Effects of locomotion mode recognition errors on volitional control of powered above-knee prostheses

Recent studies have reported various methods that recognize amputees' intent regarding locomotion modes, which is potentially useful for volitional control of powered artificial legs. However, occasional errors in locomotion mode recognition are inevitable. When these intent recognition decisions are used for volitional prosthesis control, the effects of the decision errors on the operation of the prosthesis and user's task performance is unknown. Hence, the goals of this study were to 1) systematically investigate the effects of locomotion mode recognition errors on volitional control of powered prosthetic legs and the user's gait stability, and 2) identify the critical mode recognition errors that impact safe and confident use of powered artificial legs in lower limb amputees. Five able-bodied subjects and two above-knee (AK) amputees were recruited and tested when wearing a powered AK prosthesis. Four types of locomotion mode recognition errors with different duration and at different gait phases were purposely applied to the prosthesis control. The subjects' gait stabilities were subjectively and objectively quantified. The results showed that not all of the mode recognition errors in volitional prosthesis control disturb the subjects' gait stability. The effects of errors on the user's balance depended on 1) the gait phase when the errors happened and 2) the amount of mechanical work change applied on the powered knee caused by the errors. Based on the study results, "critical errors" were defined and suggested as a new index to evaluate locomotion mode recognition algorithms for artificial legs. The outcome of this study might aid the future design of volitionally-controlled powered prosthetic legs that are reliable and safe for practice.