Recent Advances in Foot Prosthesis and Orthosis

A special issue of Prosthesis (ISSN 2673-1592).

Deadline for manuscript submissions: 20 November 2024 | Viewed by 19690

Special Issue Editor


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Guest Editor
Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi 110016, India
Interests: artificial tissues; implants; skin grafts; sensors; wearable technologies

Special Issue Information

Dear Colleagues,

We are pleased to announce the launch of this Special Issue, entitled “Recent Advances in Foot Prosthesis and Orthosis”. The aim of this Special Issue is to showcase the state-of-the-art advances in this area and seeks papers related to foot disorders and their treatments using prosthesis, orthosis, and walking aids devices. Furthermore, the advances in 3D modeling and 3D printing technologies are significantly changing the prosthetic industry, and we would also like to invite submissions on these domains. Both original research articles and review articles are welcome in this Special Issue. We encourage multinational collaboration for this Special Issue and to submit novel studies including interdisciplinary work.

We look forward to receiving your excellent work.

Dr. Arnab Chanda
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Prosthesis is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prosthetics
  • foot orthoses
  • biomechanics
  • computational modeling
  • functional movement
  • gait
  • additive manufacturing

Published Papers (9 papers)

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Research

25 pages, 5188 KiB  
Article
Non-Backdrivable Wedge Cam Mechanism for a Semi-Active Two-Axis Prosthetic Ankle
by Michael J. Greene, Ivan Fischman Ekman Simões, Preston R. Lewis, Kieran M. Nichols and Peter G. Adamczyk
Prosthesis 2024, 6(3), 683-707; https://doi.org/10.3390/prosthesis6030049 (registering DOI) - 19 Jun 2024
Abstract
Frontal plane ankle motion is important for balance in walking but is seldom controlled in robotic prostheses. This article describes the design, control and performance of a semi-active two-degree-of-freedom robotic prosthetic ankle. The mechanism uses a non-backdrivable wedge cam system based on rotating [...] Read more.
Frontal plane ankle motion is important for balance in walking but is seldom controlled in robotic prostheses. This article describes the design, control and performance of a semi-active two-degree-of-freedom robotic prosthetic ankle. The mechanism uses a non-backdrivable wedge cam system based on rotating inclined planes, allowing actuation only during swing phases for low power, light weight and compactness. We present details of the mechanism and its kinematic and mechatronic control, and a benchtop investigation of the system’s speed and accuracy in ankle angle control. The two-axis ankle achieves angular reorientation movements spanning ±10 deg in any direction in less than 0.9 s. It achieves a plantarflexion/dorsiflexion error of 0.35 ± 0.27 deg and an inversion/eversion error of 0.29 ± 0.25 deg. Backdriven motion during walking tests is negligible. Strengths of the design include self-locking behavior for low power and simple kinematic control. Two-axis ankle angle control could enable applications such as balance augmentation, turning assistance, and wearable perturbation training. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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18 pages, 9774 KiB  
Article
Investigating Material Performance in Artificial Ankle Joints: A Biomechanical Study
by Hasan Mhd Nazha, Muhsen Adrah, Thaer Osman, Mohammad Issa, Ahmed Imran, Yicha Zhang and Daniel Juhre
Prosthesis 2024, 6(3), 509-526; https://doi.org/10.3390/prosthesis6030036 - 13 May 2024
Viewed by 941
Abstract
This study delves into an in-depth examination of the biomechanical characteristics of various materials commonly utilized in the fabrication of artificial ankle joints. Specifically, this research focuses on the design of an ankle joint resembling the salto-talaris type, aiming to comprehensively understand its [...] Read more.
This study delves into an in-depth examination of the biomechanical characteristics of various materials commonly utilized in the fabrication of artificial ankle joints. Specifically, this research focuses on the design of an ankle joint resembling the salto-talaris type, aiming to comprehensively understand its performance under different loading conditions. Employing advanced finite element analysis techniques, this investigation rigorously evaluates the stresses and displacements experienced by the designed ankle joint when subjected to varying loads. Furthermore, this study endeavors to identify the vibrating frequencies associated with these displacements, offering valuable insights into the dynamic behavior of the ankle joint. Notably, the analysis extends to studying random frequencies across three axes of motion, enabling a comprehensive assessment of directional deformities that may arise during joint function. To validate the effectiveness of the proposed design, a comparative analysis is conducted against the star ankle design, a widely recognized benchmark in ankle joint prosthetics. This comparative approach serves dual purposes: confirming the accuracy of the findings derived from the salto-talaris design and elucidating the relative efficacy of the proposed design in practical application scenarios. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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28 pages, 5516 KiB  
Article
Numerical Analysis of the Plantar Pressure Points during the Stance Phases for the Design of a 3D-Printable Patient-Specific Insole
by Jesus Alejandro Serrato-Pedrosa, Guillermo Urriolagoitia-Sosa, Beatriz Romero-Ángeles, Francisco Carrasco-Hernández, Francisco Javier Gallegos-Funes, Alfonso Trejo-Enriquez, Alfredo Carbajal-López, Jorge Alberto Gomez-Niebla, Martin Ivan Correa-Corona and Guillermo Manuel Urriolagoitia-Calderón
Prosthesis 2024, 6(3), 429-456; https://doi.org/10.3390/prosthesis6030032 - 26 Apr 2024
Viewed by 641
Abstract
The study of the phenomena occurring in the plantar region is remarkably intriguing, especially when performing a normal gait cycle where the foot is under loading conditions. The effects presented in the foot while walking provide relevant indicators regarding clinical means for enhancing [...] Read more.
The study of the phenomena occurring in the plantar region is remarkably intriguing, especially when performing a normal gait cycle where the foot is under loading conditions. The effects presented in the foot while walking provide relevant indicators regarding clinical means for enhancing regular performance or rehabilitation therapies. Nevertheless, more than traditional methods are needed to biomechanically evaluate foot structural conditions, leading to an incomplete database for determining the patient’s needs so that advanced methodologies provide detailed medical assessment. Therefore, it is necessary to employ technological engineering tools to optimize biomechanical plantar pressure evaluations to reach suitable personalized treatments. This research initially evaluated numerically the pressure points in the foot sole region in each one of the five stance phases in a normal gait cycle. Medical imaging techniques were utilized to construct an anatomically accurate biomodel of the soft tissues of the right foot. The Finite Element Method was employed to predict peak plantar pressure in barefoot conditions for all stance phases; results from this case study presented a close alignment with gait experimental testing implemented to analyze the feasibility and validation of all mechanical considerations for the numerical analyses. Hence, having a solid foundation in the biomechanical behavior from the first case study close estimates, a 3D-printable patient-specific insole was designed and numerically analyzed to observe the mechanical response in the plantar critical zones utilizing a personalized orthotic device. Results from the second case study notably demonstrated a crucial decrement in excessive pressure values. Employing morphological customization orthopedics modeling combined with 3D-printable materials is revolutionizing assistive device design and fabrication techniques. The fundamental contribution of this research relies on deepening the knowledge of foot biomechanics from an interdisciplinary approach by numerically analyzing pressure distribution in critical regions for all five stances phases; thus, based on the methods employed, the results obtained contribute to the advances of patient-specific foot orthopedics. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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25 pages, 3580 KiB  
Article
EMG and IMU Data Fusion for Locomotion Mode Classification in Transtibial Amputees
by Omar A. Gonzales-Huisa, Gonzalo Oshiro, Victoria E. Abarca, Jorge G. Chavez-Echajaya and Dante A. Elias
Prosthesis 2023, 5(4), 1232-1256; https://doi.org/10.3390/prosthesis5040085 - 21 Nov 2023
Cited by 1 | Viewed by 1671
Abstract
Despite recent advancements in prosthetic technology, lower-limb amputees often remain limited to passive prostheses, which leads to an asymmetric gait and increased energy expenditure. Developing active prostheses with effective control systems is important to improve mobility for these individuals. This study presents a [...] Read more.
Despite recent advancements in prosthetic technology, lower-limb amputees often remain limited to passive prostheses, which leads to an asymmetric gait and increased energy expenditure. Developing active prostheses with effective control systems is important to improve mobility for these individuals. This study presents a machine-learning-based approach to classify five distinct locomotion tasks: ground-level walking (GWL), ramp ascent (RPA), ramp descent (RPD), stairs ascent (SSA), and stairs descent (SSD). The dataset comprises fused electromyographic (EMG) and inertial measurement unit (IMU) signals from twenty non-amputated and five transtibial amputated participants. EMG sensors were strategically positioned on the thigh muscles, while IMU sensors were placed on various leg segments. The performance of two classification algorithms, support vector machine (SVM) and long short-term memory (LSTM), were evaluated on segmented data. The results indicate that SVM models outperform LSTM models in accuracy, precision, and F1 score in the individual evaluation of amputee and non-amputee datasets for 80–20 and 50–50 data distributions. In the 80–20 distribution, an accuracy of 95.46% and 95.35% was obtained with SVM for non-amputees and amputees, respectively. An accuracy of 93.33% and 93.30% was obtained for non-amputees and amputees by using LSTM, respectively. LSTM models show more robustness and inter-population generalizability than SVM models when applying domain-adaptation techniques. Furthermore, the average classification latency for SVM and LSTM models was 19.84 ms and 37.07 ms, respectively, within acceptable limits for real-time applications. This study contributes to the field by comprehensively comparing SVM and LSTM classifiers for locomotion tasks, laying the foundation for the future development of real-time control systems for active transtibial prostheses. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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12 pages, 1758 KiB  
Article
Design Analysis of Prosthetic Unilateral Transtibial Lower Limb with Gait Coordination
by Susmita Das, Dalia Nandi and Biswarup Neogi
Prosthesis 2023, 5(2), 575-586; https://doi.org/10.3390/prosthesis5020040 - 15 Jun 2023
Cited by 1 | Viewed by 2073
Abstract
People with lower limb amputations struggle through difficulties during locomotion in their daily activities. People with transtibial amputations take support from prosthetic legs for systematic movement. During motion, they experience some mobility issues while using general prosthetic limbs regarding gait pattern. The design [...] Read more.
People with lower limb amputations struggle through difficulties during locomotion in their daily activities. People with transtibial amputations take support from prosthetic legs for systematic movement. During motion, they experience some mobility issues while using general prosthetic limbs regarding gait pattern. The design of a prosthetic-controlled lower limb with gait synchronization for physically disabled persons is the main goal of the present research work, which can provide an improved walking experience. The design and performance analysis of prosthetic lower limbs for people with transtibial amputations is performed in the present paper. The designed rehabilitation system shows synchronization between the normal and the prosthetic limbs achieved with gait coordination. The dynamics of the lower extremities in different postural activities are used for design purpose utilizing Euler–Lagrange motion theory. The artificial motion of the knee and the ankle joints function through the angular movement of the servo motors according to the movements of the rotary encoders placed on the sound limb joints. The range of motion of both the sound and prosthetic limbs are compared for different steps during a gait cycle. The prosthetic electronic system design of the artificial lower limb is able to show the gait style of human being with body kinesics. The nonlinear domain stability analysis of the designed prosthetic limb is presented through the Lyapunov method. A PIDF2 controller tuning process is implemented for the designed limb’s performance improvement. The designed prosthetic system is beneficial for people with unilateral transtibial amputations with a great societal impact. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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12 pages, 6902 KiB  
Article
Effects of Customized 3D-Printed Insoles in Patients with Foot-Related Musculoskeletal Ailments—A Survey-Based Study
by Salman Shaikh, Bhakti Jamdade and Arnab Chanda
Prosthesis 2023, 5(2), 550-561; https://doi.org/10.3390/prosthesis5020038 - 7 Jun 2023
Cited by 20 | Viewed by 4479
Abstract
The prevalence of individuals with flat feet and high arches is very high (between 15% to 37%), which can often lead to other orthopedic complications. Three-dimensional-printed insoles are being studied and validated for their effects in correcting these highly prevalent foot disorders. Highly [...] Read more.
The prevalence of individuals with flat feet and high arches is very high (between 15% to 37%), which can often lead to other orthopedic complications. Three-dimensional-printed insoles are being studied and validated for their effects in correcting these highly prevalent foot disorders. Highly customizable parameters while printing the insole allows for precise correction of foot biomechanics. In this study, 200 patients suffering from various foot-related problems and joint pain were given 3d-printed insoles (designed using plantar pressure systems and clinical practitioner’s assessment) to use in their footwear. Tested activities included standing, walking, running, sports, and gym workout. Customization of insoles included custom density, heel cup, heel rise, medial arch height, and lateral wedge. Based on the patient history, additional podiatry elements were provided for patients with diabetes. Each insole was designed as per the insole profile of the shoe with a comfortable fit. These insoles were found to be effective in alleviating pain for more than 90% of the patients and provided a longer life cycle with effective orthotic correction (for >16 months of daily use). This paper presents the post-use effects (6–18 months) of custom 3D-printed insoles. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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13 pages, 1365 KiB  
Article
Morton’s Extension on Hallux Rigidus Pathology
by Rubén Sánchez-Gómez, Juan Manuel López-Alcorocho, Almudena Núñez-Fernández, María Luz González Fernández, Carlos Martínez-Sebastián, Ismael Ortuño-Soriano, Ignacio Zaragoza-García and Álvaro Gómez-Carrión
Prosthesis 2023, 5(1), 251-263; https://doi.org/10.3390/prosthesis5010019 - 21 Feb 2023
Cited by 4 | Viewed by 2995
Abstract
Study design, case-control study: Background, Morton’s extension (ME) is a kind of orthotic that has been used as a conservative treatment of painful hallux rigidus (HR) osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have [...] Read more.
Study design, case-control study: Background, Morton’s extension (ME) is a kind of orthotic that has been used as a conservative treatment of painful hallux rigidus (HR) osteoarthritis, but only their effects on first metatarsophalangeal joint (MPJ) mobility and position in healthy subjects have been studied, but not on its applied pulled tension forces neither in subjects with HR. Objectives: This study sought to understand how ME’s orthotics with three different thicknesses could influence the kinematic first MPJ by measuring hallux dorsiflexion using Jack’s test and a digital algometer with a rigid strip anchored to the iron hook’s extremity and comparing subjects with healthy first MPJ mobility to those with HR. We aimed to clarify whether tension values were different between healthy and HR subjects. Methods: Fifty-eight subjects were selected, of whom thirty were included in the case group according to HR criteria and twenty-eight were included in the control group. A digital algometer (FPX®® 25, Wagner Instruments®®, Greenwich, CT, USA) was used to assess the pulled tension values (kgf) of the first MPJ during Jack’s test. Results: The pulled tension values were highly reliable (ICC > 0.963). There were no statistically significant differences between the pulled tension values for the different ME conditions in the case (p = 0.969) or control (p = 0.718) groups. However, as it’s expected, there were statistically significant differences comparing all pulled tension values between case and control group subjects (p < 0.001). Conclusions: Different ME’s thicknesses had no influence on the pulled effort applied during the dorsiflexion Jack’s test between the healthy and HR groups; therefore, it can be prescribed without joint-care danger. In addition, it is proven that there is greater resistance to performing Jack’s test in the HR group than in the healthy group, regardless of ME’s orthotics. Furthermore, it is shown that the digital algometer device is a valid tool to detect the first MPJ restriction and is more reliable than other tests. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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12 pages, 2360 KiB  
Article
Friction Optimization of Talc Powder-Reinforced Elastomers for Prosthetic Foot Application
by Muhammad Khafidh, Donny Suryawan, Lilis Kistriyani, Muhammad Naufal and Rifky Ismail
Prosthesis 2023, 5(1), 88-99; https://doi.org/10.3390/prosthesis5010007 - 12 Jan 2023
Cited by 1 | Viewed by 1906
Abstract
Patients with lower limb amputation usually use prosthetic feet. Elastomeric material is an important part of prosthetic feet since it can determine their safety and lifetime. The elastomeric material should have high friction for safety, and at the same time it should have [...] Read more.
Patients with lower limb amputation usually use prosthetic feet. Elastomeric material is an important part of prosthetic feet since it can determine their safety and lifetime. The elastomeric material should have high friction for safety, and at the same time it should have low wear for a longer lifetime. This research is aimed to study the optimum formulation of talc-powder-reinforced silicone elastomer to obtain high friction during sliding contact. The Taguchi orthogonal array L9 formula is used to achieve the aforementioned goal. The experiments use multiple parameters, namely, the type of silicone, the type of surface texture, the amount of catalyst, and the amount of talc powder. The results show that the combination of RTV 683, a smooth texture, 4% of catalyst, and 60% of talc powder is the most optimum composition to obtain the highest frictional force. It has a higher friction force in comparison with the imported products, and, at the same time, it has comparable wear with the imported products. The hardness of the optimized materials is comparable with the imported products. However, the tensile and tear strengths of the optimized materials need to be improved. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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15 pages, 5660 KiB  
Article
Development and Effectiveness Testing of a Novel 3D-Printed Multi-Material Orthosis in Nurses with Plantar Foot Pain
by Komal Chhikara, Sarabjeet Singh Sidhu, Shubham Gupta, Sakshi Saharawat, Chitra Kataria and Arnab Chanda
Prosthesis 2023, 5(1), 73-87; https://doi.org/10.3390/prosthesis5010006 - 11 Jan 2023
Cited by 6 | Viewed by 2397
Abstract
Plantar foot pain is one of the most common musculoskeletal conditions affecting the foot. It is regularly experienced by the population with occupations that require prolonged standing hours, especially in nurses. The etiology of plantar foot pain remains unclear, but it is likely [...] Read more.
Plantar foot pain is one of the most common musculoskeletal conditions affecting the foot. It is regularly experienced by the population with occupations that require prolonged standing hours, especially in nurses. The etiology of plantar foot pain remains unclear, but it is likely to be multi-factorial, with many associated risk factors including increased hours of standing. Orthoses and insoles are often recommended to plantar foot pain patients, however with minimal scientific advancements and limited customizations. In this study, a novel 3D-printed multi-material customized foot orthosis was developed, and its effectiveness on plantar foot pain reduction and functional ability improvement was studied in the nursing population. A total of thirty-six subjects were recruited and were randomized into two groups. The experimental group received the novel 3D-printed multi-material customized foot orthosis, whereas the control group received the standard-of-care (or traditional) intervention. Pre-test and the post-test scores of pains, functional ability and plantar pressure were observed using SPSS software. Improvements were observed in both of the groups; however, better improvements were seen in the experimental group. Overall, the novel 3D printing-based customized foot orthosis showed significant efficacy in reducing plantar foot pain and pressure, and also in increasing functional ability in the nursing population as compared to the traditional method. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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