Biomechanical Effects of Stiffness in Parallel With the Knee Joint During Walking.

The human knee behaves similarly to a linear torsional spring during the stance phase of walking with a stiffness referred to as the knee quasi-stiffness. The spring-like behavior of the knee joint led us to hypothesize that we might partially replace the knee joint contribution during stance by utilizing an external spring acting in parallel with the knee joint. We investigated the validity of this hypothesis using a pair of experimental robotic knee exoskeletons that provided an external stiffness in parallel with the knee joints in the stance phase. We conducted a series of experiments involving walking with the exoskeletons with four levels of stiffness, including 0%, 33%, 66%, and 100% of the estimated human knee quasi-stiffness, and a pair of joint-less replicas. The results indicated that the ankle and hip joints tend to retain relatively invariant moment and angle patterns under the effects of the exoskeleton mass, articulation, and stiffness. The results also showed that the knee joint responds in a way such that the moment and quasi-stiffness of the knee complex (knee joint and exoskeleton) remains mostly invariant. A careful analysis of the knee moment profile indicated that the knee moment could fully adapt to the assistive moment; whereas, the knee quasi-stiffness fully adapts to values of the assistive stiffness only up to ∼80%. Above this value, we found biarticular consequences emerge at the hip joint.