Do Microprocessor Knees Improve Outcomes in Early Prosthetic Rehabilitation Compared to Nonmicroprocessor Knees?
Abstract
Objective: The purpose of this study is to evaluate the potential for prosthetic knee technologies applied in early rehabilitation to improve functional abilities, health, and quality of life among people with recent amputations. We will conduct a high-quality, randomized controlled trial to compare falls, step activity, balance confidence, mobility, health-related quality of life, and community reintegration in two prosthetic knee conditions: microprocessor-controlled knees and non-microprocessor-controlled knees. We hypothesize that use of microprocessor-controlled knees in the critical, early rehabilitation period will result in improved outcomes for people with recent limb amputation and increase the likelihood of long-term prosthetic use. Rationale: Amputation is a life-altering injury that requires extensive rehabilitation. Early rehabilitation is especially challenging for people with above-knee amputation due to the absence of supportive body structures, direct muscle control of multiple joints, and sensory feedback. Loss of these critical body structures and functions has dire immediate and long-term consequences for mobility and safety. Falling is common for people with above-knee amputation, especially those just learning to walk, and can result in injury, fear of falling, and activity avoidance. Further, acquired gait deviations and compensatory overuse developed during early rehabilitation can endure and lead to debilitating secondary conditions, such as low back pain and osteoarthritis. Microprocessor-controlled knees have been shown to improve outcomes in established users of prosthetic limbs. However, these sophisticated devices are often not used in early rehabilitation due to the misconception that they are best suited for people who have demonstrated successful prosthesis use and achieved high activity levels. The lack of microprocessor knee use for people with recent amputation is unfortunate because these knees have inherent safety features with the potential to reduce falls, improve balance confidence, and promote well-being. With these positive outcomes in mind, it is likely that people in early rehabilitation are ideal candidates for microprocessor knees and could experience lifelong benefits from early use of this technology. Applicability and Impact of Research: There is very little research available to guide early prosthetic care for people with above-knee amputation and no evidence available that supports the use of microprocessor knees during early rehabilitation. The proposed research will address the need for objective, high-quality evidence of functional outcomes that may be expected with use of microprocessor technology for the people who need it most. By focusing on early rehabilitation, this research has the potential to positively impact an amputee’s entire lifetime of prosthetic use. Through early application, prosthesis users can maximize mobility, activity level, and safety while minimizing amputation-related disability. Study results will produce evidence that can guide and may substantially alter prosthetic prescriptions for people with recent limb amputation. Patients Who Will Be Aided by the Research: We expect the results of this research will contribute to improved rehabilitation outcomes for Service members, Veterans, and civilians at risk for limb amputation. There are an estimated 600,000-700,000 people with major limb amputations presently living in the U.S. These numbers include more than 1500 Service members who have experienced major limb amputation from Service-related injuries in Operations Iraqi Freedom, Enduring Freedom, and New Dawn. Further, Veterans with diabetes undergo more than 1000 major limb amputations every year, over 500 of which are above the knee. Clinical applications, benefits, and risks. The potential benefits of this research are increased knowledge of and access to a promising prosthetic technology that may improve user
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710617
Entities
People
- Sara J Morgan
Organizations
- United States Army
- University of Washington