position on upper extremity demand(2012-08) Slowik, Jonathan Steven; Neptune, Richard R.; Mulroy, Sara J.The high demands of manual wheelchair propulsion put users at risk of additional pain and injury that can lead to further reductions in independence and quality of life. Seat position is an adjustable parameter that has been shown to influence propulsion biomechanics. As a result, a number of studies have attempted to optimize this position. However, due to complexities in quantifying upper extremity demand, seat position guidelines are often based on studies aimed at reducing indirect quantities (e.g., cadence, handrim forces, joint ranges of motion and muscle excitation levels) rather than more direct measures of demand (e.g., muscle stress and metabolic cost). Forward dynamics simulations provide an alternative approach to systematically investigate the influence of seat position on more direct measures of upper extremity demand. The objective of this study was to generate and analyze a set of forward dynamics simulations of wheelchair propulsion across the range of attainable seat positions to identify the optimal seat position that minimizes upper extremity demand (i.e., muscle stress, metabolic cost and muscle antagonism). The optimization results showed both metabolic cost and muscle stresses were near minimal values at superior/inferior positions corresponding to top dead center elbow angles between 110 and 120 degrees while at an anterior/posterior position with a hub-shoulder angle between 10 and 2.5 degrees. These minimal values coincided with a reduction in the level of antagonistic muscle activity, primarily at the glenohumeral joint. Seat positions that deviated from these minimal values increased the level of co-contraction required to maintain a stable, smooth propulsive stroke, and consequentially increased upper extremity demand. These results can provide guidelines for positioning the seat to help reduce upper extremity overuse injuries and pain, and thus improve the overall quality of life for wheelchair users.