Article

Transfemoral amputees have decreased ability to descend ramps and
hills. The Hill Assessment Index quantifies transfemoral amputee ramp
performance, but interrater reliability has not been assessed. Objectives: To
determine whether C-Leg use improves hill descent gait and evaluate the Hill
Assessment Index's interrater reliability. Methods: Twenty-one transfemoral
amputees descended a ramp while timed and video recorded, using their
nonmicroprocessor prosthetic knee. Subjects were fitted and accommodated with a
C-Leg and retested. Test times were compared, and ramp performances were
independently reviewed using the Hill Assessment Index by two raters. Hill
Assessment Index scores were compared between knee conditions within raters for
performance and between raters to assess the Hill Assessment Index's interrater
reliability. Results: Mean Hill Assessment Index scores were greater for C-Leg
compared to nonmicroprocessor prosthetic knee for both raters. C-Leg resulted in
faster ramp descent. Strong correlations resulted between raters on Hill
Assessment Index scores for nonmicroprocessor prosthetic knee (intraclass
correlation coefficient = 0.97) and C-Leg (intraclass correlation coefficient =
0.99). Conclusions: C-Leg improves Hill Assessment Index ramp descent performance
and time. In descent quality, C-Leg offers the possibility of eliminating
assistive device use and/or improving step length in the absence of an assistive
device. C-Leg resulted in 23% gait speed increase during ramp descent. The Hill
Assessment Index had very good interrater reliability but should be assessed for
intrarater reliability, minimal detectable change, and validity. Clinical
relevance Transfemoral amputees have difficulty ambulating on ramps. While the
C-Leg has been shown to improve ramp descent, this has not been confirmed, and
the Hill Assessment Index has not been studied for reliability. This study
confirms that the C-Leg improves ramp descent performance and the Hill Assessment
Index's interrater reliability.

Langue : ANGLAIS