Functional added value of microprocessor-controlled knee joints in daily life performance of Medicare Functional Classification Level-2 amputees
Journal of Rehabilitation Medicine
Objective: To assess the effects of using a microprocessorcontrolled prosthetic knee joint on the functional performance of activities of daily living in persons with an aboveknee leg amputation. Design: Randomised cross-over trial. Subjects: Forty-one persons with unilateral above-knee or knee disarticulation limb loss, classified as Medicare Functional Classification Level-2 (MFCL-2). Methods: Participants were measured in 3 conditions, i.e. using a mechanically controlled knee joint and two
... knee joint and two types of microprocessor-controlled prosthetic knee joints. Functional performance level was assessed using a test in which participants performed 17 simulated activities of daily living (Assessment of Daily Activity Performance in Transfemoral amputees test). Performance time was measured and selfperceived level of difficulty was scored on a visual analogue scale for each activity. Results: High levels of within-group variability in functional performance obscured detection of any effects of using a microprocessor-controlled prosthetic knee joint. Data analysis after stratification of the participants into 3 subgroups, i.e. participants with a "low", "intermediate" and "high" functional mobility level, showed that the two higher functional subgroups performed significantly faster using microprocessor-controlled prosthetic knee joints. Conclusion: MFCL-2 amputees constitute a heterogeneous patient group with large variation in functional performance levels. A substantial part of this group seems to benefit from using a microprocessor-controlled prosthetic knee joint when performing activities of daily living.