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  1. null (Ed.)
    Introduction Tuning of lower-limb (LL) robotic prosthesis control is necessary to provide personalised assistance to each human wearer during walking. Prostheses wearers’ adaptation processes are subjective and the efficiency largely depends on one’s mental processes. Therefore, beyond physical motor performance, prosthesis personalisation should consider the wearer’s preference and cognitive performance during walking. As a first step, it is necessary to examine the current measures of cognitive performance when a wearer walks with an LL prosthesis, identify the gaps and methodological considerations, and explore additional measures in a walking setting. In this protocol, we outlined a scoping review that will systematically summarise and evaluate the measures of cognitive performance during walking with and without LL prosthesis. Methods and analysis The review process will be guided and documented by CADIMA, an open-access online data management portal for evidence synthesis. Keyword searches will be conducted in seven databases (Web of Science, MEDLINE, BIOSIS, SciELO Citation Index, ProQuest, CINAHL and PsycINFO) up to 2020 supplemented with grey literature searches. Retrieved records will be screened by at least two independent reviewers on the title-and-abstract level and then the full-text level. Selected studies will be evaluated for reporting bias. Data on sample characteristics, type of cognitive function, characteristics of cognitive measures, task prioritisation, experimental design and walking setting will be extracted. Ethics and dissemination This scoping review will evaluate the measures used in previously published studies thus does not require ethical approval. The results will contribute to the advancement of prosthesis tuning processes by reviewing the application status of cognitive measures during walking with and without prosthesis and laying the foundation for developing needed measures for cognitive assessment during walking. The results will be disseminated through conferences and journals. 
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  2. Amputees’ preferences for prosthesis settings are critical not only for their psychological well-being but also for long-term adherence to device adoption and health. Although active lower-limb prostheses can provide enhanced functionality than passive devices, little is known about the mechanism of preferences for settings in active devices. Therefore, a think-aloud study was conducted on three amputees to unravel their preferences for a powered robotic knee prosthesis during user-guided auto-tuning. The inductive thematic analysis revealed that amputee patients were more likely to use their own passive device rather than the intact leg as the reference for the natural walking that they were looking for in the powered device. There were large individual differences in factors influencing naturalness. The mental optimization of preference decisions was mostly based on the noticeableness of the differences between knee profiles. The implications on future design and research in active prostheses were discussed.

     
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    Free, publicly-accessible full text available November 27, 2024
  3. Healthy human locomotion functions with good gait symmetry depend on rhythmic coordination of the left and right legs, which can be deteriorated by neurological disorders like stroke and spinal cord injury. Powered exoskeletons are promising devices to improve impaired people's locomotion functions, like gait symmetry. However, given higher uncertainties and the time-varying nature of human-robot interaction, providing personalized robotic assistance from exoskeletons to achieve the best gait symmetry is challenging, especially for people with neurological disorders. In this paper, we propose a hierarchical control framework for a bilateral hip exoskeleton to provide the adaptive optimal hip joint assistance with a control objective of imposing the desired gait symmetry during walking. Three control levels are included in the hierarchical framework, including the high-level control to tune three control parameters based on a policy iteration reinforcement learning approach, the middle-level control to define the desired assistive torque profile based on a delayed output feedback control method, and the low-level control to achieve a good torque trajectory tracking performance. To evaluate the feasibility of the proposed control framework, five healthy young participants are recruited for treadmill walking experiments, where an artificial gait asymmetry is imitated as the hemiparesis post-stroke, and only the ‘paretic’ hip joint is controlled with the proposed framework. The pilot experimental studies demonstrate that the hierarchical control framework for the hip exoskeleton successfully (asymmetry index from 8.8% to − 0.5%) and efficiently (less than 4 minutes) achieved the desired gait symmetry by providing adaptive optimal assistance on the ‘paretic’ hip joint. 
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    Free, publicly-accessible full text available October 1, 2024
  4. Prostheses help amputees to maintain physical health and quality of life. Prosthesis wearers’ satisfaction and adherence to the prosthesis are closely related to the preferences for prosthesis tuning settings. However, the underlying factors that contribute to the preferences were under-explored. In this study, two able-bodied participants were asked to change the robotic prosthesis settings to their preferred state and the think-aloud technique with a mixed-method approach was used to reveal the contributing factors of preferences. We found that physical perception (e.g., positions of the prosthetic foot, balance, and stability) and subjective feelings (e.g., comfortableness, satisfaction, confidence, and worries) were two major factors. Experiences with the intact leg and other profiles were used as anchors for their preference levels. Preferences may also differ with situational context such as walking speed. The saturation points were reached with no strong approach motivation. The implications for prosthesis design and research were discussed.

     
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  5. null (Ed.)