Design and evaluation of a stance-control knee-ankle-foot orthosis knee joint.

Conventional knee-ankle-foot orthoses (KAFOs) are prescribed for people with knee-extensor muscle weakness. However, the orthoses lock the knee in full extension and, therefore, do not permit a natural gait pattern. A new electromechanical stance-control knee-ankle-foot orthosis (SCKAFO) knee joint that employs a novel friction-based belt-clamping mechanism was designed to enable a more natural gait. The SCKAFO knee joint allows free knee motion during swing and other non-weight-bearing activities and inhibits knee flexion while allowing knee extension during weight bearing. A prototype SCKAFO knee joint was mechanically tested to determine the moment at failure, loading behavior, and wear resistance. The mean maximum resisting moment of the SCKAFO knee joint over five loading trials was 69 Nm +/- 4.9 Nm. The SCKAFO knee-joint strength and performance were sufficient to allow testing on a 90 kg subject at normal walking cadence. Proper function of the new electromechanical knee joint was verified in walking trials of an able-bodied subject.