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高级假肢膝关节对低功能股骨截肢或膝关节离断患者感知表现和日常生活活动水平的影响。

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.

机构信息

Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, The Netherlands.

出版信息

J Rehabil Med. 2012 May;44(5):454-61. doi: 10.2340/16501977-0969.

Abstract

OBJECTIVE

To assess the effects of two types of microprocessor-controlled prosthetic knee joints (MPKs) on perceived performance and everyday life activity level.

DESIGN

Randomized cross-over trial.

SUBJECTS

Thirty persons with a unilateral above-knee amputation or knee disarticulation classified as Medicare Functional Classification Level-2.

METHODS

Participants were measured in 3 conditions, i.e. using a mechanically controlled prosthesis, an MPK featuring a microprocessor-controlled stance and swing phase (MPKA), and an MPK featuring a microprocessor-controlled stance phase (MPKB). Subjects' perceived performance regarding prosthesis use was measured with the Prosthesis Evaluation Questionnaire. Subjects' activity level was quantified using accelerometry. As high within-group variability regarding subjects' functional performance was expected to impede detection of possible effects of an MPK, data were analysed for the total group and for 3 subgroups of participants.

RESULTS

Participants' perception regarding ambulation, residual limb health, utility, and satisfaction with walking were significantly higher in the MPKA condition compared with the mechanical knee joint condition. Participants' activity level was similar in all knee joint conditions.

CONCLUSION

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.

摘要

目的

评估两种微处理器控制假肢膝关节(MPK)对感知性能和日常生活活动水平的影响。

设计

随机交叉试验。

受试者

30 名单侧大腿截肢或膝关节离断患者,按医疗保险功能分级 2 级分类。

方法

参与者在 3 种条件下进行测量,即使用机械控制假肢、具有微处理器控制站立和摆动阶段的 MPK(MPKA)和具有微处理器控制站立阶段的 MPK(MPKB)。受试者使用假肢的感知性能通过假肢评估问卷进行测量。使用加速度计量化受试者的活动水平。由于预计受试者的功能表现存在高组内变异性会阻碍对 MPK 可能效果的检测,因此对总组和 3 个亚组的参与者进行了数据分析。

结果

与机械膝关节条件相比,MPKA 条件下,参与者对步行、残肢健康、实用性和对行走的满意度的感知明显更高。在所有膝关节条件下,参与者的活动水平相似。

结论

尽管医疗保险功能分级 2 级截肢者报告在使用 MPK 时在性能方面受益,但在使用 MPK 一周后,他们的实际日常活动水平并没有反映出来。

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