title: Benefits for Adults with Transfemoral Amputations and Peripheral Artery Disease Using Microprocessor Compared with Nonmicroprocessor Prosthetic Knees.
abstract: OBJECTIVE
  Approximately 50% of people with leg amputation fall annually. Evidence suggests that microprocessor knees (MK) may decrease falls and improve prosthetic function in people with traumatic amputations. This study explored whether adults with transfemoral amputations and peripheral artery disease would have reduced falls and improved balance confidence, balance, and walking ability when using prostheses with MK compared with non-MK.
  
  
  METHODS
  This was a prospective cohort study.
  
  
  RESULTS
  Eight subjects averaged 60.8 ± 11.3 yrs or age and 9.5 ± 16.1 yrs since first amputation. Four were K1-K2-level and four were K3-level functional walkers; only Houghton prosthetic use score was different between K1-K2 and K3 walkers (P = 0.03). After 48.3 ± 38.1 wks of acclimation using MK, subjects demonstrated improvements in fear of falling, balance confidence, Timed Up-and-Go time, and rate of falls (P < 0.05). The improvements in fear of falling, balance confidence, and rate of falls had large effect sizes (d > 0.80). Average decreased Timed Up-and-Go time (12.3 secs) had a medium effect size (d = 0.34). Decreases in the number of falls correlated with faster Timed Up-and-Go speed (ρ = -0.76) and greater balance confidence (ρ = 0.83).
  
  
  CONCLUSIONS
  People with peripheral artery disease and transfemoral amputations had fewer falls and improved balance confidence and walking performance when using prostheses with MK.
authors.affiliation: From the Department of Rehabilitation & Regenerative Medicine, Columbia University Medical Center, New York (CKW); Hanger Clinic, New York (JR); and Department of Rehabilitation at Jacobi Medical Center/North Central Bronx Hospital and Albert Einstein College of Medicine, Bronx, New York (MAS).
authors.forename: Christopher Kevin
authors.initials: CK
authors.lastname: Wong
authors.forename: John
authors.initials: J
authors.lastname: Rheinstein
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Stern
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000671:Amputation, Surgical; D000674:Amputees / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D007869:Leg Injuries / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology / Q000503:physiopathology; D004856:Postural Balance; D011446:Prospective Studies; D011474:Prosthesis Design