Médecine

Paramédical

Autres domaines


S'abonner

Mobility and satisfaction with a microprocessor-controlled knee in moderately active amputees: A multi-centric randomized crossover trial - 29/08/18

Doi : 10.1016/j.rehab.2018.04.003 
Céline Lansade a, , Eric Vicaut b, Jean Paysant c, Doménico Ménager a, Marie-Christine Cristina d, Frank Braatz e, Stephan Domayer f, Dominic Pérennou g, Gérard Chiesa a
a Institut Robert-Merle d’Aubigné, 2, rue Emilion-Michaut et Lucien-Rabeux, 94460 Valenton, France 
b Clinical Trial Unit of Lariboisière Hospital, Medial Device Evaluation Center, France 
c Institut régional de médecine physique et de réadaptation, 75, boulevard Lobau, 54042 Nancy, France 
d Pôle Saint-Hélier, 54, rue Saint-Hélier, CS 74330, 35043 Rennes, France 
e Universitätsmedizin Göttingen, Robert-Koch Strasse 40, 37075 Göttingen, Germany 
f Sonderkrankenanstalt Zicksee, Otto Pohanka Platz, 7161 Sankt Andrä am Zicksee, Austria 
g Hôpital Sud, CHU de Grenoble, BP 338, avenue de Kimberley, 38434 Echirolles, France 

Corresponding author.

Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.

Connectez-vous pour en bénéficier!

Highlights

With the Kenevo microprocessor-controlled knee (MPK) for moderately active amputees, the Timed Up and Go score was shorter than with non-MPKs (NMPKs). The global score of the locomotor capacity index was significantly improved with the MPK.
Global satisfaction was significantly improved with the MPK versus the NMPK.
MPKs explicitly tailored to the specific needs of this vulnerable population should be considered as a viable therapeutic option to increase mobility and participation.

Le texte complet de cet article est disponible en PDF.

Abstract

Objective

Microprocessor-controlled knees are generally prescribed and reimbursed for active amputees. Recent studies suggested that this technology could be useful for amputees with moderate activity level. We compared the efficiency of a microprocessor-controlled knee (MPK, Kenevo, Otto Bock) and non-MPKs (NMPKs) in these indications.

Methods

A multi-centric randomized crossover trial was conducted in 16 hospitals from 3 European countries. Participants were randomized to an MPK-NMPK sequence, testing the MPK for 3 months and the NMPK for 1 month, or to an NMPK-MPK sequence, testing the NMPK for 1 month and the MPK for 3 months. Dynamic balance, the main criteria, was assessed with the Timed-Up and Go test (TUG), functional mobility with the Locomotor Capability Index (LCI-5), quality of life with the Medical Outcomes Study Short Form 36 v2 (SF-36v2) and satisfaction with the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0. The occurrence of falls was monitored during the last month of trial. Analysis was by intent-to-treat and per-protocol (PP).

Results

We recruited 35 individuals with transfemoral amputation or knee disarticulation (27 males; mean age 65.6years [SD 10.1]). On PP analysis, dynamic balance and functional mobility were improved with the MPK, as shown by a reduced median TUG time (from 21.4s [Q1–Q3 19.3–26.6] to 17.9s [15.4–22.7], P=0.001) and higher mean global LCI-5 (from 40.4 [SD 7.6] to 42.8 [6.2], P=0.02). Median global satisfaction score increased (from 3.9 [Q1–Q3 3.8–4.4] to 4.7 [4.1–4.9], P=0.001) and quality of life was improved for the mental component summary of the SF-36v2 (median score from 53.3 [Q1–Q3 47.8–60.7] to 60.2 [51.6–62.6], P=0.03) and physical component summary but not significantly (mean score from 44.1 [SD 6.3] to 46.3 [7.0], P=0.08). Monitoring of adverse events including falls revealed no differences between both assessed devices.

Conclusion

This study enhances the level of evidence to argue equal opportunity for all individuals with transfemoral amputation or knee disarticulation, regardless of their mobility grade, to be provided with appropriate prostheses.

Le texte complet de cet article est disponible en PDF.

Keywords : Amputation, Balance, Mobility, Multi-centric, Randomized, Crossover


Plan


© 2018  The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 61 - N° 5

P. 278-285 - septembre 2018 Retour au numéro
Article précédent Article précédent
  • Assessment of innovation in prosthetic fitting for transfemoral amputees: A model for asking basic questions of physical and rehabilitation medicine?
  • Jean-Marie Casillas
| Article suivant Article suivant
  • Effect of single-session dual-tDCS before physical therapy on lower-limb performance in sub-acute stroke patients: A randomized sham-controlled crossover study
  • Wanalee Klomjai, Benchaporn Aneksan, Anuchai Pheungphrarattanatrai, Thanwarat Chantanachai, Nattha Choowong, Soontaree Bunleukhet, Paradee Auvichayapat, Yongchai Nilanon, Vimonwan Hiengkaew

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

;

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.