title: Benefits of microprocessor-controlled prosthetic knees to limited community ambulators: systematic review.
abstract: The benefits of microprocessor-controlled prosthetic knees (MPKs) have been well established in community ambulators (Medicare Functional Classification Level [MFCL]-3) with a transfemoral amputation (TFA). A systematic review of the literature was performed to analyze whether limited community ambulators (MFCL-2) may also benefit from using an MPK in safety, performance-based function and mobility, and perceived function and satisfaction. We searched 10 scientific databases for clinical trials with MPKs and identified six publications with 57 subjects with TFA and MFCL-2 mobility grade. Using the criteria of a Cochrane Review on prosthetic components, we rated methodological quality moderate in four publications and low in two publications. MPK use may significantly reduce uncontrolled falls by up to 80% as well as significantly improve indicators of fall risk. Performance-based outcome measures suggest that persons with MFCL-2 mobility grade may be able to walk about 14% to 25% faster on level ground, be around 20% quicker on uneven surfaces, and descend a slope almost 30% faster when using an MPK. The results of this systematic review suggest that trial fittings may be used to determine whether or not individuals with TFA and MFCL-2 mobility grade benefit from MPK use. Criteria for patient selection and assessment of trial fitting success or failure are proposed.
authors: Medical Affairs, Otto Bock Healthcare LP, Austin, TX;
authors: Andreas
authors: A
authors: Kannenberg
authors: Britta
authors: B
authors: Zacharias
authors: Eva
authors: E
authors: Pröbsting
mesh_terms: D000674:Amputees / Q000145:classification / Q000534:rehabilitation*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D008838:Microcomputers; D018579:Patient Selection; D011474:Prosthesis Design; D016138:Walking
keywords: MPK; Medicare Functional Classification Level-2; community ambulator; limited community ambulator; microprocessor-controlled knees; mobility; non-microprocessor-controlled prosthetic knees; perceived function; performance-based function and mobility; safety; transfemoral amputation