Article

Prosthetic knees are a vital component in an artificial limb. Contemporary knees
include passive, (mechanical), adaptive (computerized), or active (motorized)
control systems and have the potential to mitigate amputation-related functional
impairments and activity limitations. A 14 mo randomized crossover trial was
conducted. Participants (n = 12, mean age = 58 yr) were tested under three
conditions: passive control (existing knee), adaptive control (Ossur Rheo Knee
II), and active control (Ossur Power Knee II). Training and acclimation time were
provided to participants in the adaptive and active knees. Outcome measures
included indoor tests (Timed Up and Go test [TUG], stairs, and ramp), outdoor
tests (walking course and perceived exertion), step activity monitor, self-report
surveys (mobility, balance confidence, physical function, fatigue, and general
health), and fall incidence. Mixed-effects linear regression modeling was used to
evaluate data. Compared with passive control, adaptive control significantly
improved comfortable TUG time (difference = 0.91 s, p = 0.001) and reported
physical function (difference = 1.26 [T-score], p = 0.03). Active control
significantly increased comfortable TUG, fast TUG, and ramp times (difference =
3.02, 2.66, and 0.96 s, respectively, all p < 0.03) and increased balance
confidence (difference = 3.77, p = 0.003) compared with passive control. Findings
suggest that adaptive knee control may enhance function compared with passive
control but that active control can restrict mobility in middle-age or older
users with transfemoral amputation. CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov; "Use of Passive, Adaptive, and Active Prosthetic Knees in
Persons With Unilateral, Transfemoral Amputation": NCT02219230;
https://clinicaltrials.gov/ct2/show/NCT02219230.

Langue : ANGLAIS