Kinsey Herrin, Sujay Kestur, Sixu Zhou, Gwyn O'Sullivan, Teresa Snow, Walter Lee Childers, Aaron Young
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Secondary outcomes were stance time asymmetry, physiological cost index, stair and ramp speeds, the narrowing beam walking test, and community ambulation monitoring.</p><p><strong>Results: </strong>Participants walked 11% faster in Rheo than Power Knee during the 10-mwt (95% confidence interval [CI]: 0.046-0.184, p = .015). In the 2-mwt, participants walked 12% faster in C-Leg (95% CI: 0.034-0.241, p = .003) and 9% faster in Rheo (95% CI: 0.031, 0.163, p = .027) than in Power Knee. On the PEQ, participants reported greater satisfaction with C-Leg compared to Power Knee (p = .006). Ramp ascent speed was 8% faster in Rheo than Power Knee (95% CI: 0.026-0.130, p = .024). No significant differences were found for other secondary outcomes. Notably, 10 of 12 outcomes showed individuals performing their best by a defined difference on an MPK different from the cohort's best-performing MPK.</p><p><strong>Conclusions: </strong>Participants walked faster in C-Leg and Rheo than Power Knee and reported greater satisfaction with C-Leg. Consideration of patient needs and characteristics may allow more individualized MPK prescription and thereby improve rehabilitation outcomes.</p><p><strong>Database registration: </strong>NCT06399471.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Toward personalizing prosthesis prescription: A take-home study of three microprocessor-controlled prosthetic knees: A randomized crossover study.\",\"authors\":\"Kinsey Herrin, Sujay Kestur, Sixu Zhou, Gwyn O'Sullivan, Teresa Snow, Walter Lee Childers, Aaron Young\",\"doi\":\"10.1002/pmrj.70028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous studies on microprocessor-controlled prosthetic knees (MPKs) often investigate benefits of MPKs as a class of knees rather than clinically relevant differences between specific knees, despite their distinct features.</p><p><strong>Objectives: </strong>To systematically evaluate and report outcomes associated with three commercially available MPKs following a standardized real-world use period.</p><p><strong>Design: </strong>Randomized crossover study.</p><p><strong>Setting: </strong>Research laboratory and community environment.</p><p><strong>Participants: </strong>Ten patients with transfemoral amputation.</p><p><strong>Interventions: </strong>Three MPKs were fitted, trained, and worn for a 1-week period including C-Leg 4.0 (Ottobock, Duderstadt, Germany), Rheo Knee-Model RM7 (Össur, Reykjavik, Iceland), and Power Knee-PKA01 (Össur, Reykjavik, Iceland).</p><p><strong>Main outcome measures: </strong>Primary outcomes were the 10-meter walk test (10-mwt), the 2-minute walk test (2-mwt), and the Prosthesis Evaluation Questionnaire (PEQ). 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引用次数: 0
摘要
背景：尽管微处理器控制的假膝（mpk）具有不同的特征，但之前的研究通常是将mpk作为一类膝关节来研究其益处，而不是特定膝关节之间的临床相关差异。目的：系统地评估和报告三种市售mpk在标准化实际使用期后的相关结果。设计：随机交叉研究。环境：研究实验室和社区环境。研究对象：经股截肢患者10例。干预措施：三个mpk被安装、训练并佩戴一周，包括C-Leg 4.0 （Ottobock, Duderstadt，德国）、Rheo Knee-Model RM7 （Össur，冰岛雷克雅未克）和Power Knee-PKA01 （Össur，冰岛雷克雅未克）。主要结果测量：主要结果为10米步行测试（10-mwt）、2分钟步行测试（2-mwt）和假体评估问卷（PEQ）。次要结果为站立时间不对称、生理成本指数、楼梯和坡道速度、窄梁步行试验和社区步行监测。结果：在10 mwt期间，参与者在Rheo中行走速度比Power Knee快11%（95%置信区间[CI]: 0.046-0.184, p = 0.015）。在2 mwt中，参与者的c腿行走速度提高了12% (95% CI: 0.034-0.241, p =。003)， Rheo组快9% (95% CI: 0.031, 0.163, p =。比《力量的膝盖》更有趣。在PEQ测试中，参与者对c型腿的满意度高于强力膝（p = 0.006）。Rheo患者坡道上升速度比Power Knee患者快8% （95% CI: 0.026-0.130, p = 0.024）。其他次要结局无显著差异。值得注意的是，在12个结果中，有10个结果显示，个体在MPK上的最佳表现与群体中表现最佳的MPK有明显的差异。结论：参与者在C-Leg和Rheo中比Power Knee走得更快，并且报告对C-Leg的满意度更高。考虑到患者的需求和特点，可能允许更个性化的MPK处方，从而改善康复结果。数据库注册：NCT06399471。
Toward personalizing prosthesis prescription: A take-home study of three microprocessor-controlled prosthetic knees: A randomized crossover study.
Background: Previous studies on microprocessor-controlled prosthetic knees (MPKs) often investigate benefits of MPKs as a class of knees rather than clinically relevant differences between specific knees, despite their distinct features.
Objectives: To systematically evaluate and report outcomes associated with three commercially available MPKs following a standardized real-world use period.
Design: Randomized crossover study.
Setting: Research laboratory and community environment.
Participants: Ten patients with transfemoral amputation.
Interventions: Three MPKs were fitted, trained, and worn for a 1-week period including C-Leg 4.0 (Ottobock, Duderstadt, Germany), Rheo Knee-Model RM7 (Össur, Reykjavik, Iceland), and Power Knee-PKA01 (Össur, Reykjavik, Iceland).
Main outcome measures: Primary outcomes were the 10-meter walk test (10-mwt), the 2-minute walk test (2-mwt), and the Prosthesis Evaluation Questionnaire (PEQ). Secondary outcomes were stance time asymmetry, physiological cost index, stair and ramp speeds, the narrowing beam walking test, and community ambulation monitoring.
Results: Participants walked 11% faster in Rheo than Power Knee during the 10-mwt (95% confidence interval [CI]: 0.046-0.184, p = .015). In the 2-mwt, participants walked 12% faster in C-Leg (95% CI: 0.034-0.241, p = .003) and 9% faster in Rheo (95% CI: 0.031, 0.163, p = .027) than in Power Knee. On the PEQ, participants reported greater satisfaction with C-Leg compared to Power Knee (p = .006). Ramp ascent speed was 8% faster in Rheo than Power Knee (95% CI: 0.026-0.130, p = .024). No significant differences were found for other secondary outcomes. Notably, 10 of 12 outcomes showed individuals performing their best by a defined difference on an MPK different from the cohort's best-performing MPK.
Conclusions: Participants walked faster in C-Leg and Rheo than Power Knee and reported greater satisfaction with C-Leg. Consideration of patient needs and characteristics may allow more individualized MPK prescription and thereby improve rehabilitation outcomes.
期刊介绍：
Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.
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