Robotic
Advances Promise Artificial Legs That Emulate Healthy Limbs
Recent advances in robotics
technology make it possible to create prosthetics that can duplicate the
natural movement of human legs. This capability promises to dramatically
improve the mobility of lower-limb amputees, allowing them to negotiate stairs
and slopes and uneven ground, significantly reducing their risk of falling as
well as reducing stress on the rest of their bodies.
For the last decade, Goldfarb's team has been doing pioneering
research in lower-limb prosthetics. It developed the first robotic prosthesis
with both powered knee and ankle joints. And the design became the first
artificial leg controlled by thought when researchers at the Rehabilitation
Institute of Chicago created a neural interface for it.
In the article, Goldfarb and graduate students Brian Lawson and
Amanda Shultz describe the technological advances that have made robotic
prostheses viable. These include lithium-ion batteries that can store more
electricity, powerful brushless electric motors with rare-Earth magnets,
miniaturized sensors built into semiconductor chips, particularly
accelerometers and gyroscopes, and low-power computer chips.
The size and weight of these components is small enough so that
they can be combined into a package comparable to that of a biological leg and
they can duplicate all of its basic functions. The electric motors play the
role of muscles. The batteries store enough power so the robot legs can operate
for a full day on a single charge. The sensors serve the function of the nerves
in the peripheral nervous system, providing vital information such as the angle
between the thigh and lower leg and the force being exerted on the bottom of
the foot, etc. The microprocessor provides the coordination function normally
provided by the central nervous system. And, in the most advanced systems, a
neural interface enhances integration with the brain.
Unlike passive artificial legs, robotic legs have the capability
of moving independently and out of sync with its users movements. So the
development of a system that integrates the movement of the prosthesis with the
movement of the user is "substantially more important with a robotic
leg," according to the authors.
Not only must this control system coordinate the actions of the
prosthesis within an activity, such as walking, but it must also recognize a
user's intent to change from one activity to another, such as moving from
walking to stair climbing.
Identifying the user's intent requires some connection with the
central nervous system. Currently, there are several different approaches to
establishing this connection that vary greatly in invasiveness. The least
invasive method uses physical sensors that divine the user's intent from his or
her body language. Another method -- the electromyography interface -- uses
electrodes implanted into the user's leg muscles. The most invasive techniques
involve implanting electrodes directly into a patient's peripheral nerves or
directly into his or her brain. The jury is still out on which of these
approaches will prove to be best. "Approaches that entail a greater degree
of invasiveness must obviously justify the invasiveness with substantial
functional advantage…," the article states.
There are a number of potential advantages of bionic legs, the
authors point out.
Studies have shown that users equipped with the lower-limb
prostheses with powered knee and heel joints naturally walk faster with
decreased hip effort while expending less energy than when they are using
passive prostheses.
In addition, amputees using conventional artificial legs
experience falls that lead to hospitalization at a higher rate than elderly
living in institutions. The rate is actually highest among younger amputees,
presumably because they are less likely to limit their activities and terrain.
There are several reasons why a robotic prosthesis should decrease the rate of
falls: Users don't have to compensate for deficiencies in its movement like
they do for passive legs because it moves like a natural leg. Both walking and
standing, it can compensate better for uneven ground. Active responses can be
programmed into the robotic leg that helps users recover from stumbles.
Before individuals in the U.S. can begin realizing these benefits,
however, the new devices must be approved by the U.S. Food and Drug
Administration (FDA).
Single-joint devices are currently considered to be Class I
medical devices, so they are subject to the least amount of regulatory control.
Currently, transfemoral prostheses are generally constructed by combining two,
single-joint prostheses. As a result, they have also been considered Class I
devices.
In robotic legs the knee and ankle joints are electronically
linked. According to the FDA that makes them multi-joint devices, which are
considered Class II medical devices. This means that they must meet a number of
additional regulatory requirements, including the development of performance
standards, post-market surveillance, establishing patient registries and
special labeling requirements.
Another translational issue that must be resolved before robotic
prostheses can become viable products is the need to provide additional
training for the clinicians who prescribe prostheses. Because the new devices
are substantially more complex than standard prostheses, the clinicians will
need additional training in robotics, the authors point out.
In addition to the robotics leg, Goldfarb's Center for Intelligent
Mechatronics has developed an advanced exoskeleton that allows paraplegics to
stand up and walk, which led Popular Mechanics magazine to name him as one of
the 10 innovators who changed the world in 2013, and a robotic hand with a
dexterity that approaches that of the human hand.