Prosthetic rehabilitation for bilateral transfemoral amputees using microprocessor-controlled knees with a novel training program: A study of two cases.

Abstract

The use of microprocessor-controlled prosthetic knees facilitates safe and efficient ambulation in individuals with unilateral transfemoral amputation, contributing to their reintegration into daily life. We report rehabilitation outcomes in two individuals with bilateral transfemoral amputations that used Kenevo (Ottobock, Germany), a microprocessor-controlled prosthetic knee designed for low-activity users (K1/K2), as the first prosthesis. Gait training began in the most stable mode (A) and then progressed to modes B, B+, or C depending on gait stability. One patient subsequently trained with C-Leg 4 (Ottobock), a higher-functioning microprocessor-controlled prosthetic knee (K3/K4). Training durations were 8 months (1 month pre-prosthetic, 3 months stubby, 3 months Kenevo, and 1 month C-Leg 4) and 12 months (1 month pre-prosthetic, 2 months stubby, and 9 months Kenevo). The longer duration was due to the patient having a short residual limb and difficulty with outdoor ambulation. Both patients achieved independent walking with C-Leg or Kenevo and maintained prosthetic walking in the community after discharge. Ten-meter walk speeds were 0.77 and 0.93 m/s; 6-minute walk distances were 365 and 332 m; oxygen uptakes were 21.0 and 37.1 mL/kg/min. These cases suggest that initial training with Kenevo may support efficient rehabilitation in bilateral transfemoral amputees, while residual limb length may influence oxygen uptake during prosthetic ambulation.