The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial
Abstract Background Powered prosthetic ankles provide battery-powered mechanical push-off, with the aim of reducing the metabolic demands of walking for people with transtibial amputations. The efficacy of powered ankles has been shown in active, high functioning individuals with transtibial amputat...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-021-00842-2 |
| _version_ | 1818576462695890944 |
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| author | Jay Kim Jeffrey Wensman Natalie Colabianchi Deanna H. Gates |
| author_facet | Jay Kim Jeffrey Wensman Natalie Colabianchi Deanna H. Gates |
| author_sort | Jay Kim |
| collection | DOAJ |
| description | Abstract Background Powered prosthetic ankles provide battery-powered mechanical push-off, with the aim of reducing the metabolic demands of walking for people with transtibial amputations. The efficacy of powered ankles has been shown in active, high functioning individuals with transtibial amputation, but is less clear in other populations. Additionally, it is unclear how use of a powered prosthesis influences everyday physical activity and mobility. Methods Individuals with unilateral transtibial amputations participated in a randomized clinical trial comparing their prescribed, unpowered prosthesis and the BiOM powered prosthesis. Participants’ metabolic costs and self-selected walking speeds were measured in the laboratory and daily step count, daily steps away from home, and walking speed were measured over two weeks of at-home prosthesis use. Participants also rated their perception of mobility and quality of life and provided free-form feedback. Dependent measures were compared between prostheses and the relationships between metabolic cost, perception of mobility, and characteristics of walking in daily life were explored using Pearson’s correlations. Results Twelve people were randomly allocated to the powered prosthesis first (n = 7) or unpowered prosthesis first (n = 5) and ten completed the full study. There were no differences in metabolic costs (p = 0.585), daily step count (p = 0.995), walking speed in-lab (p = 0.145) and in daily life (p = 0.226), or perception of mobility between prostheses (p ≥ 0.058). Changes varied across participants, however. There were several medium-sized effects for device comparisons. With the powered prosthesis, participants had increased self-reported ambulation (g = 0.682) and decreased frustration (g = 0.506). Conclusions There were no universal benefits of the powered prosthesis on function in the lab or home environment. However, the effects were subject-specific, with some reporting preference for power and improved mobility, and some increasing their activity and decreasing their metabolic effort. Additionally, self-reported preferences did not often correlate with objective measures of function. This highlights the need for future clinical research to include both perception and objective measures to better inform prosthetic prescription. Trial registration: https://clinicaltrials.gov , #NCT02828982. Registered 12 July 2016, https://clinicaltrials.gov/ct2/show/NCT02828982 |
| first_indexed | 2024-12-16T06:14:24Z |
| format | Article |
| id | doaj.art-1eee174e9e6a424e9f79d7596dd5206a |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-12-16T06:14:24Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-1eee174e9e6a424e9f79d7596dd5206a2022-12-21T22:41:18ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032021-03-0118111310.1186/s12984-021-00842-2The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trialJay Kim0Jeffrey Wensman1Natalie Colabianchi2Deanna H. Gates3School of Kinesiology, University of MichiganUniversity of Michigan Orthotics and Prosthetics CenterSchool of Kinesiology, University of MichiganSchool of Kinesiology, University of MichiganAbstract Background Powered prosthetic ankles provide battery-powered mechanical push-off, with the aim of reducing the metabolic demands of walking for people with transtibial amputations. The efficacy of powered ankles has been shown in active, high functioning individuals with transtibial amputation, but is less clear in other populations. Additionally, it is unclear how use of a powered prosthesis influences everyday physical activity and mobility. Methods Individuals with unilateral transtibial amputations participated in a randomized clinical trial comparing their prescribed, unpowered prosthesis and the BiOM powered prosthesis. Participants’ metabolic costs and self-selected walking speeds were measured in the laboratory and daily step count, daily steps away from home, and walking speed were measured over two weeks of at-home prosthesis use. Participants also rated their perception of mobility and quality of life and provided free-form feedback. Dependent measures were compared between prostheses and the relationships between metabolic cost, perception of mobility, and characteristics of walking in daily life were explored using Pearson’s correlations. Results Twelve people were randomly allocated to the powered prosthesis first (n = 7) or unpowered prosthesis first (n = 5) and ten completed the full study. There were no differences in metabolic costs (p = 0.585), daily step count (p = 0.995), walking speed in-lab (p = 0.145) and in daily life (p = 0.226), or perception of mobility between prostheses (p ≥ 0.058). Changes varied across participants, however. There were several medium-sized effects for device comparisons. With the powered prosthesis, participants had increased self-reported ambulation (g = 0.682) and decreased frustration (g = 0.506). Conclusions There were no universal benefits of the powered prosthesis on function in the lab or home environment. However, the effects were subject-specific, with some reporting preference for power and improved mobility, and some increasing their activity and decreasing their metabolic effort. Additionally, self-reported preferences did not often correlate with objective measures of function. This highlights the need for future clinical research to include both perception and objective measures to better inform prosthetic prescription. Trial registration: https://clinicaltrials.gov , #NCT02828982. Registered 12 July 2016, https://clinicaltrials.gov/ct2/show/NCT02828982https://doi.org/10.1186/s12984-021-00842-2Transtibial amputationMicroprocessor ankleInertial measurement unitAccelerometerMetabolic costPreference |
| spellingShingle | Jay Kim Jeffrey Wensman Natalie Colabianchi Deanna H. Gates The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial Journal of NeuroEngineering and Rehabilitation Transtibial amputation Microprocessor ankle Inertial measurement unit Accelerometer Metabolic cost Preference |
| title | The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial |
| title_full | The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial |
| title_fullStr | The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial |
| title_full_unstemmed | The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial |
| title_short | The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial |
| title_sort | influence of powered prostheses on user perspectives metabolics and activity a randomized crossover trial |
| topic | Transtibial amputation Microprocessor ankle Inertial measurement unit Accelerometer Metabolic cost Preference |
| url | https://doi.org/10.1186/s12984-021-00842-2 |
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