While a powered knee and ankle prosthesis can restore additional functional activities, such as reciprocal stair climbing, learning to incorporate all the features of the device and optimize ambulation requires user and clinician education. To help fill the gap in instruction for people with transfemoral amputations, researchers from the Shirley Ryan Abilitylab and Northwestern University developed a training protocol for people who use a powered knee and ankle prosthesis to provide increased functional mobility and allow them a return to activities of daily living.
The protocol was developed while training 30 participants with unilateral transfemoral or knee disarticulation amputations. The participants received instruction for level-ground walking, stair climbing, incline walking, and sit-to-stand transitions. A therapist provided specific training for each mode, including verbal, visual, and tactile cueing, along with patient education on device functionality.
The primary outcome measure was the ability of each participant to demonstrate independence with walking and sit-to-stand transitions along with modified independence for stair climbing and incline walking due to the use of a handrail.
Using the protocol, every individual was successful in comfortable ambulation of level-ground walking and 27 out of 30 were successful in all other functional modes after participating in one to three sessions of one to two hours in length (three participants did not attempt all activities).
“This paper serves as education on new training techniques that can provide amputees with the best possible tools to take advantage of these powered devices to achieve their desired clinical outcomes,” the authors wrote.
The open-access study, “Functional mobility training with a powered knee and ankle prosthesis,” was published in Frontiers in Rehabilitation Sciences.