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Can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users?

While all lower limb prosthesis walkers have a high risk of tripping and/or falling, above knee prosthesis users are reported to fall more frequently. Recognising this, engineers designed microprocessor knees (MPK) to help mitigate these risks, but to what extent these devices reduce this disparity...

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Detalles Bibliográficos
Autores principales: McGrath, Michael, Gray, Laura A., Rek, Beata, Davies, Kate C., Savage, Zoe, McLean, Jane, Stenson, Alison, Zahedi, Saeed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439191/
https://www.ncbi.nlm.nih.gov/pubmed/36054087
http://dx.doi.org/10.1371/journal.pone.0271315
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author McGrath, Michael
Gray, Laura A.
Rek, Beata
Davies, Kate C.
Savage, Zoe
McLean, Jane
Stenson, Alison
Zahedi, Saeed
author_facet McGrath, Michael
Gray, Laura A.
Rek, Beata
Davies, Kate C.
Savage, Zoe
McLean, Jane
Stenson, Alison
Zahedi, Saeed
author_sort McGrath, Michael
collection PubMed
description While all lower limb prosthesis walkers have a high risk of tripping and/or falling, above knee prosthesis users are reported to fall more frequently. Recognising this, engineers designed microprocessor knees (MPK) to help mitigate these risks, but to what extent these devices reduce this disparity between above and below knee users is unclear. A service review was carried out in a prosthetic limb centre regarding the frequency of trips and falls in the previous four weeks. Data from unilateral, community ambulators were extracted. Ordered logistic regressions were applied to investigate whether MPKs mitigated the increased risk of trips and falls for prosthetic knee users, compared to below knee prosthesis users. Socio-demographics (sex, age), prosthesis (prosthesis type, years of use), health (comorbidities, vision, contralateral limb status, medication), and physical function (use of additional walking aids, activity level) were included as covariates. Of the 315 participants in the analysis, 57.5% reported tripping and 20.3% reported falling. Non-microprocessor prosthetic knee (non-MPK) users were shown to trip significantly more than below knee prosthesis users (OR = 1.96, 95% CI = 1.17–3.28). Other covariates showing a significant association included contralateral limb injuries (OR = 1.91, 95% CI = 1.15–3.18) and using an additional walking aid (OR = 1.99, 95% CI = 1.13–3.50). Non-MPK users were also shown to fall significantly more than below knee prosthesis users (OR = 3.34, 95% CI = 1.73–6.45), with no other covariates showing a significant association. MPK users did not show an increased frequency of trips (OR = 0.74, 95% CI = 0.33–1.64) or falls (OR = 0.34, 95% CI = 0.18–2.62), compared to below knee prosthesis users. Of those who tripped at least once in the previous four weeks, those using a non-MPK (OR = 2.73, 95% CI = 1.30–5.74) presented an increased frequency of falling. These findings provide evidence to suggest that the use of MPKs reduces the difference in falls risk between above knee and below knee prosthesis users, providing justification for their provision.
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spelling pubmed-94391912022-09-03 Can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users? McGrath, Michael Gray, Laura A. Rek, Beata Davies, Kate C. Savage, Zoe McLean, Jane Stenson, Alison Zahedi, Saeed PLoS One Research Article While all lower limb prosthesis walkers have a high risk of tripping and/or falling, above knee prosthesis users are reported to fall more frequently. Recognising this, engineers designed microprocessor knees (MPK) to help mitigate these risks, but to what extent these devices reduce this disparity between above and below knee users is unclear. A service review was carried out in a prosthetic limb centre regarding the frequency of trips and falls in the previous four weeks. Data from unilateral, community ambulators were extracted. Ordered logistic regressions were applied to investigate whether MPKs mitigated the increased risk of trips and falls for prosthetic knee users, compared to below knee prosthesis users. Socio-demographics (sex, age), prosthesis (prosthesis type, years of use), health (comorbidities, vision, contralateral limb status, medication), and physical function (use of additional walking aids, activity level) were included as covariates. Of the 315 participants in the analysis, 57.5% reported tripping and 20.3% reported falling. Non-microprocessor prosthetic knee (non-MPK) users were shown to trip significantly more than below knee prosthesis users (OR = 1.96, 95% CI = 1.17–3.28). Other covariates showing a significant association included contralateral limb injuries (OR = 1.91, 95% CI = 1.15–3.18) and using an additional walking aid (OR = 1.99, 95% CI = 1.13–3.50). Non-MPK users were also shown to fall significantly more than below knee prosthesis users (OR = 3.34, 95% CI = 1.73–6.45), with no other covariates showing a significant association. MPK users did not show an increased frequency of trips (OR = 0.74, 95% CI = 0.33–1.64) or falls (OR = 0.34, 95% CI = 0.18–2.62), compared to below knee prosthesis users. Of those who tripped at least once in the previous four weeks, those using a non-MPK (OR = 2.73, 95% CI = 1.30–5.74) presented an increased frequency of falling. These findings provide evidence to suggest that the use of MPKs reduces the difference in falls risk between above knee and below knee prosthesis users, providing justification for their provision. Public Library of Science 2022-09-02 /pmc/articles/PMC9439191/ /pubmed/36054087 http://dx.doi.org/10.1371/journal.pone.0271315 Text en © 2022 McGrath et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
McGrath, Michael
Gray, Laura A.
Rek, Beata
Davies, Kate C.
Savage, Zoe
McLean, Jane
Stenson, Alison
Zahedi, Saeed
Can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users?
title Can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users?
title_full Can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users?
title_fullStr Can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users?
title_full_unstemmed Can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users?
title_short Can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users?
title_sort can microprocessor knees reduce the disparity in trips and falls risks between above and below knee prosthesis users?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439191/
https://www.ncbi.nlm.nih.gov/pubmed/36054087
http://dx.doi.org/10.1371/journal.pone.0271315
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