Personalizing MPK Prescription for Individuals with Transfemoral Amputation
Abstract
Rationale for This Study: In current clinical prosthetic practice, there is no evidence-based method for selecting a microprocessor knee (MPK) joint for a patient with an above-the-knee amputation. Of individuals with amputation in Veteran and Service Member populations, approximately 35% present with an above-the-knee amputation. It is well understood in clinical practice that MPKs provide numerous benefits to patients with amputations above the knee including improved gait, safety, comfort, confidence, reduced falls, balance, patient satisfaction and reduced energy expenditure, greater ease in negotiating varying terrains, improvements in multi-tasking and cost-effectiveness. Studies that have investigated commercially available MPKs tend to lump all of them together within a single group rather than teasing out individual differences between each knee. Therefore, clinicians are left to rely on their own intuition and past experiences with an MPK when selecting for a patient with an above-the-knee amputation rather than making their decision based on evidence collected from the specific patient. This may mean that some individuals with an above-the-knee amputation may not be receiving the best component for them, which may delay or inhibit their rehabilitation potential following their amputation. Objectives: Our objective is to personalize the prosthetic prescription process for an individual with an above-the-knee amputation. To accomplish this, we will measure functional performance of 12 individuals with above-the-knee amputations while using three different commercially available MPKs and a research-grade powered knee. Body motions and associated forces will be measured while subjects perform everyday activities like walking on level ground, up and down ramps and stairs. Subjects will then rate the amount of exertion they perceive while performing the different tasks in each knee. This physical performance across knees will be compared within each individual. Second, we will collect specific data on each individual including their height, weight, length of their limb, activity level and others and then ask each subject to fill out several standardized surveys regarding their preferences and feelings after having used each of the different MPKs. Finally, using all of the above-mentioned collected data, we will generate a clinical decision algorithm, which will allow prosthetists to select the most appropriate MPK for an individual with an above-the-knee amputation based on information they are able to collect within their clinic. Clinical Applicability and Benefit to Prosthetics Community: This project stands to benefit individuals who require the use of a prosthetic knee within their prosthesis such as a person with an above-the-knee amputation. It will help these patients by providing a framework for clinicians to select an MPK for them based on data from the individual patient rather than clinician preferences or past experiences alone. This project will investigate three commercially available and very commonly used MPKs in clinical practice as well as a research-grade powered knee over the course of 2 years with the end goal to create clinical practice guidelines and a clinical decision algorithm for the selection of the best MPK for a brand-new patient with an above-the-knee amputation. Benefit to Service Members, Veterans and American Public with Amputation: Military personnel are often more active and agile than the general population with an above-the-knee amputation so are frequently candidates for MPK technology to be fit within their prostheses. It is only logical that the best choice should be made when a prosthesis is initially being prescribed to improve and quicken an amputee’s rehabilitation process. Our hope is that in the future, this study will also have an impact on the overall general amputee population by showing that evidence-based clinical decisions will ultimately lead to improved o
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110686
Entities
People
- Aaron Young
Organizations
- Georgia Tech Research Corporation
- United States Army