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Mobility and satisfaction with a microprocessor-controlled knee in moderately active amputees: A multi-centric

Céline Lansade1, Eric Vicaut2, Jean Paysant3

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Microprocessor-controlled knees (MPKs) improve dynamic balance, functional mobility, and quality of life in amputees with moderate activity levels. This study supports equal access to advanced prosthetic technology for all individuals with transfemoral amputation or knee disarticulation.

Keywords:
AmputationBalanceCrossoverMobilityMulti-centricRandomized

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Area of Science:

  • Prosthetics and Orthotics
  • Rehabilitation Engineering
  • Biomechanics

Background:

  • Microprocessor-controlled knees (MPKs) are typically prescribed for highly active amputees.
  • Emerging evidence suggests MPKs may benefit individuals with moderate activity levels.
  • This study evaluates MPK efficacy in a population not traditionally targeted for this technology.

Purpose of the Study:

  • To compare the functional efficiency of microprocessor-controlled knees (MPKs) versus non-MPKs (NMPKs) in amputees with moderate mobility.
  • To assess the impact of MPKs on dynamic balance, functional mobility, quality of life, and user satisfaction.
  • To determine the safety profile, including fall incidence, of MPKs in this patient group.

Main Methods:

  • A multi-center, randomized crossover trial involving 35 participants with transfemoral amputation or knee disarticulation across 16 European hospitals.
  • Participants were assigned to either an MPK-NMPK or NMPK-MPK sequence, with devices used for 3 months (MPK) and 1 month (NMPK).
  • Outcome measures included the Timed-Up and Go (TUG) test for dynamic balance, Locomotor Capability Index (LCI-5) for functional mobility, SF-36v2 for quality of life, and user satisfaction questionnaires. Fall occurrence was monitored.

Main Results:

  • Per-protocol analysis showed significant improvements with MPKs: reduced TUG times (P=0.001), increased LCI-5 scores (P=0.02), and higher user satisfaction (P=0.001).
  • Quality of life improved, particularly the mental component summary of the SF-36v2 (P=0.03), with non-significant improvements in the physical component.
  • No significant differences in adverse events, including falls, were observed between MPKs and NMPKs.

Conclusions:

  • Microprocessor-controlled knees demonstrate significant benefits in dynamic balance, functional mobility, and user satisfaction for amputees with moderate activity levels.
  • The findings support expanding access to MPKs for individuals with transfemoral amputation or knee disarticulation, irrespective of their mobility grade.
  • This study contributes robust evidence advocating for equitable prosthetic provision based on individual needs rather than activity level alone.