Powered knee and ankle prosthesis use with a K2 level ambulator: a case report.
Ann M Simon, Suzanne B Finucane, Andrea J Ikeda and 2 others
PMID 37387731WHAT IT FOUND
A K2-level amputator learned to climb stairs reciprocally with a powered prosthesis.
He reported greater confidence and safety on inclines, though he preferred his passive device for sit-to-stand transfers due to its lighter weight and better cosmesis.
Key findings
01The participant achieved a significant improvement in stair assessment scores, moving from a step-to pattern to reciprocal stepping for both ascent and descent.
02While level-ground walking speeds and kinematics were similar between devices, the participant reported higher satisfaction and confidence with the powered prosthesis for incline walking and stair climbing.
03Training required modifications for the K2 level, including slower progression, more frequent rest breaks for fatigue, and specific control adjustments to limit knee swing speed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a single case report, so findings cannot be generalized to all K2 ambulators. The powered prosthesis was heavier (5.8 kg) than the prescribed passive prosthesis (4.8 kg), which may have influenced the participant's preference for the passive device in transfers and cosmesis. There was no follow-up after the post-training assessment, so long-term retention of skills or device usage is unknown. Training time was limited to eight hours, and the authors note that further optimization of joint power for stair climbing and sit-to-stand movements might have been possible with more time.
Declared interests
Funding was provided by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), the National Institute of Health (NIH), and the MSL Renewed Hope Foundation. The authors declare no conflicts of interest with commercial device manufacturers.
The easy way to misread this
Do not assume that powered prostheses are universally superior for K2 ambulators. This participant preferred his passive device for sit-to-stand transfers due to the powered device's weight and resistance, and the study highlights that training requires significant modification for lower-level users to avoid fatigue and balance issues.