Article

OBJECTIVE: To investigate and identify functional differences of 4
microprocessor-controlled prosthetic knee joints (C-Leg, Hybrid Knee [also called
Energy Knee], Rheo Knee, Adaptive 2). DESIGN: Tested situations were walking on
level ground, on stairs and ramps; additionally, the fall prevention potentials
for each design were examined. The measuring technology used included an
optoelectronic camera system combined with 2 forceplates as well as a mobile
spiroergometric system. SETTING: The study was conducted in a gait laboratory.
PARTICIPANTS: Subjects with unilateral transfemoral amputations (N=9; mobility
grade, 3-4; age, 22-49y) were tested. INTERVENTIONS: Participants were fitted and
tested with 4 different microprocessor-controlled knee joints. MAIN OUTCOME
MEASURES: Static prosthetic alignment, time distance parameters, kinematic and
kinetic data and metabolic energy consumption. RESULTS: Compared with the Hybrid
Knee and the Adaptive 2, the C-Leg offers clear advantages in the provision of
adequate swing phase flexion resistances and terminal extension damping during
level walking at various speeds, especially at higher walking speeds. The Rheo
Knee provides sufficient terminal extension; however, swing phase flexion
resistances seem to be too low. The values for metabolic energy consumption show
only slight differences during level walking. The joint resistances generated for
descending stairs and ramps relieve the contralateral side to varying degrees.
When walking on stairs, safety-relevant technical differences between the
investigated joint types can be observed. Designs with adequate internal
resistances offer stability advantages when the foot is positioned on the step.
Stumble recovery tests reveal that the different knee joint designs vary in their
effectiveness in preventing the patient from falling. CONCLUSIONS: The patient
benefits provided by the investigated electronic prosthetic knee joints differ
considerably. The C-Leg appears to offer the amputee greater functional and
safety-related advantages than the other tested knee joints. Reduced loading of
the contralateral side has been demonstrated during ramp and stair descent.
Metabolic energy consumption does not vary significantly between the tested
knees. Hence, this parameter seems not to be a suitable criterion for assessing
microprocessor-controlled knee components.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS