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Enhancement of a prosthetic knee with a microprocessor-controlled gait phase switch reduces falls and improves balance confidence and gait speed in community ambulators with unilateral transfemoral amputation

Despite the evidence for improved safety and function of
microprocessor stance and swing-controlled prosthetic knees,
non-microprocessor-controlled prosthetic knees are still standard of care for
persons with transfemoral amputations in most countries. Limited feature
microprocessor-control enhancement of such knees could stand to significantly
improve patient outcomes. OBJECTIVES: To evaluate gait speed, balance, and fall
reduction benefits of the new 3E80 default stance hydraulic knee compared to
standard non-microprocessor-controlled prosthetic knees. STUDY DESIGN:
Comparative within-subject clinical study. METHODS: A total of 13 young,
high-functioning community ambulators with a transfemoral amputation underwent
assessment of performance-based (e.g. 2-min walk test, timed ramp/stair tests)
and self-reported (e.g. falls, Activities-Specific Balance Confidence scale,
Prosthesis Evaluation Questionnaire question #1, Satisfaction with the
Prosthesis) outcome measures for their non-microprocessor-controlled prosthetic
knees and again after 8 weeks of accommodation to the 3E80
microprocessor-enhanced knee. RESULTS: Self-reported falls significantly declined
77% ( p = .04), Activities-Specific Balance Confidence scores improved 12 points
( p = .005), 2-min walk test walking distance increased 20 m on level ( p = .01)
and uneven ( p = .045) terrain, and patient satisfaction significantly improved (
p < .01) when using the 3E80 knee. Slope and stair ambulation performance did not
differ between knee conditions. CONCLUSION: The 3E80 knee reduced self-reported
fall incidents and improved balance confidence. Walking performance on both level
and uneven terrains also improved compared to non-microprocessor-controlled
prosthetic knees. Subjects' satisfaction was significantly higher than with their
previous non-microprocessor-controlled prosthetic knees. The 3E80 may be
considered a prosthetic option for improving gait performance, balance
confidence, and safety in highly active amputees. Clinical relevance This study
compared performance-based and self-reported outcome measures when using
non-microprocessor and a new microprocessor-enhanced, default stance rotary
hydraulic knee. The results inform rehabilitation professionals about the
functional benefits of a limited-feature, microprocessor-enhanced hydraulic
prosthetic knee over standard non-microprocessor-controlled prosthetic knees.

Langue : ANGLAIS

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