Influence of advanced prosthetic knee joints on perceived performance and everyday life activity level of low-functional persons with a transfemoral amputation or knee disarticulation

Theeven, Patrick J. R.; Hemmen, Bea; Geers, Richard; Smeets, Rob; Brink, Peter R.; Seelen, Henk

doi:10.2340/16501977-0969

Cited by 42 publications

(56 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Newer studies show that although patients with above knee amputation report benefitting from e.g. microprocessor-controlled prosthetic knee joints after one week of using them, this benefit is not reflected in their actual daily activity level [9]. Additionally the epidemiology may have impact on the satisfaction during motor performance [1].…”

Section: Introductionmentioning

confidence: 99%

User-Centered Prosthetic Development: Comprehension of Amputees’ Needs

Christ

Jokisch

Preller

et al. 2012

Biomedical Engineering / Biomedizinische Technik

View full text Add to dashboard Cite

The goal of user-centered development (UCD) is an active involvement of the user for a clear understanding of the users' needs. In the context of rehabilitation engineering it is essential to integrate the users' needs into the development methodology. In fact the use or disclaim of assistive device depends on good comfort and satisfaction during application. Especially prostheses are developed to improve amputees' quality of life up to live independently again. UCD can improve integrating the amputees' needs into the prosthesis' properties. For a more detailed view of the prosthesis-users' needs we developed a questionnaire and collected data from patients regarding their needs using lower limb prostheses. 88 items, describing satisfaction, usability, appearance, functionality and handling of the prosthesis in different motor situations, were generated. Among 65 participants, 29 transfemoral amputees and experienced prosthesis users completed the questionnaire. The results indicate a lack of satisfaction with the prosthesis shaft as well as with different motor functions. Furthermore, the majority feels socially restricted and is dissatisfied with their appearance in public. While the latter is significantly negative correlated with feelings of social restriction, problems during changing gait speed are significantly negative correlated with feelings of certainty and stability during spontaneous movements. Although prostheses are developed to help to improve amputees' quality of life, the lack in different motor-and social-issues are noticeable. This indicates that the enhancement of changing gait speed in prostheses may help amputees to feel more certain and natural during walking. From an amputee's point of view, this could be one important predictor for being more satisfied and a first step for being more independent in life in general. With this first step of UCD, important information for the design of prosthesis in future has been generated.

show abstract

Section: Introductionmentioning

confidence: 99%

User-Centered Prosthetic Development: Comprehension of Amputees’ Needs

Christ

Jokisch

Preller

et al. 2012

Biomedical Engineering / Biomedizinische Technik

View full text Add to dashboard Cite

show abstract

“…Theeven and colleagues have been busy using and refining the ADAPT and publishing subsequent articles in 2011 13 and 2012 14 investigating the effects of MPK on K2-level amputees, interestingly using a US healthcare system code in an international setting. Microprocessor-controlled prosthetic knees have not been generally available to K2 functional level amputees, although some published research has shown that some K2 functional level amputees can improve to K3 with an MPK.…”

Section: Activities Of Living Measures Acclimation and Terrainmentioning

confidence: 99%

“…Theeven et al 14 also examined in detail 30 of these same prosthesis users' perceived performance enhancements when wearing MPKs versus NMPKs in the community using the Prosthetic Evaluation Questionnaire (PEQ). Although there was no improvement in activity during community ambulation as recorded by a waist-mounted accelerometer, there was a preference expressed for the MPK that offered both swing-and stance-phase control (C-Leg).…”

Section: Activities Of Living Measures Acclimation and Terrainmentioning

confidence: 99%

Literature Review of Published Research Investigating Microprocessor-Controlled Prosthetic Knees

Orendurff¹

2013

JPO Journal of Prosthetics and Orthotics

View full text Add to dashboard Cite

Since 2009, several articles on microprocessor-controlled prosthetic knee (MPK) joint mechanisms have been published. Recent published data are generally rated as providing moderate to low levels of evidence because of structural weakness of the study designs. These weaknesses are due to low statistical power, a lack of blinding, industry funding, precise measures with no estimate of minimal clinically important difference (MCID), or subjective participant responses on questionnaires. Strong support for the advantages of MPKs is not available within this cohort of studies. Statistically significant improvements were observed in some gait measures when comparing MPKs with non-MPKs (NMPKs), but the values are not close to those of intact individuals. For measures of gait kinematics, gait kinetics, gait parameters, gait symmetry, or performance time, MPKs seem to offer marginal improvements over NMPKs in a few measures. There are few data and information on the differences between the types of MPKs currently on the market. Several of the articles in this review do provide novel outcome measures that incorporate multiple domains in biomechanics, function, and patient perception. The strongest metric in all studies is patient preference for MPKs, as opposed to technical gait metrics, objective functional improvements in mobility, or the activity of prosthetic users. This patient preference might easily be influenced by marketing or design appeal rather than objective technical or functional outcome measures. Although MPKs seem to produce minor improvements in some aspects of gait over NMPKs, the cost-benefit ratio of MPKs is not available. (J Prosthet Orthot. 2013;25:P41YP46.)KEY INDEXING TERMS: outcomes, prosthetic knee, transfemoral, limb loss, amputee, comparative effectiveness T his review focuses on 14 studies evaluating microprocessor-controlled prosthetic knees (MPKs) published between 2010 and 2012. Three of these are themselves review articles on the efficacy of MPKs for transfemoral amputees. A more comprehensive historical review is also covered by this State-of-the-Science Conference (SSC) but does not include these most recent publications. This review evaluated each included article on a range of study design and results characteristics using a hybrid approach combining established scientific methodological criteria and specific prosthetic research parameters. Unlike the formal Evidence Report associated with this SSC, this review of more recent literature did not strictly follow the evidence review guidelines published by the American Academy of Orthotists and Prosthetists. In general, prosthetics research fares poorly in formal evaluations of scientific methodological criteria. 1,2 Much of the published literature on prostheses suffers from a lack of blinding, and this is understandable because it is quite difficult to accomplish effectively, especially when attempting to blind the user. Blinding may be somewhat easier for the researchers involved in assessing prosthetic gait, and this might be a subst...

show abstract

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Prinsen¹

View full text Add to dashboard Cite

Influence of advanced prosthetic knee joints on perceived performance and everyday life activity level of low-functional persons with a transfemoral amputation or knee disarticulation

Abstract: Although Medicare Functional Classification Level-2 amputees report benefitting in terms of their performance from using an MPK, this is not reflected in their actual daily activity level after one week of using an MPK.

Cited by 42 publications

References 28 publications

User-Centered Prosthetic Development: Comprehension of Amputees’ Needs

User-Centered Prosthetic Development: Comprehension of Amputees’ Needs

Literature Review of Published Research Investigating Microprocessor-Controlled Prosthetic Knees

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

Contact Info

Product

Resources

About