Comparison of nonmicroprocessor knee mechanism versus C-Leg on Prosthesis Evaluation Questionnaire, stumbles, falls, walking tests, stair descent and knee preference
Comparison of nonmicroprocessor knee mechanism versus C-Leg on Prosthesis Evaluation Questionnaire, stumbles, falls, walking tests, stair descent and knee preference
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DOI：
10.1682/jrrd.2007.04.0054
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发表时间：
2008-01-01
影响因子：
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通讯作者：
Hubbard, Sandra L.
中科院分区：
文献类型：
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作者：
Kahle, Jason T.;Highsmith, M. Jason;Hubbard, Sandra L.
本研究比较了受试者使用非微处理器膝关节机制（NMKM）与C型腿的9项临床可重复评价指标的表现。我们记录了受试者在使用适应性NMKM时的性能数据，并在90天适应期后，在来自门诊假肢诊所的19名经股动脉（TF）截肢者（平均年龄51 +/- 19）的便利样本中使用C型腿。我们发现使用C型腿改善了所有结局的功能：（1）假体评估问卷评分提高20%（p = 0.007），（2）跌倒减少59%（p = 0.006），（3）福尔斯减少64%（p = 0.03），（4）75例在平坦地形上的自选步行速度提高15%（p = 0.03），（5）在平坦地形上的最快步行速度（FPWS）提高了12%（p = 0.005），（6）38例在不平坦地形上的FPWS改善了21%（p < 0.001），（7）6在平坦地形上的FPWS提高了17%（p = 0.001），（8）12名受试者的蒙特利尔康复性能特征性能综合评分增加，（9）14名受试者首选C型腿而非NMKM。四个有限的社区步行者（医疗保险功能分类水平[MFCL] K2）将其步行功能水平提高到无限社区步行者（MFCL K3）。客观的临床评估措施对于证明TF截肢者膝关节机制的医学必要性至关重要。使用C型腿可以提高性能和生活质量，并可以提高MFCL和社区医疗水平。
This study compared subjects' performance with a nonmicroprocessor knee mechanism (NMKM) versus a C-Leg on nine clinically repeatable evaluative measures. We recorded data on subjects' performance while they used an accommodated NMKM and, following a 90-day accommodation period, the C-Leg in a convenience sample of 19 transfemoral (TF) amputees (mean age 51 +/- 19) from an outpatient prosthetic clinic. We found that use of the C-Leg improved function in all outcomes: (1) Prosthesis Evaluation Questionnaire scores increased 20% (p = 0.007), (2) stumbles decreased 59% (p = 0.006), (3) falls decreased 64% (p = 0.03), (4) 75 in self-selected walking speed on even terrain improved 15% (p = 0.03), (5) 75 in fastest possible walking speed (FPWS) on even terrain improved 12% (p = 0.005), (6) 38 in FPWS on uneven terrain improved 21% (p < 0.001), (7) 6 in FPWS on even terrain improved 17% (p = 0.001), (8) Montreal Rehabilitation Performance Profile Performance Composite Scores for stair descent increased for 12 subjects, and (9) the C-Leg was preferred over the NMKM by 14 subjects. Four limited community ambulators (Medicare Functional Classification Level [MFCL] K2) increased their ambulatory functional level to unlimited community ambulation (MFCL K3). Objective evaluative clinical measures are vital for justifying the medical necessity of knee mechanisms for TF amputees. Use of the C-Leg improves performance and quality of life and can increase MFCL and community ambulation level.