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Evaluation of activity and function before and immediately after the provision of a microprocessor knee in individuals with transfemoral amputation

Evaluation of activity and function before and immediately after the provision of a microprocessor knee in individuals with transfemoral amputation
Evaluation of activity and function before and immediately after the provision of a microprocessor knee in individuals with transfemoral amputation

BACKGROUND: In many cases, individuals with lower limb amputation become less active because of impaired balance and stability and increased risk of falling. Microprocessor knees (MPKs) have been shown to reduce the risk of falls, improve balance, and increase function, evaluated with self-reported scales and questionnaires. This study aims at investigating whether the patient-reported improvements are reflected in objective physical activity (PA) parameters estimated from actimetry sensors and assess the short-term provision of an MPK.

STUDY DESIGN: Transfemoral amputee patients (n=29) undertaking an MPK trial at 2 prosthetic centers in the South of England were recruited for this study. Self-reported and functional test outcomes (Activities Balance Confidence, Reintegration of Normal Living Index, Prosthesis Evaluation Questionnaire scores, and 2-min walk test) were obtained before and after (4 weeks) the provision of the MPK. Activity levels were recorded over 7 consecutive days pre- and post-MPK.

RESULTS: Self-reported scores and function test outcomes showed a general improvement in most of the patients after the provision of the MPK, with a statistically significant change ( p < 0.05) in Activities Balance Confidence, Reintegration of Normal Living Index, Prosthesis Evaluation Questionnaire scores, and 2-min walk test. By contrast, the activity-based parameters estimated from actimetry showed no statistically significant changes ( p > 0.05). Associations between self-reported and functional outcomes and actimetry parameters were limited.

CONCLUSIONS: Perceived and in-clinic outcome measures improved after short-term provision of an MPK for transfemoral amputees. However, PA did not change in this cohort of patients over the study period. More longitudinal studies are needed to characterize the impact of MPK provision on PA and societal participation.

activity monitor, function, lower limb amputation, microprocessor knees, mobility, physical activity
0309-3646
368-377
Caggiari, Silvia
58f49054-6ca6-429b-b499-49b93357e5ba
Randell, Tim
b6853813-b38b-4426-ac85-145b8af0ffe8
Ostler, Chantel Marie
c5e34ffb-7763-4fc0-98a4-128d1ed5d967
Dickinson, Alex
10151972-c1b5-4f7d-bc12-6482b5870cad
Worsley, Pete
6d33aee3-ef43-468d-aef6-86d190de6756
Caggiari, Silvia
58f49054-6ca6-429b-b499-49b93357e5ba
Randell, Tim
b6853813-b38b-4426-ac85-145b8af0ffe8
Ostler, Chantel Marie
c5e34ffb-7763-4fc0-98a4-128d1ed5d967
Dickinson, Alex
10151972-c1b5-4f7d-bc12-6482b5870cad
Worsley, Pete
6d33aee3-ef43-468d-aef6-86d190de6756

Caggiari, Silvia, Randell, Tim, Ostler, Chantel Marie, Dickinson, Alex and Worsley, Pete (2025) Evaluation of activity and function before and immediately after the provision of a microprocessor knee in individuals with transfemoral amputation. Prosthetics and Orthotics International, 49 (4), 368-377. (doi:10.1097/PXR.0000000000000449).

Record type: Article

Abstract

BACKGROUND: In many cases, individuals with lower limb amputation become less active because of impaired balance and stability and increased risk of falling. Microprocessor knees (MPKs) have been shown to reduce the risk of falls, improve balance, and increase function, evaluated with self-reported scales and questionnaires. This study aims at investigating whether the patient-reported improvements are reflected in objective physical activity (PA) parameters estimated from actimetry sensors and assess the short-term provision of an MPK.

STUDY DESIGN: Transfemoral amputee patients (n=29) undertaking an MPK trial at 2 prosthetic centers in the South of England were recruited for this study. Self-reported and functional test outcomes (Activities Balance Confidence, Reintegration of Normal Living Index, Prosthesis Evaluation Questionnaire scores, and 2-min walk test) were obtained before and after (4 weeks) the provision of the MPK. Activity levels were recorded over 7 consecutive days pre- and post-MPK.

RESULTS: Self-reported scores and function test outcomes showed a general improvement in most of the patients after the provision of the MPK, with a statistically significant change ( p < 0.05) in Activities Balance Confidence, Reintegration of Normal Living Index, Prosthesis Evaluation Questionnaire scores, and 2-min walk test. By contrast, the activity-based parameters estimated from actimetry showed no statistically significant changes ( p > 0.05). Associations between self-reported and functional outcomes and actimetry parameters were limited.

CONCLUSIONS: Perceived and in-clinic outcome measures improved after short-term provision of an MPK for transfemoral amputees. However, PA did not change in this cohort of patients over the study period. More longitudinal studies are needed to characterize the impact of MPK provision on PA and societal participation.

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More information

Accepted/In Press date: 22 February 2025
e-pub ahead of print date: 9 April 2025
Published date: 9 April 2025
Additional Information: Copyright © 2025 The Authors. Published by Wolters Kluwer Inc. on behalf of The International Society for Prosthetics and Orthotics.
Keywords: activity monitor, function, lower limb amputation, microprocessor knees, mobility, physical activity

Identifiers

Local EPrints ID: 501238
URI: http://eprints.soton.ac.uk/id/eprint/501238
ISSN: 0309-3646
PURE UUID: ca833101-c220-4f77-bcf6-08f4db23bc6b
ORCID for Silvia Caggiari: ORCID iD orcid.org/0000-0002-8928-2141
ORCID for Chantel Marie Ostler: ORCID iD orcid.org/0000-0002-8267-2892
ORCID for Alex Dickinson: ORCID iD orcid.org/0000-0002-9647-1944
ORCID for Pete Worsley: ORCID iD orcid.org/0000-0003-0145-5042

Catalogue record

Date deposited: 27 May 2025 18:06
Last modified: 22 Aug 2025 02:31

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Contributors

Author: Silvia Caggiari ORCID iD
Author: Tim Randell
Author: Chantel Marie Ostler ORCID iD
Author: Alex Dickinson ORCID iD
Author: Pete Worsley ORCID iD

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