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research-article

A Coronally-Clutching Ankle to Improve Amputee Balance on Coronally-Uneven and Unpredictable Terrain

[+] Author and Article Information
Kyle Yeates

Department of Mechanical Engineering, University of Washington, Seattle, WA 98195; Department of Veterans Affairs Center for Limb Loss and Mobility, 1660 S. Columbian Way MS-151, Seattle, WA 98108
kyle.yeates@gmail.com

Ava Segal

Department of Veterans Affairs Center for Limb Loss and Mobility, 1660 S. Columbian Way MS-151, Seattle, WA 98108
avasegal@gmail.com

Richard Neptune

Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX
rneptune@mail.utexas.edu

Glenn K. Klute

Department of Mechanical Engineering, University of Washington, Seattle, WA 98195; Department of Veterans Affairs Center for Limb Loss and Mobility, 1660 S. Columbian Way MS-151, Seattle, WA 98108
gklute@u.washington.edu

1Corresponding author.

ASME doi:10.1115/1.4040183 History: Received January 18, 2017; Revised April 11, 2018

Abstract

To improve balance of individuals with lower limb amputation on coronally-uneven terrain, a coronally-clutching ankle (CCA) was developed to actively adapt through ±15° of free coronal foot rotation during the first ~60 ms of initial contact. Three individuals with lower limb amputations were fit with the CCA and walked across an instrumented walkway with a middle step that was either flush, 15° inverted, or 15° everted. An opaque latex membrane was placed over the middle step, making the coronally-uneven terrain unpredictable. Compared to participants' clinically-prescribed prosthesis, the CCA exhibited significantly more coronal angular adaption during early stance. The CCA also improved participants' center of mass path regulation during the recovery step (reduced variation in mediolateral position) and reduced the use of the hip and stepping recovery strategies, suggesting it improved participants' balance and enabled a quicker recovery from the disturbance. However, use of the CCA did not significantly affect participants' ability to regulate their coronal angular momentum during the disturbance, suggesting the CCA did not improve all elements of dynamic balance. Reducing the distance between the CCA's pivot axis and the base of the prosthetic foot might resolve this issue. These findings suggest actively adapting the coronal plane angle of a prosthetic ankle can improve certain elements of balance for individuals with lower limb amputation who walk on coronally-uneven and unpredictable terrain.

Copyright (c) 2018 by ASME
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