Prosthetics

(C16) Anatomy of a Fall: Could the Microprocessor Knee Have Prevented the Fall?

Organizing Chair(s)

• 

  Robert Gailey, PhD, PT, FAPTA

  Professor
  University of Miami Miller School of Medicine
  Pinecrest, Florida

Speaker(s)

• 

  Christopher Wong, PT, PhD (he/him/his)

  Professor, Rehabilitation & Regenerative Medicine
  Columbia University Irving Medical Center
  Pelham, New York
• 

  Kurt Gruben, MSBE CPO

  Clinical Manager
  Ossur

Moderator(s)

• 

  Robert Gailey, PhD, PT, FAPTA

  Professor
  University of Miami Miller School of Medicine
  Pinecrest, Florida

The microprocessor knees (MPK) have been attributed to the reduction of falls in people with transfemoral limb loss. However, the anatomy of falls is complex. In fact, most falls are not exclusively prosthetic related but rather correlated to physical limitations, impaired balance (1), comorbidities, gait limitations (2) environment, cognition, decreased social participation (3), and other pre-existing factors. Identifying the characteristics of patients at risk can assist with prosthetic prescription and treatment. This evidence-based presentation will discuss a series of relevant systematic reviews performed by various working groups with other professions (4) with a focus on outlining the mechanism of falls, patient characteristics, falls outcomes measures, multi-disciplinary treatment approaches and patient documentation. Integrating routine assessments, treatments and documentation related to the influence of MPKs on our patient’s well-being can have positive effects for patients, clinicians, providers and the profession.

References (short list)
1) Wong CK, Chen C, Blackwell W, Rahal R, Benoy SA. Balance ability measured with the Berg Balance Scale: a determinant of fall history in community-dwelling adults with leg amputation. J Rehabil Med 2015; 47: 80–86.
2) Yiou E, Caderby T, Delafontaine A, Fourcade P, Honeine J-L. Balance control during gait initiation State-of-the-art and research perspective. Worl J Orthop. 2017;18,8(11):815-828.
3) Miller W, Speechley M, Deathe B. The prevalence of risk factors of falling and fear of falling among lower extremity amputees. Arch Phys Med Rehabil 2001; 82: 1031–1037.
4) Outcome Measure Toolkit for Geriatric Fall/Balance Assessment. APTA Geriatrics, an Academy of American Physical Therapy Association. 2019.