EFFECTS OF THE GENIUM KNEE SYSTEM ON FUNCTIONAL LEVEL, STAIR AMBULATION, PERCEPTIVE AND ECONOMIC OUTCOMES IN TRANSFEMORAL AMPUTEES.
EFFECTS OF THE GENIUM KNEE SYSTEM ON FUNCTIONAL LEVEL, STAIR AMBULATION, PERCEPTIVE AND ECONOMIC OUTCOMES IN TRANSFEMORAL AMPUTEES.
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DOI：
10.21300/18.2-3.2016.139
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发表时间：
2016-09
影响因子：
0.5
通讯作者：
Sutton BS
中科院分区：
文献类型：
--
作者：
Highsmith MJ;Kahle JT;Wernke MM;Carey SL;Miro RM;Lura DJ;Sutton BS
与非微处理器膝关节系统相比，C型腿微处理器膝关节系统（MPK）在生物能量和经济方面更有效，对经股截肢（TFA）患者更安全。与C型腿相比，Genium MPK在感知功能、膝关节运动学和身体功能表现方面均有所改善。尚未对Genium膝关节系统进行临床和健康经济学分析。本研究的目的是确定Genium的实验室确定的益处是否可以使用常见的临床评估检测到，以及是否存在与其使用相关的经济效益。本研究采用随机AB交叉研究，随访60 d，包括成本-效果分析。20名TFA患者在活动性和偏好测量中对双膝进行了测试。增量成本效益比（ICER）计算的基础上的性能指标。Genium改善了楼梯评估指数评分。膝关节之间的平均楼梯完成时间和下降步进率没有差异。与Genium相比，C型腿的爬楼梯步进率更高（p = 0.04）。Genium的使用减少了四个正方形步骤测试的完成时间，并增加了功能水平和步骤活动（p ≤ 0.05）。此外，Genium的使用改善了（p ≤ 0.05）五个日常生活活动（ADL）调查领域中三个领域的功能和安全性。最后，更多的受试者在测试后更喜欢Genium。使用功能测量来计算ICER。Genium的ICER值在既定的可能接受值范围内。与C型腿相比，Genium的使用改善了楼梯行走性能、多向踏步、功能水平和感知功能。在这组使用TFA的社区步行机中，Genium是首选，虽然成本更高，但由于ADL的功能表现有显着改善，因此可能值得资助。
Compared to non-microprocessor knees, the C-Leg microprocessor knee (MPK) is bioenergentically and economically more efficient and safer for transfemoral amputation (TFA) patients. The Genium MPK has demonstrated improvements in perceived function, knee kinematics, and physical functional performance compared to C-Leg. Clinical and health economic analyses have not been conducted with the Genium knee system. The purpose of this study was to determine if laboratory determined benefits of Genium are detectable using common clinical assessments and if there are economic benefits associated with its use. This study utilized a randomized AB crossover study with 60 d follow-up including cost-effectiveness analysis. Twenty TFA patients tested with both knees in mobility and preference measures. Incremental cost-effectiveness ratios (ICER) were calculated based on performance measures. Stair Assessment Index scores improved with Genium. Mean stair completion times and descent stepping rate were not different between knees. Stair ascent stepping rate for C-Leg was greater compared with Genium (p = 0.04). Genium use decreased Four square step test completion time and increased functional level and step activity (p ≤ 0.05). Further, Genium use improved (p ≤ 0.05) function and safety in three out of five Activities of Daily Living (ADL) survey domains. Finally, more subjects preferred Genium following testing. Functional measures were used to calculate ICERs. ICER values for Genium fall within established likely-to-accept value ranges. Compared with C-Leg, Genium use improved stair walking performance, multi-directional stepping, functional level, and perceived function. In this group of community ambulators with TFA, Genium was preferred, and, while more costly, it may be worth funding due to significant improvements in functional performance with ADLs.