More than 21% of adult Americans (46 million) have some form of diagnosed arthritis, and the number is anticipated to rise to 67 million by 2030 (Hootman and Helmick, 2006). The most common type of arthritis, osteoarthritis (OA), affected more than 27 million Americans (Lawrence et al., 2008). Nearly one-half of all adults and two-thirds of those who are obese can now be expected to develop symptomatic knee OA at some point in their lives (Murphy et al., 2008). Knee OA is a major contributor to functional impairment and reduced independence in older adults (Peat et al., 2001).
There is a growing recognition of the role of local neuromechanical factors in influencing physical function and knee OA disease progression. One such factor is varus-valgus laxity and dynamic instability. However, few exercise treatment strategies to target this particular biomechanical and neuromuscular impairment exist.
Although it is well recognized that knee OA is associated with excessive knee adduction moment (KAM) in the frontal plane, there has been a lack of convenient and effective ways of training people with knee OA in better dealing with the frontal plane knee adduction moment loading.
In general, one or more components of lower-limb joint moments may need to be better controlled through feedback training for the purposes of post-injury rehabilitation and injury prevention. There is a general need for real-time feedback training of selected joint moment(s).
The multi-axis rehabilitation system described here addresses such a need and provides us a useful tool to better control a certain joint moment through real-time biofeedback of the targeted joint moment(s).
a) shows knee adduction moment (KAM) estimated during normal stepping;
An apparatus and method of 3-dimensional (3-D) knee and ankle moments and forces estimation method are described, which can be used for real-time feedback training on controlling one or more of the 3-D knee and ankle joint moments and forces without requiring the computation of center of pressure (COP)—the location of the vertical ground reaction force (GRF) vector from a force platform (
The 3-D knee moments under real-time feedback control can be one or more of the moment components including knee flexion-extension, abduction-adduction, and internal-external rotation moments; and the 3-D knee forces can be one or more of the force components including lateral, anterior, and proximal translation forces. The 3-D ankle moments under real-time feedback control can be one or more of the moment components including dorsiflexion-plantar flexion, inversion-eversion and internal-external rotation moments; and the 3-D ankle forces can be one of more force components including lateral, anterior, and proximal translation forces.
For example, knee adduction moment (KAM), a widely used surrogate measure of medial knee compression (Foroughi et al., 2009; Komistek et al., 1999; Miyazaki et al., 2002; Pollo et al., 2002; Reeves and Bowling, 2011; Shelburne et al., 2008; Simic et al., 2011), is significantly correlated with the severity of knee osteoarthritis (OA) (Foroughi et al., 2009; Reeves and Bowling, 2011; Simic et al., 2011), a disease affecting more than 27 million Americans (Lawrence et al., 2008); and is the cause of 60˜80% of the compressive load at the medial tibiofemoral knee compartment (Foroughi et al., 2009). Especially, the largest peak of the KAM, which occurs during the load acceptance phase, is the strong predictor of medial compartment OA presence (Simic et al., 2011), radiographic disease severity (Sharma et al., 1998; Simic et al., 2011), rate of progression (Miyazaki et al., 2002), and the presence of OA symptoms (Thorp et al., 2007).
Thus, KAM estimated in real-time may enable the patients with knee OA to use it as a biofeedback in order to control the KAM during locomotion. Considering the wide usage of the ET, the real-time estimation of KAM during ET exercise may be beneficial to millions of patients with knee OA. Until now, there are no reports on real-time biofeedback of the KAM during the training but there are some reports on real-time feedback of dynamic knee frontal alignment (Barrios et al., 2010; Reeves and Bowling, 2011; Simic et al., 2011).
Since the emergence of the biomechanical and gait study, there has been extensive efforts on the estimation of 3D moments (as well as forces) with the advance of measurement technologies (Baker, 2006; Elftman, 1939; Koontz et al., 2006; Shiavi et al., 1987; Whittle, 1996; Winter, 2005; Zhang et al., 2003; Zhou and Hu, 2008), because the 3D moments of lower limb joints are important and provide valuable information in many disciplines including biomechanics, orthopedics, physical rehabilitation, and sports science. Examples are, to name just a few, assessing patients with a walking disorder (Whittle, 1996) based on the normal gait patterns (Elftman, 1939; Riley et al., 2001; Winter, 1984, 1980) and investigating association between KAM and biomechanical variables of patients with knee osteoarthritis (OA) (Foroughi et al., 2009; Hurwitz et al., 2002).
However, most current estimation methods need off-line post processing in order to obtain the moments and forces of lower limb joints. Moreover, there may be other potential difficulties in using readily available methods including a long duration of preparation of attaching markers on the parts of the lower limbs of interest for visual/non-visual motion tracking, occlusion at some points (phases) of gait with visual tracking system (e.g., Optotrak™), drift in the computation of velocity and position from accelerometer data, and distortion of sensed information of magnetic sensors due to the magnetic fields of other devices (e.g., electromagnetic motors and/or ferrite structures) (Zhou and Hu, 2008).
Besides, one of the differences of the proposed robotic multi-axis ET exercise and the ground walking (or the running) is that there is no relative motion between the foot and the footplate, because the bootstrap prevents motion of the foot relative to the footplate. Thus, the foot and the footplate always move together. In other words, the distance between the center of mass (COM) of the foot (PFt) and the center of the 6-axis Force/Torque (F/T) sensor (PF/T), which is firmly mounted underneath the footplate, is time-invariant during the exercise. Moreover, due to the movement constraint imposed on the foot and the footplate, non-zero pure moment (also called couple), which is usually ignorable in normal walking and running in a gait lab setting (Cohen et al., 1980), is no longer negligible and may be applied to the footplate. Thus, the typical well established inverse dynamics methods (Winter, 2005; Zatsiorsky, 2002), which require the location of COP, is not applicable to the proposed robotic multi-axis ET exercise. Specifically, with a regular force plate in a gait lab setting, which gives same measured forces/moments as the 6-axis F/T sensor mounted on the proposed robotic multi-axis ET, the COP is computed under the assumption that there is no pure moment exerted on the force plate in the horizontal plane (i.e., zero Tax and Tay) (Cohen et al., 1980; Winter, 2005; Zatsiorsky, 2002). Therefore, it might not be applicable to use existing methods developed for the analysis of the over-ground walking and the running, because of the constrained foot movement.
Hence, in order to compute the 3D knee moments as well as other moments including ankle joint moments, a modified inverse dynamic method is described below, which does not involve the computation of location of COP and is tailored for the robotic multi-axis ET exercise.
1. Computation of COP
For the computation of the 3D knee moments and other lower limb moments, COP is generally needed in order to use well-established inverse dynamics methods based on Newton-Euler equation (Cohen et al., 1980; Winter, 2005; Zatsiorsky, 2002). A typical 3D knee moments computation method (Cohen et al., 1980; Winter, 2005; Zatsiorsky, 2002) may be summarized as follows () and force (Faε
) vectors acting on the ankle using the inverse dynamics with GRF and COP; consequently, from Ma and Fa thus computed, knee moment vector (Mkε
) can be obtained.
My
where
h1=zF/T−zFt (2)
h2=za−zFt (3)
d1=xF/T−xFt (4)
d2=xa−xFt (5)
PFt=[xFt yFt zFt]T and Pa=[xa ya za]T denote coordinates of the COM of the foot, and that of ankle, respectively; xcop denotes the x direction coordinate difference between F/T sensor center and the COP, and can be computed as below
xcop=xcp−xF/T (6)
where PF/T=[xF/T yF/T zF/T]T and Pcp=[xcp ycp zcp]T denote coordinates of center of F/T sensor and that of COP.
Thus, computing location of COP is an important part of the knee moment computation. In (Winter, 2005), of course, a COP computing method with regular force plate when there is no pure moment (also called couple) in horizontal direction (i.e., xa and ya direction in
In general, the y direction moment measured with the 6-axis F/T sensor MF/T
MF/T
where zoff denotes the z direction distance between center of the 6-axis F/T sensor and the top surface of the sensor (plus footplate thickness). Note that (7) is a generalization of the relation of the COP with the forces and moments acting on a force plate in that, compared with the COP computation method given in Winter (2005), non-zero pure moment Ty is included. It is assumed in (Winter, 2005) that Ty is zero (i.e. Ty=0), thus from (7), the x direction component of COP, xcop, was obtained as follows:
xcop=(FF/T
One disadvantage of using (8) is that if FF/T
In order to remove the requirement of the COP location from net moment calculation in (1), advantages of the proposed robotic multi-axis ET are utilized. As was mentioned, the distance between the COM of foot (PFt) and the 6-axis F/T sensor (PF/T) is fixed; so is the distance between the ankle joint (Pa) and the COM of foot (PFt). In other words, once a subject's anthropometric data is obtained, d1, d2, h1 and h2 in
My
Obviously, (9) does not require the COP location. Moreover, all the distances (d1, d2, h1 and h2) are time-invariant (i.e., constants) during the exercise. Thus, these distances can be computed off-line, whereas COP requires a real-time online computation for the real-time computation of the 3D knee and ankle moments (and forces). Accordingly, the problem of potential incorrectness of xcop computation in (8) due to high sensitivity under the small FF/T
Based on (9), the 3D knee moments and forces (and ankle moments and forces) computation can be simplified as shown in
In short, due to the design of the robotic multi-axis ET, 3D knee and ankle moments and forces can be computed without computing COP location. In the following, the details of the proposed 3D knee and ankle moments computation method are provided by exemplifying the computation of the knee abduction/adduction moment. In case, if the foot is not strapped to footplate, then the usual COP calculation can still be utilized for the computation of knee and ankle forces and moments.
2. Derivation of Dynamic Equations for Real-Time Computation of 3D Moments of Lower Limb Joints
In this section, dynamic equations for real-time computation of 3D moments and forces of lower limb joints are provided with a simple 6-DOF goniometer based kinematic measurement technique.
1) Computation of Kinematic Variables
For the computation of 3D knee and ankle moments, kinematic information, which include positions, velocities, and accelerations of the joints and those of COM of segments, and joint angles, angular velocities and accelerations, are required. Specifically, one can compute the 3D knee moments with footplate angle (β), ankle dorsiflexion/planar-flexion (θ1), inversion/eversion (θ2), and shank internal/external rotation (θ3) angles, and shank length (LSk) between knee joint and ankle joint, length between knee joint and COM of shank (LSk
A. Kinematic Variables from the Robotic Multi-Axis Elliptical Trainer
where α denotes the angle between the ground and the oblique ramp in the front part of the robotic multi-axis ET. Since α, oypot, and ozpot are constants, once lob is measured with the potentiometer located at Ppot, oy2 and oz2 can be obtained.
oy2 and oz2 can be also expressed using the two angles (φ1, φ2) and lengths (l1 and l2)
From (11), φ1, φ2 can be obtained as follows (Craig, 1989):
Thus, φ1 and φ2 can be obtained with oy2 and oz2 directly computed from lob measured with a potentiometer located at P2. Although there are two inverse kinematics solutions for a given P2 position, however, a correct one can be easily selected with initial condition such as starting position.
With φ1, φ2 thus measured, footplate angle (β) can be easily derived as below
β=φ1+φ2 (14)
From simple forward kinematics, PF/T the 6-axis F/T sensory and z coordinates with respect to world frame can be computed with φ1 and φ2 as below
If the footplate and the 6-axis F/T sensor below the plate is rotating or sliding, angle of rotation or sliding distance can be incorporated into the computation of location of the F/T sensor (PF/T) in (15).
B. Kinematic Variables from the 6-DOF Goniometer
In order to calculate the ankle dorsiflexion/planar-flexion, inversion/eversion, and internal/external rotation angle using the 6-DOF goniometer, before start training on ET, subject is asked to stand straight by trying to align knee joint with laser pointer lights coming from lateral (and medial) side and from front. The laser pointer at the lateral side of footplate is aligned with center of F/T sensor (i.e., y coordinate of the laser pointer with respect to ankle frame is the same as that of 6-axis F/T sensor) and can be tilted vertically up and down in xa-za plane with respect to ankle frame. The laser pointer at the front size of footplate is located in front of 2nd toe (i.e., x coordinate of center of ankle with respect to ankle frame and that of the laser pointer is identical) and also can be tilted vertically up and down in ya-za plane with respect to ankle frame. By this way, one can find a posture that can be regarded as ‘zero degree posture’ (i.e., 0° dorsiflexion/planar-flexion, 0° inversion/eversion, 0° internal/external rotation).
Once the knee joint alignment is confirmed by checking the laser lights, the 6 angles of goniometers and the rotation matrix from the last (6th) frame (attached to the bony surface of shank) to the base frame of the 6-axis goniometer (attached to the footplate) at that time (lgbgRi) are saved. Thus, one can compute rotation matrix from knee frame to ankle frame as follows (Shiavi et al., 1987; Zhang et al., 2003):
kaR=lgbgR(lgbgRi)−1 (16)
where bglgR denotes rotation matrix from base frame to last frame of the 6-axis goniometer. From ankle dorsiflexion/planar-flexion (θ1) and inversion/eversion (θ2) angles and shank internal/external rotation angle (θ3), kaR can be also obtained as follows:
where karij denotes i,jth element of kaR obtained from (16). Note that, although the 6-DOF goniometer has a one translational DOF and a potentiometer for measuring the translation, this information is not required for computing kaR. Clearly, from (16) and (17), one can obtain the three angles (θ1, θ2, θ3) as follows:
From (18), one can select a proper solution because the dorsiflexion/planar-flexion, inversion/eversion and internal/external rotation angles must be between ±90° during normal exercise.
By using a digitizer (e.g., MicroScribe or probe of Optotrak) or referring anthropometric data (Winter, 2005; Zatsiorsky, 2002), the length of shank, LSk, from ankle to knee joint can be measured. Moreover, with LSk thus measured, the length between knee JC and COM of shank, LSk
2) Derivation of Equations of Motion for Computation of 3D Moments of Lower Limb Joints
For the derivation of knee moment, available variables, which can be known in advance or measured/estimated, are listed below.
1) Ankle position with respect to the world frame
oPa=[oxaoyaoza]T (19)
with respect to the ankle frame
aPa=[0 0 0]T (20)
and with respect to the knee frame
kPa=[0 0−LSk]T (21)
2) Knee position with respect to the knee frame
kPk=[kxkkykkzk]T=[0 0 0]T. (22)
3) Shank COM position with respect to the knee frame
kPSk=[kxSkkySkkzSk]T=[0 0−LSk
4) COM of foot position with respect to the ankle frame
aPFt=[axFtayFtazFt]T (24)
which is a constant vector (i.e., axFt, ayFt, and azFt are constants).
5) Center of 6-axis F/T sensor position with respect to the ankle frame
aPF/T=[axF/TayF/TazF/T]T (25)
which is a constant vector (i.e., axF/T, ayF/T and azF/T are constants).
6) 6-axis measurement of forces and torques exerted on foot by robotic multi-axis ET with respect to the ankle frame
aFF/T=[aFF/T
and
aMF/T=[aMF/T
7) Angular acceleration of foot with respect to the world frame and the ankle frame
a{umlaut over (θ)}Ft=o{umlaut over (θ)}Ft=[{umlaut over (β)}0 0]T. (28)
8) Angular velocity and acceleration of shank with respect to the knee frame
9) Rotation matrix from the ankle frame to the world frame
10) Rotation matrix from the world frame to the ankle frame
11) Rotation matrix from the ankle frame to the knee frame
12) Rotation matrix from the knee frame to the world frame
13) Gravitational acceleration vector with respect to the world frame
og=[0 0−g]T (35)
with respect to the ankle frame
ag=oaRog=[0−gSβ−gCβ]T (36)
with respect to the knee frame
From (19), (23) and (34), COM of shank position with respect to the world frame can be computed as follows:
By taking 2nd order time derivative of both side (38) and multiplying okR, the transpose of koR given in (34), on both side, acceleration of COM of shank, kaSk, can be obtained as follows:
Similarly, from (19), (24), and (31), COM of foot position with respect to the world frame can be obtained as follows:
Thus, from (40), one can get acceleration of COM of foot with respect to the ankle frame.
Because aPFt=[axFtayFtazFt]T is a constant vector, a{dot over (x)}Ft, a{dot over (y)}Ft, ażFt and a{umlaut over (x)}Ft, aÿFt, a{umlaut over (z)}Ft are not shown in (41). Note that the aim of this derivation is to compute the knee and ankle moments and forces.
From
mSkkaSk=−kFa+kFk+mSkkg (42)
and
kISkk{umlaut over (θ)}Sk+k{dot over (θ)}Sk×kISkk{dot over (θ)}Sk=(kPa−kPSh)×(−kFa)+(kPk−kPSh)×kFk−kMa+kMk (43)
(43) is written with respect to the knee frame, however, in (43), kISk denotes the inertia matrix of shank about its COM, and the moment arms (kPa−kPSh), and (kPk−kPSh) are the vectors from COM of shank to ankle, and to knee, respectively. Thus, (43) can be regarded as the equation of rotational motion of shank with respect to the COM of shank frame—a frame which has the same orientation of the knee frame but its origin is located at COM of shank.
Similarly, from
mFtaaFt=aFF/T+aFa+mFtag (44)
aIFta{umlaut over (θ)}Ft=(aPF/T−aPFt)×aFF/T+(aPa−aPFt)×aFa+aMF/T+aMa (45)
Similar to (43), (45) is written with respect to ankle frame, however, in (45), aIFt denotes the inertia matrix of foot about its COM, and the moment arms (aPF/T−aPFt), and (aPa−aPFt) are the vectors from COM of foot to center of 6-axis F/T sensor, and to ankle, respectively. Thus, (45) can be regarded as the equation of rotational motion with respect to the COM of foot frame—a frame which has the same orientation of ankle frame but its origin is located at COM of foot. Further, because a{dot over (θ)}Ft==[{dot over (β)}0 0]T, a{dot over (θ)}Ft×aIFta{dot over (θ)}Ft is always a zero vector (we assumed that foot inertia matrix is a diagonal matrix). Thus it is omitted from left-hand-side of (45). Solving (43) for kMk, we have
kMk=kISkk{umlaut over (θ)}Sk+k{dot over (θ)}Sk×kISkk{dot over (θ)}Sk−(kPa−kPSh)×(−kFa)−(kPk−kPSh)×kFk+kMa (46)
Substituting (20), (22), (23), and (29) into (46) and rearranging it yields
From (47), one can have the following expression of kMk
Substituting (30) into (48) yields
kMkx=kISk
+(kISk
+(LSk−LSk
kMky=kISk
+(kISk
−(LSk−LSk
kMkz=kISk
+(kISk
Substituting (37) into (42) and solving for kFk, we have
Substituting (50) into (49), one can rewrite (49) as follows:
Solving (44) for aFa yields
aFa=mFtaaFt−aFF/T−mFtag (52)
Substituting (36) and (41) into (52), we have
Solving (45) for aMa yields
aMa=aIFta{umlaut over (θ)}Ft−(aPF/T−aPFt)×aFF/T−(aPa−aPFt)×aFa−aMF/T (54)
Substituting (20), (24)-(28), and (53) into (54) and rearranging it yield
aMax=aFF/T
+mFt[−(ayFtSβ+azFtCβ)oÿa+(ayFtCβ−azFtSβ)(o{umlaut over (z)}a+g)]
+[aIft
aMay=−aFF/T
+mFt{azFto{umlaut over (x)}a+axFtSβoÿa−axFtCβ(o{umlaut over (z)}a+g)−axFtayFt{umlaut over (β)}+axFtazFt{dot over (β)}2} (56)
and
aMaz=aFF/T
+mFt{axFtCβoÿa+axFtSβ(o{umlaut over (z)}a+g)−axFtazFt{umlaut over (β)}−axFtayFt{dot over (β)}2} (57)
By multiplying rotation matrix kaR, given in (33), on both side of (53) and aMa, elements of which are given in (55), (56), and (57), one can get kFa and kMa as follows:
kFax=−aFF/T
+mFt{Cθ2Cθ3o{umlaut over (x)}a+[S(β+θ1)Sθ2Cθ3+C(β+θ1)Sθ3]oÿa
+[−C(β+θ1)Sθ2Cθ3+S(β+θ1)Sθ3](o{umlaut over (z)}a+g)
+[−Sθ2Cθ3(ayFtCθ1+azFtSθ1)+(ayFtSθ1−azFtCθ1)Sθ3]{umlaut over (β)}
+[Sθ2Cθ3(−ayFtSθ1+azFtCθ1)−Sθ3(ayFtCθ1+azFtSθ1)]{dot over (β)}2} (58)
kFay=aFF/T
mFt{[−(ayFTCθ1+azFtSθ1)Cθ3+(ayFtSθ1−azFtCθ1)Sθ2Sθ3]{dot over (β)}2
+[(azFtSθ1+ayFtCθ1)Sθ2Sθ3+(ayFtSθ1−azFtCθ1)Cθ3]{umlaut over (β)}
−o{umlaut over (x)}aCθ2Sθ3+[−S(β+θ1)Sθ2Sθ3+C(β+θ1)Cθ3]oÿa
+[C(β+θ1)Sθ2Sθ3+S(β+θ1)Cθ3](o{umlaut over (z)}a+g)} (59)
kFaz=aFF/T
+mFt{+Sθ2o{umlaut over (x)}a−S(β+θ1)Cθ2oÿa+C(β+θ1)Cθ2(o{umlaut over (z)}a+g)+
(ayFtCθ1+azFtSθ1)Cθ2{umlaut over (β)}+(ayFtSθ1−azFtCθ1)Cθ2{dot over (β)}2} (60)
kMax=(aIFt
−aMF/T
−aFF/T
+aFF/T
+aFF/T
+mFto{umlaut over (x)}a[ayFt(Cθ1Sθ2Cθ3−Sθ1Sθ3)+azFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)]
+mFtoÿa{axFt[−C(β+θ1)Sθ2Cθ3+S(β+θ1)Sθ3]−(ayFtSβ+azFtCβ)Cθ2Cθ3}
−mFt(o{umlaut over (z)}a+g){axFt[S(β+θ1)Sθ2Cθ3+C(β+θ1)Sθ3]−(ayFtCβ−azFtSβ)Cθ2Cθ3}
−mFt{umlaut over (β)}{axFt[ayFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)+azFt(−Cθ1,Sθ2Cθ3+Sθ1Sθ3)]
−(ayFt2+azFt2)Cθ2Cθ3}
+mFt{dot over (β)}2axFt[ayFt(Cθ1Sθ2Cθ3−Sθ1Sθ3)+azFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)] (61)
kMay=−(aIFt
−aMF/T
+aFF/T
−FF/T
+aFF/T
−mFto{umlaut over (x)}a[ayFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)−azFt(−Sθ1Sθ2Sθ3+Cθ1Cθ3)]
+mFtoÿa{axFt[C(β+θ1)Sθ2Sθ3+S(β+θ1)Cθ3]+(ayFtSβ+azFtCβ)Cθ2Sθ3}
−mFt(o{umlaut over (z)}a+g){axFt[−S(β+θ1)Sθ2Sθ3+C(β+θ1)Cθ3]+(ayFtCβ−azFtSβ)Cθ2Sθ3}
−mFt{umlaut over (β)}{axFt[ayFt(−Sθ1Sθ2Sθ3+Cθ1Cθ3)+azFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)]
+(ayFt2+azFt2)Cθ2Sθ3}
−mFt{dot over (β)}2axFt[ayFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)−azFt(−Sθ1Sθ2Sθ3+Cθ1Cθ3)] (62)
kMaz=(aIFt
+aFF/T
−aFF/T
−mFto{umlaut over (x)}a(ayFtCθ1+azFtSθ1)Cθ2−mFtoÿa[axFtC(β+θ1)Cθ2+(ayFtSβ+azFtCβ)Sθ2]
+mFt(o{umlaut over (z)}a+g)[axFtS(β+θ1)Cθ2+(ayFtCβ−azFtSβ)Sθ2]
+mFt{umlaut over (β)}[(ayFt2+azFt2)Sθ2+axFt(ayFtSθ1Cθ2−azFtCθ1Cθ2)]
−mFt{dot over (β)}2axFt(ayFtCθ1+azFtSθ1)Cθ2 (63)
Substituting (39), (58), (59) and (60) into (50), one can rewrite (50) as follows:
kFkx=−aFF/T
+(mSk+mFt)Cθ2Cθ3o{umlaut over (x)}a+(mSk+mFt)[S(β+θ1)Sθ2Cθ3+C(β+θ1)Sθ3]oÿa
−(mSk+mFt)[C(β+θ1)Sθ2Cθ3−S(β+θ1)Sθ3](o{umlaut over (z)}a+g)
−mFt{umlaut over (β)}[ayFt(Cθ1Sθ2Cθ3−Sθ1Sθ3)+azFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)]
+mSkLSk
−mFt{dot over (β)}2[ayFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)−azFt(Cθ1Sθ2Cθ3−Sθ1Sθ3)] (64)
kFky=aFF/T
−(mSk+mFt){Cθ2Sθ3o{umlaut over (x)}a+[S(β+θ1)Sθ2Sθ3−C(β+θ1)Cθ3]oÿa}
+(mSk+mFt)[C(β+θ1)Sθ2Sθ3+S(β+θ1)Cθ3](o{umlaut over (z)}a+g)
+mFt{umlaut over (β)}[ayFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)+azFt(Sθ1Sθ2Sθ3−Cθ1Cθ3)]
+mSkLSk
+mFt{dot over (β)}2[ayFt(Sθ1Sθ2Sθ3−Cθ1Cθ3)−azFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)] (65)
kFkz=−aFF/T
+(mSk+mFt)[Sθ2o{umlaut over (x)}a−S(β+θ1)Cθ2oÿa]+(mSk+mFt)C(β+θ1)Cθ2(o{umlaut over (z)}a+g)
+mFt{umlaut over (β)}(azFtSθ1+ayFtCθ1)Cθ2+mFt{dot over (β)}2(ayFtSθ1−azFtCθ1)Cθ2
+mSkLSk
Substituting (39), (58), (59), (60), (61), (62), and (63) into (51) yields
kMkx=−aMF/T
−aFF/T
+aFF/T
+aFF/T
+{−(mFtLSk+mSkLSk
+mFt[ayFt(Cθ1Sθ2Cθ3−Sθ1Sθ3)+azFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)]}o{umlaut over (x)}a
+(mFtLSk+mSkLSk
+mFt{axFt[−C(β+θ1)Sθ2Cθ3+S(β+θ1)Sθ3]−(ayFtSβ+azFtCβ)Cθ2Cθ3}oÿa
+(mFtLSk+mSkLSk
−mFt{axFt[S(β+θ1)Sθ2Cθ3+C(β+θ1)Sθ3]−(ayFtCβ−azFtSβ)Cθ2Cθ3}(o{umlaut over (z)}a+g)
+(kISk
+[aIFt
+mFt{LSk[ayFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)+azFt(Sθ1Sθ2Sθ3−Cθ1Cθ3)]
−axFt[ayFt(Sθ1Sθ2Cθ3+Cƒ1Sƒ3)+azFt(−Cθ1Sθ2Cθ3+Sθ1Sθ3)]}{umlaut over (β)}
+(kISk(kISk
+mFt{LSk[ayFt(Sθ1Sθ2Sθ3−Cθ1Cθ3)−azFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)]
+axFt[ayFt(Cθ1Sθ2Cθ3−Sθ1Sθ3)+azFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)]}{dot over (β)}2
−(kISk
+(kISk
+(kISk
kMky=aMF/T
+aFF/T
−FF/T
+aFF/T
−{(mSkLSk
+mFt[ayFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)−azFt(−Sθ1Sθ2Sθ3+Cθ1Cθ3)]}o{umlaut over (x)}a
+−(LSk
+mFt{axFt[C(β+θ1)Sθ2Sθ3+S(β+θ1)Cθ3]+(ayFtSβ+azFtCβ)Cθ2Sθ3}oÿa
−(mSkLSk
+mFt{axFt[−S(β+θ1)Sθ2Sθ3+C(β+θ1)Cθ3]+(ayFtCβ−azFtSβ)Cθ2Sθ3}(o{umlaut over (z)}a+g)
−[aIFt
+mFt{LSk[ayFt(Cθ1Sθ2Cθ3−Sθ1Sθ3)+azFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)]
+axFt[ayFt(Sθ1Sθ2Sθ3−Cθ1Cθ3)−azFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)]}{umlaut over (β)}
+(kISk
+(kISk
+mFt{LSk[ayFt(Sθ1Sθ2Cθ3+Cθ1Sθ3)+azFt(−Cθ1Sθ2Cθ3+Sθ1Sθ3)]
−axFt[ayFt(Cθ1Sθ2Sθ3+Sθ1Cθ3)−azFt(−Sθ1Sθ2Sθ3+Cθ1Cθ3)]}{dot over (β)}2
+(kiSk
+(kISk
−kISk
kMkz=−aMF/T
+aFF/T
−aFF/T
−aFF/T
−mFto{umlaut over (x)}a(ayFtCθ1+azFtSθ1)Cθ2
−mFtoÿa[axFtC(β+θ1)Cθ2+(ayFtSβ+azFtCβ)Sθ2]
+mFt(o{umlaut over (z)}a+g)[axFtS(β+θ1)Cθ2+(ayFtCβ−azFtSβ)Sθ2]
+kISk
+{aIFt
+[−mFtaxFt(ayFtSθ1+azFtCθ1)+(kISk
+Cθ2[kISk
+(kISk
+2(kISk
Thus, all moments and forces at knee and ankle are obtained. With close observation of (53), (55), (56), (57), (64), (65), (66), (67), (68) and (69), it is clear that the knee and ankle moments and forces can be computed in real-time with online measurements of four angles (i.e., footplate angle (β), dorsiflexion/planar-flexion angle θ1, inversion/eversion angle θ2, shank internal/external rotation angle θ3), which can be measured with the 6-DOF goniometer in
Of course, mass of shank and foot (mSk, mFt), inertias of shank (kISk
Variables needed to be measured from the goniometer and force/torque sensor below the foot in real-time for calculation of each joint moment and for are listed in
3. Feasibility Testing Experiment
1) A Sample Experimental Setup
A modified ET (e.g., Reebok Spacesaver RL) was instrumented with 6-axis F/T sensors (e.g., JR3 Inc., Woodland, Calif.) on both sides underneath the footplate. The ankle joint center (JC), midpoint between the medial and lateral malleoli, was aligned with the F/T sensor center. One end of the 6-DOF goniometer was attached to the footplate and the other end was strapped to the bony frontal-medial surface of shank. To corroborate the estimated Knee Adduction Moment (KAM) using the 6-DOF goniometer, an Optotrak 3020 system with 3 sets of markers (4 markers/set attached to a rigid shell) attached on thigh, shank, and foot was also used. The F/T and goniometer data were sampled at 1 KHz and the Optotrak data at 50 Hz. The foot was strapped to the footplate with no relative motions to the footplate. As an initial calibration, the subject stood still and initial knee JC coordinates with respect to the ankle frame was determined. From anthropometry data (Winter, 2005; Zatsiorsky, 2002), lengths—between knee JC and COM of shank and between knee JC and ankle JC—and masses and inertias with respect to COM of foot and to that of shank were obtained. With all the measured/estimated kinematic and kinetic variables, KAM was computed with respect to the knee local coordinate system and displayed as external KAM following the convention in (Foroughi et al., 2009).
2) Results
The KAM during stepping movement was estimated on a healthy volunteer (male, age: 32; height: 181 cm; mass: 97 kg). Strong KAM was generated during the stepping movement and the moment varied systematically with the stepping cycle (
Number | Name | Date | Kind |
---|---|---|---|
4601468 | Bond et al. | Jul 1986 | A |
4665928 | Linial et al. | May 1987 | A |
4745930 | Confer | May 1988 | A |
5476103 | Nahsner | Dec 1995 | A |
5551445 | Nashner | Sep 1996 | A |
5954621 | Joutras et al. | Sep 1999 | A |
6162189 | Girone et al. | Dec 2000 | A |
7278954 | Kawai et al. | Oct 2007 | B2 |
7455620 | Frykman et al. | Nov 2008 | B2 |
7758470 | Hirata et al. | Jul 2010 | B2 |
7811207 | Stearns et al. | Oct 2010 | B2 |
7860607 | Kawai et al. | Dec 2010 | B2 |
8002672 | Brunner | Aug 2011 | B2 |
8246555 | Chiu et al. | Aug 2012 | B2 |
8308615 | Vitolo et al. | Nov 2012 | B2 |
8475339 | Hwang et al. | Jul 2013 | B2 |
8523741 | Chiu et al. | Sep 2013 | B2 |
8571827 | Jang et al. | Oct 2013 | B2 |
20030064869 | Reinkensmeyer et al. | Apr 2003 | A1 |
20040097330 | Edgerton et al. | May 2004 | A1 |
20040167420 | Song et al. | Aug 2004 | A1 |
20040219498 | Davidson | Nov 2004 | A1 |
20040259690 | Frykman et al. | Dec 2004 | A1 |
20050010139 | Aminian et al. | Jan 2005 | A1 |
20050033200 | Soehren et al. | Feb 2005 | A1 |
20050209536 | Dariush | Sep 2005 | A1 |
20050288609 | Warner et al. | Dec 2005 | A1 |
20060189899 | Flaherty et al. | Aug 2006 | A1 |
20060247095 | Rummerfield | Nov 2006 | A1 |
20060282022 | Dariush | Dec 2006 | A1 |
20070054777 | Kawai et al. | Mar 2007 | A1 |
20070142177 | Simms et al. | Jun 2007 | A1 |
20070155588 | Stark et al. | Jul 2007 | A1 |
20090082701 | Zohar et al. | Mar 2009 | A1 |
20090137366 | Hirata et al. | May 2009 | A1 |
20090204031 | McNames et al. | Aug 2009 | A1 |
20090247370 | Stearns et al. | Oct 2009 | A1 |
20110028865 | Luinge et al. | Feb 2011 | A1 |
20110208444 | Solinsky | Aug 2011 | A1 |
20110218463 | Hodgins et al. | Sep 2011 | A1 |
20120021873 | Brunner | Jan 2012 | A1 |
Entry |
---|
Graves, Sue B. And Juris, Paul M. “A Comparative and Biomechanical Analysis of Two Gait Simulators.” Mar. 21, 2007. Florida Atlantic University. <http://media.cybexintl.com/cybexinstitute/research/ArcTrainervsEllipticalStudy.pdf>. |
Number | Date | Country | |
---|---|---|---|
20120277063 A1 | Nov 2012 | US |
Number | Date | Country | |
---|---|---|---|
61478937 | Apr 2011 | US |