Objective: Configuring a prosthetic leg is an integral part of the fitting process, but the personalization of a multi-modal powered knee-ankle prosthesis is often too complex to realize in a clinical environment. This paper develops both the technical means to individualize a hybrid kinematic-impedance controller for variable-incline walking and sit-stand transitions, and an intuitive Clinical Tuning Interface (CTI) that allows prosthetists to directly modify the controller behavior. Methods: Utilizing an established method for predicting kinematic gait individuality alongside a new parallel approach for kinetic individuality, we applied tuned characteristics exclusively from level-ground walking to personalize continuous-phase/task models of joint kinematics and impedance. To take advantage of this method, we developed a CTI that translates common clinical tuning parameters into model adjustments. We then conducted a case study involving an above-knee amputee participant where a prosthetist iteratively tuned the prosthesis in a simulated clinical session involving walking and sit-stand transitions. Results: The prosthetist fully tuned the multi-activity prosthesis controller in under 20 min. Each iteration of tuning (i.e., observation, parameter adjustment, and model reprocessing) took 2 min on average for walking and 1 min on average for sit-stand. The tuned behavior changes were appropriately manifested in the commanded prosthesis torques, both at the tuned tasks and across untuned tasks (inclines). Conclusion: The CTI leveraged able-bodied trends to efficiently personalize a wide array of walking tasks and sit-stand transitions. A case-study validated the CTI tuning method and demonstrated the efficiency necessary for powered knee-ankle prostheses to become clinically viable.

翻译：目的：配置假肢是装配过程中的关键环节，但多模态动力膝踝假体的个性化调节在临床环境中往往过于复杂而难以实现。本文开发了针对变坡度行走和坐-站转换任务的混合运动学-阻抗控制器的个性化技术手段，并设计了一种直观的临床调节界面（CTI），使假肢矫形师能够直接修改控制器行为。方法：利用既有的运动学步态个体性预测方法及新提出的动力学个体性并行分析方法，我们仅通过平地行走数据提取的调节特征，实现了关节运动学与阻抗的连续相位/任务模型个性化。为应用此方法，我们开发了CTI界面，将常见的临床调节参数转化为模型调整量。随后通过一例膝上截肢参与者的案例研究，由假肢矫形师在模拟临床场景中对包含行走和坐-站转换的多任务假体进行迭代调节。结果：假肢矫形师在20分钟内完成了多活动假体控制器的完整调节。每次调节迭代（即观察、参数调整与模型重处理）平均耗时：行走任务2分钟，坐-站转换1分钟。调节后的行为变化精准体现在假体指令扭矩中，不仅在调节过的任务中如此，在未调节任务（斜坡行走）中同样有效。结论：CTI利用健全人运动趋势数据，高效实现了多种行走任务与坐-站转换的个性化调节。案例研究验证了CTI调节方法的有效性，并证明了动力膝踝假体实现临床可行性所需的调节效率。