The effect of microprocessor controlled exo-prosthetic knees on limited community ambulators: systematic review and meta-analysis.

Purpose: The clinical benefits of microprocessor-controlled prosthetic knees (MPKs) in community ambulators have been well-established. A systematic review in limited community ambulators published in 2014 found benefits in safety, performance-based, and patient-reported outcomes. This work updates the previous analysis to the current state of the published evidence.

Methods: Systematic review and meta-analysis of the effect of MPKs in limited community ambulators.

Results: Thirteen research projects presented in 15 publications were identified. Overall validity was "high" in nine studies, "moderate" in three, and "low" in one. The literature described a total of 2366 patients, with 704 classified as limited community ambulators. The use of MPKs in limited community ambulators led to a reduction in falls (SMD : -0.59; 95% confidence interval (CI) [-0.85, -0.32; =0%]), fear of falling (SMD : 1.2; 95%CI [0.55, 1.85; =80%]), risk of falling as indicated by the TUG (SMD : -0.45, 95%CI [-0.87, -0.02; =0%]), an improvement in mobility grade (0.51; 95%CI [0.47,0.55]), self-selected walking speed (SMD : 0.47; 95%CI [0.14,0.81; =0%]), and patient-reported ambulation (MD 9.32; 95%CI [3.61, 15.02; =7%]), and utility (MD 7.76; 95%CI [2.05-13.47; =0%]). Other outcomes exhibited trends in favor of MPK use or remained insensitive. No outcome was identified favoring non-MPKs.

Conclusions: These results suggest that MPKs may be considered a valuable therapeutic option in limited community ambulators with a transfemoral amputation.Implications for rehabilitationAbove knee amputees may be treated with a large variety of artificial exo-prosthetic knee components.Microprocessor-controlled prosthetic knees have proven to be advantageous and cost effective for community ambulators.The current analysis shows similar effects in safety, mobility, and patient perception also for limited community ambulators.Microprocessor-controlled prosthetic knees are a viable therapeutic option for limited community ambulators.