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Related Experiment Video

Updated: Aug 17, 2025

A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
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Human-prosthesis cooperation: combining adaptive prosthesis control with visual feedback guided gait.

Bretta L Fylstra1,2, I-Chieh Lee1,2, Minhan Li1,2

  • 1Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, 27695, USA.

Journal of Neuroengineering and Rehabilitation
|December 14, 2022
PubMed
Summary

This study explored human-prosthesis cooperation for better gait. Visual feedback helped tune prosthesis control, with some lasting benefits for users with transfemoral amputation (TFA).

Keywords:
GaitHuman-in-the-loop optimizationPowered prosthesis tuningTransfemoral amputeeVisual feedback

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Area of Science:

  • Biomedical Engineering
  • Rehabilitation Robotics
  • Human-Computer Interaction

Background:

  • Personalizing prosthesis control often uses human-in-the-loop optimization, but gait performance depends on both human and prosthesis control.
  • Cooperation between human and intelligent prosthesis control is crucial for achieving desired gait patterns.
  • This study introduces a novel paradigm for human-prosthesis cooperation using visual feedback (FB) of stance time.

Purpose of the Study:

  • To investigate if user-controlled gait timing via visual FB accelerates prosthesis tuning.
  • To determine if prosthesis control affects the user's ability to achieve and maintain target stance times.
  • To assess the retention of beneficial gait behaviors after feedback removal.

Main Methods:

  • A reinforcement learning algorithm tuned prosthesis control for normative knee kinematics during walking.
  • A visual FB system guided users to control prosthesis-side stance time.
  • Seven able-bodied (AB) and four transfemoral amputation (TFA) participants used a powered knee prosthesis on a treadmill across three FB conditions (no FB, self-selected stance time FB, increased stance time FB).

Main Results:

  • User control of gait timing reduced tuning duration in AB individuals but not TFA individuals.
  • Prosthesis control adjustments did not impede users' ability to meet FB goals.
  • Participants maintained increased prosthesis-side stance time immediately after FB removal, but only a few retained longer stance times and better symmetry in the post-test.

Conclusions:

  • Human-prosthesis cooperation via visual FB offers insights into improving gait performance.
  • The findings may guide future adoption of human-in-the-loop optimization for personalized prosthesis control.
  • Further research is needed to optimize tuning strategies for sustained gait improvements in prosthesis users.