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  1. Tham LK, Al Kouzbary M, Al Kouzbary H, Liu J, Abu Osman NA
    Phys Eng Sci Med, 2023 Dec;46(4):1723-1739.
    PMID: 37870729 DOI: 10.1007/s13246-023-01332-6
    Assessment of the prosthetic gait is an important clinical approach to evaluate the quality and functionality of the prescribed lower limb prosthesis as well as to monitor rehabilitation progresses following limb amputation. Limited access to quantitative assessment tools generally affects the repeatability and consistency of prosthetic gait assessments in clinical practice. The rapidly developing wearable technology industry provides an alternative to objectively quantify prosthetic gait in the unconstrained environment. This study employs a neural network-based model in estimating three-dimensional body segmental orientation of the lower limb amputees during gait. Using a wearable system with inertial sensors attached to the lower limb segments, thirteen individuals with lower limb amputation performed two-minute walk tests on a robotic foot and a passive foot. The proposed model replicates features of a complementary filter to estimate drift free three-dimensional orientation of the intact and prosthetic limbs. The results indicate minimal estimation biases and high correlation, validating the ability of the proposed model to reproduce the properties of a complementary filter while avoiding the drawbacks, most notably in the transverse plane due to gravitational acceleration and magnetic disturbance. Results of this study also demonstrates the capability of the well-trained model to accurately estimate segmental orientation, regardless of amputation level, in different types of locomotion task.
  2. Al Kouzbary M, Al Kouzbary H, Liu J, Shasmin HN, Arifin N, Osman NAA
    PMID: 39230205 DOI: 10.1080/10255842.2024.2399023
    The aim of the present study is to investigate the complexity and stability of human ambulation and the implications on robotic prostheses control systems. Fourteen healthy individuals participate in two experiments, the first group run at three different speeds. The second group ascended and descended stairs of a five-level building block at a self-selected speed. All participants completed the experiment with seven inertial measurement units wrapped around the lower body segments and waist. The data were analyzed to determine the fractal dimension, spectral entropy, and the Lyapunov exponent (LyE). Two methods were used to calculate the long-term LyE, first LyE calculated using the full size of data sets. And the embedding dimensions were calculated using Average Mutual Information (AMI) and the False Nearest Neighbor (FNN) algorithm was used to find the time delay. Besides, a second approach was developed to find long-term LyE where the time delay was based on the average period of the gait cycle using adaptive event-based window. The average values of spectral entropy are 0.538 and 0.575 for stairs ambulation and running, respectively. The degree of uncertainty and complexity increases with the ambulation speed. The short term LyEs for tibia orientation have the minimum range of variation when it comes to stairs ascent and descent. Using two-way analysis of variance we demonstrated the effect of the ambulation speed and type of ambulation on spectral entropy. Moreover, it was shown that the fractal dimension only changed significantly with ambulation speed.
  3. Khamis T, Khamis AA, Al Kouzbary M, Al Kouzbary H, Mokayed H, AbdRazak NA, et al.
    Artif Intell Med, 2024 Oct;156:102966.
    PMID: 39197376 DOI: 10.1016/j.artmed.2024.102966
    This comprehensive systematic review critically analyzes the current progress and challenges in automating transtibial prosthesis alignment. The manual identification of alignment changes in prostheses has been found to lack reliability, necessitating the development of automated processes. Through a rigorous systematic search across major electronic databases, this review includes the highly relevant studies out of an initial pool of 2111 records. The findings highlight the urgent need for automated alignment systems in individuals with transtibial amputation. The selected studies represent cutting-edge research, employing diverse approaches such as advanced machine learning algorithms and innovative alignment tools, to automate the detection and adjustment of prosthesis alignment. Collectively, this review emphasizes the immense potential of automated transtibial prosthesis alignment systems to enhance alignment accuracy and significantly reduce human error. Furthermore, it identifies important limitations in the reviewed studies, serving as a catalyst for future research to address these gaps and explore alternative machine learning algorithms. The insights derived from this systematic review provide valuable guidance for researchers, clinicians, and developers aiming to propel the field of automated transtibial prosthesis alignment forward.
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