Stability and Falls Evaluations in AMPutees (SAFE-AMP 1): Microprocessor knee technology reduces odds of incurring an injurious fall for individuals with diabetic/dysvascular amputation

ABSTRACT

Individuals with lower limb amputation have a high incidence of falls. Above-the-knee amputation and diabetes/vascular disease are both risk factors for falls. Microprocessor knee (MPK) technology may reduce falls in this population. The objective was to determine the association between MPKs and reduced injurious falls. A retrospective analysis of injurious falls within a large, national outcomes database was conducted. Inclusion was limited to adult K3 ambulators with unilateral, transfemoral, or knee disarticulation amputation due to diabetes/vascular disease. There were 744 out of 881 individuals that did not receive an MPK. Results showed that 16.3% of non-MPK users experienced an injurious fall compared to 7.3% of MPK users (p = .007). Not having an MPK resulted in significantly increased odds (unadjusted: OR: 2.47, 95% CI: 1.26–4.83, p = .009; adjusted for confounders: OR: 2.52, 95% CI: 1.28–4.94, p = .007) of incurring an injurious fall over a 6-month period. In conclusion, the current study found use of an MPK strongly associated with reduced injurious falls in a population of patients with amputation due to diabetes/vascular disease. The findings strongly support the use of MPK technology to mitigate fall risk, and in particular injurious falls requiring medical intervention.

KEYWORDS:

• diabetes
• falls
• prosthesis design
• rehabilitation research
• transfemoral amputation
• vascular disease

Acknowledgments

The authors would like to thank Dwiesha England, MS, and Mandi Laurie, MS, for assistance with data identification and reduction, as well as all the clinicians that have embraced a cultural shift in the practice of orthotics and prosthetics to include the routine collection of outcome measures providing the ability to do these large aggregate analyses.

Abbreviations

AKA: above-the-knee amputation

MPK: microprocessor knee

BMI: body mass index

FCI: functional comorbidity index

OR: odds ratio

CI: confidence interval

Disclosure statement

No potential conflict of interest was reported by the author(s).