Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 10, 2014
   Pages 1469 — 1496

Abstract — Benefits of microprocessor-controlled prosthetic knees to limited community ambulators: Systematic review

Andreas Kannenberg, MD, PhD;1* Britta Zacharias, Dipl-Ing (FH), CPO;2 Eva Pröbsting, Dipl-Ing (FH), CPO2

1Medical Affairs, Otto Bock HealthCare LP, Austin, TX; 2Clinical Research and Services, Otto Bock HealthCare GmbH, Duderstadt, Germany

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.

Key words: community ambulator, limited community ambulator, Medicare Functional Classification Level-2, microprocessor-controlled knees, mobility, MPK, non-microprocessor-controlled prosthetic knees, perceived function, performance-based function and mobility, safety, transfemoral amputation.


View HTML ¦ View PDF ¦ Contents Vol. 51, No.10

This article and any supplementary material should be cited as follows:
Kannenberg A, Zacharias B, Pröbsting E. Benefits of microprocessor-controlled prosthetic knees to limited community ambulators: Systematic review. J Rehabil Res Dev. 2014;51(10):1469–96.
http://dx.doi.org/10.1682/JRRD.2014.05.0118
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