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Abstract Background After above-knee amputation, the missing biological knee and ankle are replaced with passive prosthetic devices. Passive prostheses are able to dissipate limited amounts of energy using resistive damper systems during “negative energy” tasks like sit-down. However, passive prosthetic knees are not able to provide high levels of resistance at the end of the sit-down movement when the knee is flexed, and users need the most support. Consequently, users are forced to over-compensate with their upper body, residual hip, and intact leg, and/or sit down with a ballistic and uncontrolled movement. Powered prostheses have the potential to solve this problem. Powered prosthetic joints are controlled by motors, which can produce higher levels of resistance at a larger range of joint positions than passive damper systems. Therefore, powered prostheses have the potential to make sitting down more controlled and less difficult for above-knee amputees, improving their functional mobility. Methods Ten individuals with above-knee amputations sat down using their prescribed passive prosthesis and a research powered knee-ankle prosthesis. Subjects performed three sit-downs with each prosthesis while we recorded joint angles, forces, and muscle activity from the intact quadricep muscle. Our main outcome measures were weight-bearing symmetry and muscle effort of the intact quadricep muscle. We performed paired t-tests on these outcome measures to test for significant differences between passive and powered prostheses. Results We found that the average weight-bearing symmetry improved by 42.1% when subjects sat down with the powered prosthesis compared to their passive prostheses. This difference was significant (p = 0.0012), and every subject’s weight-bearing symmetry improved when using the powered prosthesis. Although the intact quadricep muscle contraction differed in shape, neither the integral nor the peak of the signal was significantly different between conditions (integral p > 0.01, peak p > 0.01). Conclusions In this study, we found that a powered knee-ankle prosthesis significantly improved weight-bearing symmetry during sit-down compared to passive prostheses. However, we did not observe a corresponding decrease in intact-limb muscle effort. These results indicate that powered prosthetic devices have the potential to improve balance during sit-down for individuals with above-knee amputation and provide insight for future development of powered prosthetics. 

Powered prostheses aim to mimic the missing biological limb with controllers that are finely tuned to replicate the nominal gait pattern of non-amputee individuals. Unfortunately, this control approach poses a problem with real-world ambulation, which includes tasks such as crossing over obstacles, where the prosthesis trajectory must be modified to provide adequate foot clearance and ensure timely foot placement. Here, we show an indirect volitional control approach that enables prosthesis users to walk at different speeds while smoothly and continuously crossing over obstacles of different sizes without explicit classification of the environment. At the high level, the proposed controller relies on a heuristic algorithm to continuously change the maximum knee flexion angle and the swing duration in harmony with the user’s residual limb. At the low level, minimum-jerk planning is used to continuously adapt the swing trajectory while maximizing smoothness. Experiments with three individuals with above-knee amputation show that the proposed control approach allows for volitional control of foot clearance, which is necessary to negotiate environmental barriers. Our study suggests that a powered prosthesis controller with intrinsic, volitional adaptability may provide prosthesis users with functionality that is not currently available, facilitating real-world ambulation.