title: Outcomes associated with the use of microprocessor-controlled prosthetic knees among individuals with unilateral transfemoral limb loss: a systematic review.
abstract: Microprocessor-controlled prosthetic knees (MPKs) have been developed as an alternative to non-microprocessor-controlled knees (NMPKs) to address challenges facing individuals with lower-limb loss. A body of scientific literature comparing MPKs and NMPKs exists but has yet to be critically appraised. Therefore, we conducted a systematic review to examine outcomes associated with the use of these interventions among individuals with transfemoral limb loss. A search of biomedical databases identified 241 publications, of which 27 met the inclusion and exclusion criteria and were reviewed for methodological quality and content. We developed 28 empirical evidence statements (EESs) in 9 outcome categories (metabolic energy expenditure, activity, cognitive demand, gait mechanics, environmental obstacle negotiation, safety, preference and satisfaction, economics, and health and quality of life) based on findings in the literature. The level of evidence supporting these EESs varied due to quantity, quality, and consistency of the results. EESs supported by a moderate level of evidence that noted significant differences between MPKs and NMPKs were derived in five of the nine outcome categories. The results from this review suggest that evidence exists to inform clinical practice and that additional research is needed to confirm existing evidence and better understand outcomes associated with the use of NMPKs and MPKs.
authors.affiliation: The Wallace H. Coulter Department of Biomedical Engineering, Emory University and the Georgia Institute of Technology, 313 Ferst Dr, Atlanta, GA 30332, USA. andrew.b.sawers@emory.edu
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Sawers
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hafner
mesh_terms: D001186:Artificial Limbs / Q000191:economics; D001288:Attention; D003071:Cognition; D004734:Energy Metabolism; D019317:Evidence-Based Medicine; D005684:Gait; D006304:Health Status; D006801:Humans; D007720:Knee Prosthesis / Q000191:economics; D008838:Microcomputers / Q000191:economics; D009043:Motor Activity; D057240:Patient Preference; D011788:Quality of Life; D012449:Safety; D016138:Walking / Q000523:psychology