Energy Expenditure and Activity of Transfemoral Amputees Using Mechanical and Microprocessor-Controlled Prosthetic Knees

Abstract

Objective To quantify the energy efficiency of locomotion and free-living physical activity energy expenditure of transfemoral amputees using a mechanical and microprocessor-controlled prosthetic knee. Design Repeated-measures design to evaluate comparative functional outcomes. Setting Exercise physiology laboratory and community free-living environment. Participants Subjects (N=15; 12 men, 3 women; age, 42±9y; range, 26 –57y) with transfemoral amputation. Intervention Research participants were long-term users of a mechanical prosthesis (20±10y as an amputee; range, 3–36y). They were fitted with a microprocessor-controlled knee prosthesis and allowed to acclimate (mean time, 18±8wk) before being retested. Main Outcome Measures Objective measurements of energy efficiency and total daily energy expenditure were obtained. The Prosthetic Evaluation Questionnaire was used to gather subjective feedback from the participants. Results Subjects demonstrated significantly increased physical activity–related energy expenditure levels in the participant’s free-living environment (P=.04) after wearing the microprocessor-controlled prosthetic knee joint. There was no significant difference in the energy efficiency of walking (P=.34). When using the microprocessor-controlled knee, the subjects expressed increased satisfaction in their daily lives (P=.02). Conclusions People ambulating with a microprocessor-controlled knee significantly increased their physical activity during daily life, outside the laboratory setting, and expressed an increased quality of life.

Safety, Energy Efficiency, and Cost Efficacy of the C-Leg for Transfemoral Amputees

“…***C-Leg was preferred knee for all subjects. topic [19][20][21][22][23][24][25][26] and three were determined to be pertinent for the cost effectiveness topic 14,27,28 (see Tables 1-3). The two raters independently achieved identical scoring for methodologic quality and risk of bias so no further statistical analysis was conducted on this.…”

Temporal adaptations in generic and population-specific quality of life and falls efficacy in men with recent lower-limb amputations

“…Some of these scales pertain to more generic QOL issues, such as Social Burden, whereas others are more specific to people with lower-limb amputations, such as Residual-Limb Health. The PEQ has been used in a variety of scientific investigations pertaining to people with lower-limb amputations that have provided evidence for the efficacy of the PEQ and its subscales in the assessment of prosthesis health-related QOL [11,[22][23][28][29]. Scale scores for the PEQ were calculated using the arithmetic mean of the item scores contained within the relevant scale.…”

Adapting to change : influence if a microprocessor-controlled prosthetic knee on gait adaptations

“…Some trials report no differences, 27,32 whereas others do find differences on variable subscales of the Prosthesis Evaluation Questionnaire. 26,41,170 All in all, there seems to be no univocal evidence for a positive effect of microprocessor-controlled prosthetic knees on prosthesis-related quality of life. On balance confidence we did not find differences.…”

“…There is a moderate level of evidence that the use of swing and stance MPKs results in equivalent self-reported general health 27,40 and well-being 27,32,41 when compared with the use of NMPKs. In addition, there is a moderate level of evidence that the use of swing and stance MPKs results in increased quality adjusted life years when compared with the use of NMPKs.…”

“…26,27,32,41,170 On performance based measures of mobility, studies reported increased walking speed on both even and uneven terrain, 26 decrease in time that was needed to complete the Timed "up & go" Test, 171 increased performance of ramp and stair de-scent, 27,32,36 and improved obstacle course navigation when walking with a microprocessor-controlled prosthetic knee. 33,35 Finally, studies found no differences in daily step count between prosthetic knee conditions.…”