Obstacle course: Users maneuverability and movement efficiency when using Otto Bock C-leg, Otto Bock 3R60, and CaTech SNS prosthetic knee joints

Abstract

Abstract-The performance and movement efficiency of prosthesis users while traversing a multisectional obstacle course (OC) were evaluated using a crossover design with random allocation of three prosthetic knee joints: the SNS (CaTech; Dayton, Ohio) the C-Leg (Otto Bock; Duderstadt, Germany), and the 3R60 (Otto Bock). Twelve users completed the OC twice with each joint, once without and once with a mental loading task (MLT). The performance was objectively assessed using time measurement from digital video recordings, and the Total Heart Beat Index was used to estimate movement efficiency. A 1 mo familiarization period was provided for each knee joint before data collection. It took longer to complete the OC with the 3R60 compared with either the SNS or the C-Leg. No significant time differences were found between the C-Leg and the SNS, but differences between the 3R60 and the SNS (slalom and rock sections) and between the 3R60 and the C-Leg (rock section) were observed. Within the simulated sand section, two participants fell with the C-Leg, one with the 3R60, and none with the SNS. Movement efficiency without MLT was similar between all joints, but with an MLT a significant decrease in movement efficiency was observed with the C-Leg. Previous experience using an SNS had no influence on the results.

Functional performance differences between the Genium and C-Leg prosthetic knees and intact knees

“…When subjects used a C-Leg (Ottobock; Duderstadt, Germany) microprocessor prosthetic knee (MPK), they completed the obstacle course more quickly and with fewer steps than when they used nonmicroprocessor knees (NMPKs). Similarly, Meier et al designed a customized obstacle course involving many mobility skills including basic ambulation, stepping up, ramp ascent, turning, and walking across variably resistive surfaces [2]. C-Leg use tended to improve task completion time relative to a hydraulic swing-phase control polycentric knee.…”

“…Task completion times were not so clearly improved relative to a single axis, fluid-controlled swing and stance knee system. Meier et al found that use of the C-Leg decreased movement efficiency by 10 percent while completing the obstacle course in parallel with a mental loading task [2]. Course completion data regarding time and distance were very fractionalized.…”

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

“…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. 27,145 Previous research mainly focused on the C-Leg.…”

“…Hafner et al 34 found no differences in walking speed, whereas Meier et al 35 found an increase in walking speed while using a MPK to navigate an obstacle course.…”

“…Only few studies randomized the order in which prosthetic knees were tested. 12,35,145 Accordingly, there is limited evidence from randomized studies to help guide clinical decision making. Therefore, we aim to study the influence of a transition from a non-microprocessor-controlled prosthetic knee towards the user-adaptive Rheo Knee II on aspects of daily functioning using a randomized within subject cross-over trial.…”