Fuenzalida Squella Sara Agueda, Kannenberg Andreas, Brandão Benetti Ângelo
1 Clinical Research, Fundação de Apoio à Capacitação em Tecnologia da Informação (FACTI), São Paulo, Brazil.
2 Medical Affairs, Otto Bock HealthCare LP, Austin, TX, USA.
Prosthet Orthot Int. 2018 Apr;42(2):228-235. doi: 10.1177/0309364617716207. Epub 2017 Jul 9.
Despite the evidence for improved safety and function of microprocessor stance and swing-controlled prosthetic knees, non-microprocessor-controlled prosthetic knees are still standard of care for persons with transfemoral amputations in most countries. Limited feature microprocessor-control enhancement of such knees could stand to significantly improve patient outcomes.
To evaluate gait speed, balance, and fall reduction benefits of the new 3E80 default stance hydraulic knee compared to standard non-microprocessor-controlled prosthetic knees.
Comparative within-subject clinical study.
A total of 13 young, high-functioning community ambulators with a transfemoral amputation underwent assessment of performance-based (e.g. 2-min walk test, timed ramp/stair tests) and self-reported (e.g. falls, Activities-Specific Balance Confidence scale, Prosthesis Evaluation Questionnaire question #1, Satisfaction with the Prosthesis) outcome measures for their non-microprocessor-controlled prosthetic knees and again after 8 weeks of accommodation to the 3E80 microprocessor-enhanced knee.
Self-reported falls significantly declined 77% ( p = .04), Activities-Specific Balance Confidence scores improved 12 points ( p = .005), 2-min walk test walking distance increased 20 m on level ( p = .01) and uneven ( p = .045) terrain, and patient satisfaction significantly improved ( p < .01) when using the 3E80 knee. Slope and stair ambulation performance did not differ between knee conditions.
The 3E80 knee reduced self-reported fall incidents and improved balance confidence. Walking performance on both level and uneven terrains also improved compared to non-microprocessor-controlled prosthetic knees. Subjects' satisfaction was significantly higher than with their previous non-microprocessor-controlled prosthetic knees. The 3E80 may be considered a prosthetic option for improving gait performance, balance confidence, and safety in highly active amputees. Clinical relevance This study compared performance-based and self-reported outcome measures when using non-microprocessor and a new microprocessor-enhanced, default stance rotary hydraulic knee. The results inform rehabilitation professionals about the functional benefits of a limited-feature, microprocessor-enhanced hydraulic prosthetic knee over standard non-microprocessor-controlled prosthetic knees.
尽管有证据表明微处理器控制的站立和摆动式假肢膝关节安全性和功能有所提高，但在大多数国家，非微处理器控制的假肢膝关节仍是大腿截肢者的标准护理方式。对此类膝关节进行有限功能的微处理器控制增强可能会显著改善患者预后。
评估新型3E80默认站立液压膝关节与标准非微处理器控制的假肢膝关节相比，在步态速度、平衡和减少跌倒方面的益处。
受试者内比较临床研究。
共有13名功能良好的年轻大腿截肢社区步行者，对其非微处理器控制的假肢膝关节进行基于表现的评估（如2分钟步行测试、定时斜坡/楼梯测试）和自我报告的评估（如跌倒情况、特定活动平衡信心量表、假肢评估问卷第1题、对假肢的满意度），在适应3E80微处理器增强膝关节8周后再次进行评估。
自我报告的跌倒次数显著下降77%（p = 0.04），特定活动平衡信心得分提高12分（p = 0.005），在平坦（p = 0.01）和不平坦（p = 0.045）地形上2分钟步行测试的行走距离增加20米，使用3E80膝关节时患者满意度显著提高（p < 0.01）。两种膝关节情况下的斜坡和楼梯行走表现无差异。
3E80膝关节减少了自我报告的跌倒事件，提高了平衡信心。与非微处理器控制的假肢膝关节相比，在平坦和不平坦地形上的行走表现也有所改善。受试者的满意度明显高于他们之前使用的非微处理器控制的假肢膝关节。3E80可被视为改善高活动水平截肢者步态表现、平衡信心和安全性的假肢选择。临床意义本研究比较了使用非微处理器和新型微处理器增强的默认站立旋转液压膝关节时基于表现和自我报告的结果指标。结果向康复专业人员告知了有限功能的微处理器增强液压假肢膝关节相对于标准非微处理器控制的假肢膝关节的功能益处。
