Highsmith M Jason, Kahle Jason T, Shepard Neil T, Kaufman Kenton R
School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL, USA ; Center for Neuromusculoskeletal Research, University of South Florida, Tampa, FL, USA.
School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL, USA.
Technol Innov. 2014 Jan 27;2013(4):343-347. doi: 10.3727/194982413X13844488879212.
A mechanistic explanation for previously observed safety improvements with microprocessor-controlled prosthetic knees is needed. A repeated measures design of 15 subjects with unilateral transfemoral amputation was used to assess changes between baseline use of their standard of care, mechanical pros-theses, and a C-Leg microprocessor-controlled prosthetic knee. The primary outcome measures were sensory dependency scores for somatosensory, visual, vestibular, and visual preference, which were calculated based on a Sensory Organization Test. Falls during posturographic assessment were also recorded. Somatosensory system dependency significantly increased ( = 0.047) while using the C-Leg compared to a nonmicroprocessor prosthetic knee (NMPK). Reliance on visual with vestibular input and reliance on vestibular input alone were not significantly increased with C-Leg use ( = 0.41 and = 0.15, respectively). When utilizing the C-Leg, there was a significant reduction in the average number of falls ( = 0.03). Hence, increased reliance on somatosensory input is a possible explanation for improved balance with use of a microprocessor prosthetic knee (MPK).
需要对先前观察到的微处理器控制的假肢膝关节安全性提高给出一个机理解释。采用重复测量设计,对15名单侧股骨截肢患者进行研究,以评估其在使用标准护理机械假肢和C-Leg微处理器控制的假肢膝关节的基线状态之间的变化。主要结局指标是基于感觉组织测试计算得出的躯体感觉、视觉、前庭和视觉偏好的感觉依赖评分。姿势描记评估期间的跌倒情况也被记录下来。与非微处理器假肢膝关节(NMPK)相比,使用C-Leg时躯体感觉系统依赖性显著增加(P = 0.047)。使用C-Leg时,对视觉与前庭输入的依赖以及仅对前庭输入的依赖均未显著增加(分别为P = 0.41和P = 0.15)。使用C-Leg时,跌倒的平均次数显著减少(P = 0.03)。因此,对躯体感觉输入的依赖增加可能是使用微处理器假肢膝关节(MPK)时平衡改善的一个解释。