Wearer-Prosthesis Interaction for Symmetrical Gait: A Study Enabled by Reinforcement Learning Prosthesis Control.

With advances in robotic prostheses, rese-archers attempt to improve amputee's gait performance (e.g., gait symmetry) beyond restoring normative knee kinematics/kinetics. Yet, little is known about how the prosthesis mechanics/control influence wearer-prosthesis' gait performance, such as gait symmetry, stability, etc. This study aimed to investigate the influence of robotic transfemoral prosthesis mechanics on human wearers' gait symmetry. The investigation was enabled by our previously designed reinforcement learning (RL) supplementary control, which simultaneously tuned 12 control parameters that determined the prosthesis mechanics throughout a gait cycle. The RL control design facilitated safe explorations of prosthesis mechanics with the human in the loop. Subjects were recruited and walked with a robotic transfemoral prosthesis on a treadmill while the RL controller tuned the control parameters. Stance time symmetry, step length symmetry, and bilateral anteroposterior (AP) impulses were measured. The data analysis showed that changes in robotic knee mechanics led to movement variations in both lower limbs and therefore gait temporal-spatial symmetry measures. Consistent across all the subjects, inter-limb AP impulse measurements explained gait symmetry: the stance time symmetry was significantly correlated with the net inter-limb AP impulse, and the step length symmetry was significantly correlated with braking and propulsive impulse symmetry. The results suggest that it is possible to personalize transfemoral prosthesis control for improved temporal-spatial gait symmetry. However, adjusting prosthesis mechanics alone was insufficient to maximize the gait symmetry. Rather, achieving gait symmetry may require coordination between the wearer's motor control of the intact limb and adaptive control of the prosthetic joints. The results also indicated that the RL-based prosthesis tuning system was a potential tool for studying wearer-prosthesis interactions.