Long-term clinical evaluation of the automatic stance-phase lock-controlled prosthetic knee joint in young adults with unilateral above-knee amputation

Abstract

Purpose: The purpose of this study was to clinically evaluate the automatic stance-phase lock (ASPL) knee mechanism against participants’ existing weight-activated braking (WAB) prosthetic knee joint.

Method: This prospective crossover study involved 10 young adults with an above-knee amputation. Primary measurements consisted of tests of walking speeds and capacity. Heart rate was measured during the six-minute walk test and the Physiological Cost Index (PCI) which was calculated from heart rate estimated energy expenditure. Activity was measured with a pedometer. User function and quality of life were assessed using the Lower Limb Function Questionnaire (LLFQ) and Prosthetic Evaluation Questionnaire (PEQ). Long-term follow-up over 12 months were completed.

Results: Walking speeds were the same for WAB and APSL knees. Energy expenditure (PCI) was lower for the ASPL knees (p = 0.007). Step counts were the same for both knees, and questionnaires indicated ASPL knee preference attributed primarily to knee stability and improved walking, while limitations included terminal impact noise. Nine of 10 participants chose to keep using the ASPL knee as part of the long-term follow-up.

Conclusions: Potential benefits of the ASPL knee were identified in this study by functional measures, questionnaires and user feedback, but not changes in activity or the PEQ.

Keywords: Amputee; artificial knee joint; energy expenditure; prosthesis; stance-phase control; transfemoral amputation, stance-phase control

Keywords:

• Amputee
• artificial knee joint
• energy expenditure
• knee joint
• prosthesis
• transfemoral

Acknowledgements

We would like to thank the participants of the study.

Disclosure statement

Since the completion of the study, the AT-Knee has become a product of LegWorks Inc., which was cofounded by one of the authors.

Funding information

Funding for this work was provided by Grand Challenges Canada. Virginia Wright holds the Holland Bloorview Kids Rehabilitation Hospital Foundation Chair in Pediatric Rehabilitation.