Outcomes Associated with the Use of Microprocessor-Controlled Prosthetic Knees among Individuals with Unilateral Transfemoral Limb Loss: A Systematic Review

ABSTRACT Microprocessor-controlled prosthetic knees (MPKs) have been developed as an alternative to non-microprocessor-controlled knees (NMPKs) to address challenges facing individuals with lower limb loss. A body of scientific literature comparing MPKs and NMPKs exists, but has yet to be critically appraised. Therefore, a systematic review was conducted to examine outcomes associated with use of these interventions among individuals with transfemoral limb loss. A search of biomedical databases identified 241 publications. Twenty-seven met the inclusion/exclusion criteria and were reviewed for methodological quality and content. Twenty-eight evidence statements, in nine outcome categories (Metabolic Energy Expenditure, Activity, Cognitive Demand, Gait Mechanics, Environmental Obstacle Negotiation, Safety, Preference & Satisfaction, Economics, and Health & Quality of Life) were developed based on findings in the literature. The level of evidence supporting these statements varied due to quantity, quality, and consistency of the results in the literature. Evidence statements supported by a moderate level of evidence that noted significant differences between MPKs and NMPKs were derived in five of the nine outcome categories. The results from this review suggest that evidence exists to inform clinical practice, and that additional research is needed to confirm existing evidence and better understand outcomes associated with use of NMPKs and MPKs.