ASsessing Clinical outcomes with microprocEssor kNee uTilization in a K2 population (ASCENT K2): randomized controlled trial results for above-knee prosthesis users over age 65.

Abstract

To assess the effects of microprocessor knees (MPKs) versus non-microprocessor knees (NMPKs) among unilateral, above-the-knee prosthesis users classified as Medicare K2 ambulators over age 65. A two-arm, 12-month randomized controlled trial to compare MPKs (intervention) to standard-of-care NMPKs (control). Fear-of-falling avoidance behavior (FFABQ), falls and near-falls were assessed alongside additional measures of mobility, balance, and health-related quality-of-life (HR-QoL). A total of 107 individuals (MPK: <i>n</i> = 54, age = 73.6 ± 0.8 years, 47 diabetes/dysvascular etiology; NMPK: <i>n</i> = 53, age = 73.7 ± 0.8 years, 44 diabetes/dysvascular etiology) were enrolled. The MPK group reported significant improvement in activity avoidance due to fear of falling (FFABQ, <i>p</i> < 0.001), which was not seen in the NMPK group (FFABQ, <i>p</i> = 0.104). The MPK group also experienced significantly fewer falls (<i>p</i> = 0.015) and near-falls (<i>p</i> = 0.001) than the NMPK group. Results were also significantly favorable for mobility and HR-QoL for the MPK group and not the NMPK group. MPKs result in lower levels of activity avoidance due to fear-of-falling, reduced falls and near-falls, and better HR-QoL as opposed to NMPKs. Expanded use of MPKs has the potential to enhance safety and HR-QoL among older prosthesis users with limited functional capabilities.