Design and Evaluation of a Knee-Extension-Assist
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Quadriceps muscle weakness is a condition that can result from a wide variety of causes, from diseases like polio and multiple sclerosis to injuries of the head and spine. Individuals with weakened quadriceps often have difficulty supplying the knee-extension moments required during common mobility tasks. Existing powered orthoses that provide an assistive knee-extension moment are large and heavy, with power supplies that generally last less than two hours. A new device that provides a knee-extension-assist moment was designed to aid an individual with quadriceps muscle weakness to stand up from a seated position, sit from a standing position, and walk up and down an inclined surface. The knee-extension-assist (KEA) was designed as a modular component to be incorporated into existing knee-ankle-foot-orthoses (KAFO). The KEA consists of three springs that are compressed, as the knee is flexed under bodyweight, by cables that wrap around a sheave at the knee. The KEA returns the stored energy from knee flexion as an extension moment during knee extension. During swing or other non-weight bearing activities, the device is disengaged from the KAFO by decoupling the sheave from the KAFO knee joint, allowing free knee joint motion. A prototype was built and mechanically tested to determine KEA behaviour during loading and extension and to ensure proper KEA function. For biomechanical evaluation, able-bodied subjects used the prototype KEA while performing sit-to-stand, stand-to-sit, ramp ascent, and ramp descent tasks. The KEA facilitated sitting and standing, providing an average of 53 % of the required extension moment for the two participants, which allowed one participant to reduce quadriceps usage by 38 % and the other to perform sit-to-stand in a slower and more controlled manner that was not possible without the KEA. KEA use during ramp gait caused an overall increase in quadriceps activation by 76 %, on average, with use. Future efforts will be made to modify the design to improve functionality, especially for ramp gait, and to reduce device size and weight.