Kinematic and kinetic comparisons of transfemoral amputee gait using C-Leg and Mauch SNS prosthetic knees.
The C-Leg (Otto Bock, Duderstadt, Germany) is a microprocessor-controlled prosthetic knee that may enhance amputee gait. This intrasubject randomized study compared the gait biomechanics of transfemoral amputees wearing the C-Leg with those wearing a common noncomputerized prosthesis, the Mauch SNS (Ossur, Reykjavik, Iceland). After subjects had a 3-month acclimation period with each prosthetic knee, typical gait biomechanical data were collected in a gait laboratory. At a controlled walking speed (CWS), peak swing phase knee-flexion angle decreased for the C-Leg group compared with the Mauch SNS group (55.2 degrees +/- 6.5 degrees vs 64.41 degrees +/- 5.8 degrees , respectively; p = 0.005); the C-Leg group was similar to control subjects' peak swing knee-flexion angle (56.0 degrees +/- 3.4 degrees ). Stance knee-flexion moment increased for the C-Leg group compared with the Mauch SNS group (0.142 +/- 0.05 vs 0.067 +/- 0.07 N"m, respectively; p = 0.01), but remained significantly reduced compared with control subjects (0.477 +/- 0.1 N"m). Prosthetic limb step length at CWS was less for the C-Leg group compared with the Mauch SNS group (0.66 +/- 0.04 vs 0.70 +/- 0.06 m, respectively; p = 0.005), which resulted in increased symmetry between limbs for the C-Leg group. Subjects also walked faster with the C-Leg versus the Mauch SNS (1.30 +/- 0.1 vs 1.21 +/- 0.1 m/s, respectively; p = 0.004). The C-Leg prosthetic limb vertical ground reaction force decreased compared with the Mauch SNS (96.3 +/- 4.7 vs 100.3 +/- 7.5 % body weight, respectively; p = 0.0092).
Segal
Ava D
AD
Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, VA Puget Sound Health Care System, 1660 South Columbian Way, Mail Stop 151, Seattle, WA 98108, USA. avasegal@gmail.com
Orendurff
Michael S
MS
Klute
Glenn K
GK
McDowell
Martin L
ML
Pecoraro
Janice A
JA
Shofer
Jane
J
Czerniecki
Joseph M
JM
D000328:Adult; D000674:Amputees / Q000534:rehabilitation*; D000704:Analysis of Variance; D001186:Artificial Limbs; D001696:Biomechanical Phenomena; D018592:Cross-Over Studies; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D005269:Femur / Q000601:surgery; D005684:Gait / Q000502:physiology*; D006801:Humans; D007720:Knee Prosthesis; D007866:Leg; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity