Microprocessor Knees BACPAR Annual Conference 2015 - Rachel Neilson - Academy Clinician
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Microprocessor Knees BACPAR Annual Conference 2015 Rachel Neilson – Academy Clinician
Introduction
Goals of MPK Provision
Improve the quality of life for the
specific end user by:
• Provide enhanced safety
• knee functions can be adapted to
the user’s capabilities
• reduce needed compensatory
movements and aids as much as
possible
• Broader group of patients
• Broader range of ADL’s
– Intuitive handling for the user
– Improved fitting result for user &
MDT
Bacpar presentation Nov 2015
Introduction
Goal – Improve the quality of life for specific end users
• Better integration into the
individual’s own body image
• Greater acceptance of the
prosthetic device
• Intelligent energy management
• Higher Safety for maximum user
acceptance
Bacpar presentation Nov 2015| © Ottobock
Introduction
Sensor technology inside the MPK
• Detected parameters (sampling rate: 100 Hz)
- Axial load
- Ankle moment
- Knee moment
- Linear accelerations
- Knee angle (+ velocity)
- Shank inclination (+ velocity)
• Calculated parameters
- Ground Reaction Force (GRF)
- Center of Pressure (COP)
- Distance from force vector to center of
knee rotation
Bacpar presentation Nov 2015 06/11/2015 | © Ottobock
Introduction
Functional sequence of prosthetic control
Processor
Input signals C-Leg 4 Output signals
Knee angle Servo motor
Knee moment Flexion valve
Linear accelerations
Shank inclination
Servo motor
Angular velocities Extension valve
Bacpar presentation Nov 2015 06/11/2015 | © Ottobock
Family of Micro Processor Knees
Kenevo C leg4 Genium X3
Bacpar presentation Nov 2015 06/11/2015 | © Ottobock
Kenevo
| © Ottobock
Introduction Kenevo
Basic functions
Sitting down Wheelchair/Sitting Standing up Standing
SSafety
(Mode C)
In general
• Are always active
• Created for the specific needs of MG1 and MG2 users
• Are intuitive functions
Bacpar presentation Nov 2015 | © Ottobock
Introduction
Modes
Only indoor Many outdoor activities
10°
Bacpar presentation Nov 2015 | © Ottobock
Explanation of activity modes
Choose the right mode for the user
Basic questions:
Can the user safely walk with a flexed knee during swing phase?
Does the user walk with a step-to gait or closer to a symmetrical gait?
Is a non step-to gait possible at different walking speeds?
Can the user load the forefoot during terminal stance phase?
Can the user flex his hip at different walking speeds?
Bacpar presentation Nov 2015 | © OttobockIntroduction to Training Methodology
Modes –Prerequisites
Mode C
Mode B Mode B+ Able to walk with
Able to walk Able to walk alternating steps!
Mode A with with alternating Able to control knee
Not able to alternating steps! flexion during swing
control knee steps! Able to control Able to control a
flexion Able to control knee flexion yielding knee joint
during swing knee flexion during swing during walking
phase during swing Accept Benefit from a
bouncing yielding knee joint
Bacpar presentation Nov 2015 | © OttobockMode A
Unlocking the knee joint
Basic exercises – do in parallel bars
• Standing – prosthesis a little bit ahead
„Nose
towards • Load prosthesis (15 – 70% of bodyweight)
the toes“
• Sit down (= usual way to sit)
– Trunk leans forward
– Hands go to armrests (ipsilateral hand first – often easier)
– Move hip rotation point backwards fluidly and sit down
Main unlocking criteria:
= backward rotation of lower leg + knee flexion moment
3C60 User training | Esther Brücker | Academy | 02.04.2015 | © Ottobock 13Mode A
Unlocking the knee joint
Supported standing up/sitting down
This function can be useful for transfer purposes – e.g.
repositioning of the hands, taking something off the chair…
1. Start to sit down – stop, feel knee is locked
– continue to sit down
(move hip rotation point further backwards)
2. Stand up – stop, feel knee is locked
– continue to stand up
Keep center of mass over the feet
Unlock criteria are the same as for “sitting down”
3C60 User training | Esther Brücker | Academy | 02.04.2015 | © Ottobock 14Mode A
Unlocking the knee joint
Supported standing up/sitting down
This function can be useful for transfer purposes – e.g.
repositioning of the hands, taking something off the chair…
1. Start to sit down – stop, feel knee is locked
– continue to sit down
(move hip rotation point further backwards)
2. Stand up – stop, feel knee is locked
– continue to stand up
Keep center of mass over the feet
Unlock criteria are the same as for “sitting down”
Bacpar presentation Nov 2015 | © OttobockC-Leg 4
| © OttobockComponent selection
MPK C leg 4 Mobility 2,3,4
Total new concept to previous Versions
New Technology ( IMU)
Improved Safety Features
Additional Modes
Cockpit App
Easier use for User and MDT
Recordable Data
Bacpar presentation Nov 2015 06/11/2015 | © OttobockAlignment and adjustment
Activities
The prosthetist first has to activate
the data storage! The activity
measurement can be reset and also
deactivated at any time!
Bacpar presentation Nov 2015 06/11/2015 | © OttobockAlignment and adjustment
Activities – Distribution
• The activity
monitoring
collects different
kind of gait data
(e.g. amount of
steps, average
walking speed...)
• The data is
displayed in a
numerical or
graphical way in
C-Soft Plus and
X-Soft 1.4
Alignment and adjustment | Genium 3B1-2 | Academy | 06.11.2015 | © Ottobock 19User training
Basic training with C-Leg 4
• The “Step by Step” DVD from the old
C-Leg serves as basis for the training
with C-Leg 4
• The training program can be used with
only some minor exceptions (e.g.
stance release training)
• For some new functionalities of C-Leg
4 (e.g. intuitive stance function) there
are no exercises on the “Step by Step”
DVD
• Physiotherapist Training Courses
available
Bacpar presentation Nov 2015 06/11/2015 | © OttobockGenium
| © OttobockComponent selection
MPK Mobility 2,3,4 Genium and Genium X3
• Sophisticated Technology
• Improved Battery technology
• Improved gait with OPG
• Improved alignment CAA
• Easier use for User & MDT
• Weatherproof & Waterproof
• Additional Modes
Bacpar presentation Nov 2015 06/11/2015 | © OttobockUser Function ADVANCED
Stance function
• Standing on a decline (e.g. ramp)
• Load the prosthesis increasingly
without moving the knee joint → joint
locks
• If the prosthesis is moved, the flexion
damping is reduced instantly
• Everyday life example: Relaxed
standing on a ramp
Bacpar presentation Nov 2015 06/11/2015 | © OttobockUser training
Overcoming an obstacle ADVANCED
Always start between parallel bars
With contralateral side first
– Overcome the obstacle
– Pull the prosthesis over the obstacle
(whip movement)
With the prosthesis first
– Do the whip movement
– Overcome the obstacle
– Step on the heel with the bent and
locked knee joint
– Pull the sound leg over the obstacle
Vary the size of the obstacles
26 | © OttobockUser Training ADVANCED
Stairs function
• Hold the contralateral hand rail
• Trigger the whip movement → place the
prosthetic foot flat on the higher ste
• Through active extension of the residual limb the
user can push himself upstairs
• The center of gravity (pelvis) is moving forward
and upward (line of vision straight ahead)
• If necessary, support the patient by guiding the
pelvis and the knee joint
• FULL TRAINING COURSE AVAILABLE
Bacpar presentation Nov 2015 06/11/2015 | © OttobockBacpar presentation Nov 2015 06/11/2015 | © Ottobock
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