Available functions in Common Various Micro Processor

Gait in Normalcy,
Prosthetic Knee Controlled Knee Units
Ankle Knee
designs available
Functions
  Weight Acceptance
 Single limb Support
 Limb Advancement

 Energy consumption &

stable kinetic chain

To understand normal knee functions

To understand importance of knee

 Repeated, Rhythmic Sequence of

events of lower limb
 Translates the Body
 Ankle Knee Hip
Neutral Close to full Extn Flxn 30 degrees

GRF at heel strike:

Posterior to ankle –P.Flxn moment

Anterior to the Knee – Extensor Torque
Anterior to Hip Axis – Flexion torque

Heel rocker rolls

GRF at Loading Response:

Greater than Body Weight at peak

 Initial Limb Stability

 Shock absorption
 Preservation of Forward Momentum along with stability
 • Body Weight travels along stance limb
• The ankle rocker activated &tibia
rolls/glides over talus(regulated by
gastro - soleus)
• Eccentric action of Plantarflexors offer
stability at knee
• Toe rocker at terminal stance

 Single closed kinetic pillar

 Weight taking capacity
 • Knee: 35 to 40 degrees of flexion at pre
swing
(Passive because of GRF)
• Initial Swing – Dorsiflexors ,Short head of
biceps(IS) till 60 degrees of knee flexion
ensures Toe Clearance
• Quadriceps for extension momentum at M.Sw
• Preparation for heel contact in Terminal
Swing
Ankle Knee Hip
Dorsiflexion to Flxn to extension then to Extension to Flexion
plantarflexion flexion

 Controlled Knee Flexion and Extension, Toe Clearance

 Flow of limb in air from one point to another
 Heel Foot Mid Heel off Toe Off Acc Mid Dec.
Strike Flat Stance Swing Swing swing
Hip 300 Flxn 200Flxn 00 100 – 200 Extn 50 – 200 Flxn 300 Flxn
150 Extn 100 Flxn
Knee 00 200 150-50 Full 400 650 300 50-00
Flxn Flxn Extn Flxn Flxn Flxn Flxn
Ankle 00 150 20-30 150 200 20-50 00 00
pflxn D.F Dorsi Plantar Plantar
Stance:
•Ability to Absorb the Shock
•Ability to Accept the Weight
•Ability to stand as a Pillar offering Stability
•Ability to withstand against buckling
•Shortening after Toe off

Swing:
• Smooth transition from stance, flex and extend
• To mimic the normal gait as much as possible
e.g, shock absorption to limb shortening
• To accommodate according to the need of patient
e.g. to accommodate the speed variations
• To be long Lasting
• Comfort to Use
• Cosmetically good
• Nil/Less maintenance
• Less in Weight
• Less in Price
• Other ADL Activities: Step Climbing, Sitting & Standing
Stability(Stance)
Intrinsic : Bone Length, Muscle Strength

Extrinsic : Alignment
Offsetting the axis by knee design
e.g. Four Bar Linkage
Offsetting the axis by Socket and shin Alignment
Locking the Knee unit by Manual, Automatic, Semi Automatic
Increasing the Resistance against Flexion(Hydraulic,
Pneumatic)
Mobility(Swing):

Assist : Elastic, Hydraulic/Pneumatic

Cylinders

Friction: Mechanical Resistance through

screws
 Knee Designs

Computerized
Mechanical

Single Axis
Poly Centric
along with additional mechanisms for stability manual, weight-activated
locking systems and mechanism for control of motion, Constant/variable
friction and “fluid” pneumatic or hydraulic control).
• Walking Speed is Constant(single cadence) & determined by
amount of friction. (On other hand Prosthesis is not able to cope up
to the patients speed) – seen in single axis with friction control
• Patient to be Hazardous about Buckling of knee while applying
load over the prosthesis(from heel contact to Loading Response)
• Energy consumption may go high(manual Locking Knee, Knees that
doesn’t allow shortening of shin, offset knee axis units)
• Knees that provide variable cadence, stability are heavier in
weight, High in Cost and requires more maintenance
• Kinesthetic feedback is not achieved till recent past(Patient need
to be cautious about the placement of foot and knee, ankle
positions to step)
• Prosthetic Settings(e.g Friction, Extension/Flexion Controls)are
set according to the patients cadence.

• Settings done for slower cadence will not be suitable for other
situations like uneven terrain, faster walking
Settings of walking down stairs Vs Ramp Climbing
Settings of slow walk Vs Speed Walking

• The microprocessor knee ensures that the prosthesis is always in

the correct and optimum position for the above-knee amputee
during walking.

• The processor will not allow the knee to go into free swing until
certain parameters are met.
The microprocessor will prevent the knee from
bending or collapsing at heel contact.
The knee will enable STANCE FLEXION, which is a
minor flexion of the knee which acts like a shock
absorber for the wearer allowing for a more natural
and smooth gait.• Non-computer knees have to be
forced back into extension to prevent the knee from
bending and the patient from falling.
• Ensures the optimum degree of knee resistance to
ensure the knee will not collapse or bend when weight
is applied.

• Monitors the weight and stress applied to the knee.

In case of additional weight lifting

recognizes the additional load

Provides more resistance

• As the toe leaves the ground, initiates the swing phase

• Continues relay of data is being sent to Processor

through Sensors

• So the speed at which the patient is walking is

calculated

• The Resistance or Assistance for Flexing the Knee is

signaled to motors
• Ensures the knee resistance is appropriate for the
speed the wearer is walking.
• If the wearer is walking fast or running, the knee must
swing quickly to ensure it is in the proper position for
heel contact;
• If the wearer is walking slow, the knee must swing at
a lower speed.
• Ensures the knee is swinging at the appropriate
speed regardless of the how often and how quickly
the wearer changes walking speeds throughout the
day.
• The sensor sends the data about the relative position
of ankle, Knee to the processor

• The processor recognizes wearer is on a slope and

automatically initiate “ramp mode” or adjusts the
knee to be stabilized untill the forefoot is being
loaded(i.e heel off)

• Then the Knee starts bending

• The wearer will be able to walk directly down slopes

step over step without fear of the knee bending and
collapsing.
• The onboard monitor will immediately recognize that
the wearer is descending stairs and automatically
initiate “stair mode”.
• The microprocessor provides appropriate resistance
to knee bending which enables the wearer to walk
down stairs step over step.
• Stance control will prevent falls while walking on uneven
ground or slippery surfaces.

• Monitors the position and stability of the knee.

• If the prosthesis experiences any unexpected forces or

conditions, the computer will immediately initiate the
settings to ensure the knee is at maximum security and
stability.
• The onboard computer will sense when the wearer
wants to sit down, the internal sensors will adjust the
resistance of the knee to allow the wearer to “ride the
knee down” to a seated position.
• For standing, allows the knee to extend freely to full
upright position providing maximum resistance to
bending.
• If the wearer were to lose his/her balance while
standing and put weight on the prosthesis, the knee will
automatically be ready with the programme of
maximum resistance and stability, thus preventing a fall.
• Uses
• Components
• Working On
• Various types
• Latest Advancements
• Drawbacks
• Improves balance
• Enhances stability to prevent falls and stumbles.
• Keeps up with quicker walking pace.
• Enables changes in walking speed quickly and efficiently
• Ensures stability on uneven ground
• Provides security and confidence for walking in public areas
• Allows for walking down ramps step over step
• Enables descent of stairs step over step
• Conserves energy during the day
By Ottobock:
C Leg, C leg Compact & Genium
By Blatchford:
Orion, Adaptive, I.P Series
By Ossur
Rheo Knee & Power Knee
By Nabtesco
Hybrid Knee & Nabtesco Four-bar
Intelligent Knee
• 1993 – Intelligent Prosthesis by Blatchford
• 1999 – C – Leg
• 2005 – Rheo Knee
• 2006 – Power Knee
• Nabtesco Microprocessor Controlled Knees
• Single Axis Knee Unit with Micro Processor
• Hydraulic Cylinder
• Knee angle Sensor and Moment sensor
• Li – Ion Battery
• Sensors to relay 50 times per second
• Compact is the modified version with minor changes
Component Weight : 1.179 Kgs

Weight Limit : 124. 73 Kgs

Stance Control : Hydraulic

Swing Control : Hydraulic

Build Height : 25 Cms

Battery : Rechargeable li

Foot Options : Limited

M.P Stance : + nt

M.P Swing : + nt

Stance Flexion : + nt

Second Mode : + nt
• In 1999
• On Board Micro Processor to adjust both stance and swing
• In Stance complete stability through sensor details to readjust
the hydraulic resistance
• First Knee having Micro Processor to control both stance and
swing unlike Intelligent Prosthetic Micro Processor that controls
only swing)
• The C-leg will not release its stance control until the knee reads
full extension and 70% of toe load.
• Improved swing phase control.

• Higher weight limit.

• Improved stumble recovery.

• A third mode.

• Adjustable safety mode.

• Improved protection.
• First Micro Processor Knee Unit
• Single Axis Knee with Drum Brake
Mechanism
• Pneumatic Cylinder
• Solenoid Switch

• So the Stance Flexion advantage, Swing

Control advantage

• Given for K3 level activities

Single Axis Knee, Weight activated drum brake mechanism

Pneumatic Cylinder with solenoid switch

Micro Processor controls the air flow within pneumatic cylinder

Solenoid switch works as sensors

Adjustable stance flexion option

Battery life expectancy 9-12 months

135° - 140° knee flexion

Remote handheld programmer required

24 month warranty
Component Weight : 1.2 Kgs(2lbs 12 ounce)

Weight Limit : 124.74 Kgs(275 lbs)

Stance Control : Drum brake

Swing Control : Pneumatic + Micro processor

Build Height : 23.8 & 26 Cms

Battery : Rechargeable

Foot Options : Unlimited

M.P Stance : - nt

M.P Swing : + nt

Stance Flexion : + nt
• Programmable by Prosthetist with hand Held device
• Smart I.P – Self Programmable
• Modes:
Slow, Medium, Fast
• Allows comfortable gait at
slow speeds
• Enhanced range of walking
speeds, and smoother gait
through program optimization
• Stance flex option allows for
enhanced comfort while
mimicking natural knee
movement
• Battery life expectancy 9-12
months under normal usage
• 135° - 140° knee flexion
• No training course required
• 36 month warranty
• Microprocessor hybrid control -
hydraulic stance, pneumatic
swing
• Smart Programming
• 140° knee flexion
• Stance flex for comfort and
smooth progression through the
gait cycle
• Stumble and support mode
• On-board batteries last up to 14
days on a single charge
• 36 month warranty
• K3 – k4 Activity level patients
Component Weight : 1.01 Kgs

Weight Limit : 100 Kgs

Stance Control : Four Bar Linkage

Swing Control : Micro Processor, Pneumatic

Build Height : 26.7 Cms(~10”)

Battery : Rechareable li

Foot Options : Unlimited

M.P Stance : + nt

M.P Swing : + nt

Stance Flexion : + nt
A proximity sensor within the microprocessor
Detects time taken for each walking cycle, using
knee joint flexion data.

The microprocessor then signals a stepping motor

within the unit which in turn activates the needle
valve of the pneumatic cylinder causing it to
adjust to the patients walking speed.
Initial programming involves setting the cylinder
to 3 different walking speeds (slow, normal and
fast) for the individual user.

This then produces a range of 10 different

walking speeds within their particular programme
to allow smooth transition within a wide cadence
range.
Component Weight : 1.01 Kgs

Weight Limit : 100 Kgs

Stance Control : Hydraulic, MRS

Swing Control : Micro Processor, Pneumatic

Build Height : 26.7 Cms(~10”)

Flexion Range : 140 Degrees

Battery : Rechareable li

Foot Options : Unlimited

M.P Stance : + nt

M.P Swing : + nt

Stance Flexion : + nt
• A mechanical sensor senses pressure along the foot.

• The system controls yielding depending on the current

location of the ground reaction force.

• Controlled by the MRS(Mechanism of Reaction force

Scensing) system, when the heel contacts the ground,
the hydraulic system is triggered to ensure user
safety.

• When force is detected at the toe end, the hydraulic

resistance is released for smooth transition to the
swing phase.

• The MRS system enables a more natural walking

rhythm.

• Only have to replace the batteries every couple of

years.
• Microprocessor monitors walking
speed, automatically adjusts the
swing speed of the knee joint. This
enables the user to freely change
walking speed.

• Pneumatic cylinder harmonizes a

soft and light motion from the time
when the knee initiates the swing.
This allows the residual leg to work
much less.
• Having to swing the leg less
strongly, the user performs less work
and suffers less fatigue
Component Weight : 1.54 Kgs

Weight Limit : 90.71 Kgs

Stance Control : Magneto Rheological

Swing Control : Magneto Rheological

Build Height : Cms(~”)

Battery : Rechareable li

Foot Options : Unlimited

M.P Stance : + nt

M.P Swing : + nt

Stance Flexion : + nt
• Magnetized fluid provides frictional resistance to flexion and
extension movement

• The software in the micro-processor has artificial intelligence

capable of independent thought, it learns how the user walks,
recognizing and responding immediately to changes in speed,
load and terrain.

• The Rheo was designed for someone with voluntary control of

their limb and which do not require inherent stance control
• First and only motor- POWER KNEE™ Product Information
powered, artificially
2.7kg (6lbs) w/o
intelligent prosthesis for Net Weight:
battery

above-knee amputees Battery Weight: 0.49kg (1.1lbs)

Build Height: 275mm (10 13/16")

Knee Flexion: 120

Minimum Clearance: 380mm (14 15/16")

Aluminum Frame
Construction
Other:
Internal Extension Assist
• Uses Gyrometer,
Accelerometer in the
knee

• The Resistance to the

hydraulic cylinders are
dependent by the
signals from these
monitors to the
microprocessors
• Too Expensive

• Limitations in fitting length

• Maintenance