Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands.
BMC Musculoskelet Disord. 2013 Nov 27;14:333. doi: 10.1186/1471-2474-14-333.
The effectiveness of microprocessor-controlled prosthetic knee joints (MPKs) has been assessed using a variety of outcome measures in a variety of health and health-related domains. However, if the patient is to receive a prosthetic knee joint that enables him to function optimally in daily life, it is vital that the clinician has adequate information about the effects of that particular component on all aspects of persons' functioning. Especially information concerning activities and participation is of high importance, as this component of functioning closely describes the person's ability to function with the prosthesis in daily life. The present study aimed to review the outcome measures that have been utilized to assess the effects of microprocessor-controlled prosthetic knee joints (MPK), in comparison with mechanically controlled prosthetic knee joints, and aimed to classify these measures according to the components and categories of functioning defined by the International Classification of Functioning, Disability and Health (ICF). Subsequently, the gaps in the scientific evidence regarding the effectiveness of MPKs were determined.
A systematic literature search in 6 databases (i.e. PubMed, CINAHL, Cochrane Library, Embase, Medline and PsychInfo) identified scientific studies that compared the effects of using MPKs with mechanically controlled prosthetic knee joints on persons' functioning. The outcome measures that have been utilized in those studies were extracted and categorized according to the ICF framework. Also, a descriptive analysis regarding all studies has been performed.
A total of 37 studies and 72 outcome measures have been identified. The majority (67%) of the outcome measures that described the effects of using an MPK on persons' actual performance with the prosthesis covered the ICF body functions component. Only 31% of the measures on persons' actual performance investigated how an MPK may affect performance in daily life. Research also typically focused on young, fit and active persons.
Scientifically valid evidence regarding the performance of persons with an MPK in everyday life is limited. Future research should specifically focus on activities and participation to increase the understanding of the possible functional added value of MPKs.
已使用各种健康和健康相关领域的结果测量来评估微处理器控制假肢膝关节（MPK）的有效性。但是，如果要为患者配备能够使其在日常生活中最佳发挥功能的假肢膝关节，则临床医生必须充分了解该特定组件对人员功能的所有方面的影响。特别是活动和参与方面的信息非常重要，因为功能的这一组成部分密切描述了患者在日常生活中使用假肢的功能能力。本研究旨在评估微处理器控制假肢膝关节（MPK）的效果，并与机械控制假肢膝关节进行比较，所使用的结果测量方法，并根据国际功能、残疾和健康分类（ICF）定义的功能组成部分和类别对这些测量方法进行分类。随后，确定了关于 MPK 有效性的科学证据中的空白。
在 6 个数据库（PubMed、CINAHL、Cochrane Library、Embase、Medline 和 PsychInfo）中进行系统文献检索，确定了比较使用 MPK 与机械控制假肢膝关节对人员功能影响的科学研究。从这些研究中提取并根据 ICF 框架对使用的结果测量方法进行分类。还对所有研究进行了描述性分析。
共确定了 37 项研究和 72 项结果测量方法。描述使用 MPK 对患者实际使用假肢的效果的结果测量方法中，有 67%（大多数）涵盖了 ICF 身体功能部分。只有 31%的关于患者实际表现的测量方法研究了 MPK 如何影响日常生活中的表现。研究还通常侧重于年轻、健康和活跃的人群。
关于使用 MPK 的患者在日常生活中的表现的科学有效证据有限。未来的研究应特别关注活动和参与，以提高对 MPK 可能具有的功能附加值的理解。
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