Human-prosthesis cooperation: combining adaptive prosthesis control with visual feedback guided gait.
Bretta L Fylstra, I-Chieh Lee, Minhan Li and 2 others
PMID 36517814WHAT IT FOUND
Combining visual feedback for stance time with automatic prosthesis tuning did not speed up tuning or improve gait symmetry in amputees.
Participants reverted to baseline stance times ten minutes after feedback was removed, showing no lasting benefit.
Key findings
01Visual feedback did not accelerate the automatic tuning of prosthesis control parameters for individuals with amputation; in fact, it required more iterations for most.
02While participants could increase prosthesis-side stance time during feedback, this change was not retained ten minutes after feedback was removed.
03There was no significant difference in stance time or symmetry between the prosthesis control parameters tuned with increased stance time feedback and those tuned without feedback.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was very small (4 individuals with amputation), limiting the generalizability of the findings. The majority of participants (7 out of 11) were able-bodied individuals wearing a prosthesis adapter, which may not fully replicate the biomechanics and experience of true amputees. The study was conducted on a treadmill, which does not reflect overground walking conditions. The retention of gait changes was only assessed after a 10-minute break, so longer-term effects are unknown. One amputee participant (TF02) showed a significant decrease in margin of stability with feedback, suggesting that visual feedback may interfere with balance for some users.
Declared interests
The study was funded by the National Institutes of Health. The text does not report any commercial conflicts of interest, though it mentions commercially available devices (Ottobock, Össur) used in the background.
The easy way to misread this
Do not interpret the lack of tuning speed improvement in amputees as a failure of the concept itself, but rather as evidence that human motor control and balance challenges interfere with the interaction. Also, do not assume that the short-term stance time increase seen during feedback will lead to lasting gait changes, as the effects disappeared within ten minutes.