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Regular use of prostheses is critical for individuals with lower limb amputations to achieve everyday mobility, maintain physical and physiological health, and achieve a better quality of life. Use of prostheses is influenced by numerous factors, with prosthetic design playing a critical role in facilitating mobility for an amputee. Thus, prostheses design can either promote biomechanically efficient or inefficient gait behavior. In addition to increased energy expenditure, inefficient gait behavior can expose prosthetic user to an increased risk of secondary musculoskeletal injuries and may eventually lead to rejection of the prosthesis. Consequently, researchers have utilized the technological advancements in various fields to improve prosthetic devices and customize them for user specific needs. One evolving technology is powered prosthetic components. Presently, an active area in lower limb prosthetic research is the design of novel controllers and components in order to enable the users of such powered devices to be able to reproduce gait biomechanics that are similar in behavior to a healthy limb. In this case series, we studied the impact of using a powered knee-ankle prostheses (PKA) on two transfemoral amputees who currently use advanced microprocessor controlled knee prostheses (MPK). We utilized outcomes pertaining to kinematics, kinetics, metabolics, and functional activities of daily living to compare the efficacy between the MPK and PKA devices. Our results suggests that the PKA allows the participants to walk with gait kinematics similar to normal gait patterns observed in a healthy limb. Additionally, it was observed that use of the PKA reduced the level of asymmetry in terms of mechanical loading and muscle activation, specifically in the low back spinae regions and lower extremity muscles. Further, the PKA allowed the participants to achieve a greater range of cadence than their predicate MPK, thus allowing them to safely ambulate in variable environments and dynamically control speed changes. Based on the results of this case series, it appears that there is considerable potential for powered prosthetic components to provide safe and efficient gait for individuals with above the knee amputation.

下肢截肢患者规律佩戴假肢，对于实现日常移动、维持躯体与生理健康，以及提升生活质量均至关重要。假肢的使用受诸多因素影响，其中假肢设计对截肢者的移动辅助发挥着关键作用。因此，假肢设计可分别促成生物力学层面高效或低效的步态模式。除能量消耗增加外，低效步态还会使假肢佩戴者面临更高的继发性肌肉骨骼损伤风险，甚至最终导致患者对假肢产生排斥。为此，研究人员借助多领域技术进步来改进假肢装置，并根据使用者的个性化需求进行定制。其中一项不断发展的技术便是主动式假肢部件。当前，下肢假肢研究的热点领域之一便是新型控制器与部件的设计，旨在让这类主动式假肢的使用者能够复刻与健康肢体步态生物力学特征相近的步态行为。在本系列病例研究中，我们针对2名当前使用先进微处理器控制膝关节假肢（microprocessor controlled knee prostheses, MPK）的膝上截肢患者，探究了主动式膝踝假肢（powered knee-ankle prostheses, PKA）的使用效果。我们通过运动学、动力学、代谢指标以及日常功能活动相关的结局指标，对比了MPK与PKA两种装置的使用效果。研究结果显示，PKA可让受试者的步态运动学特征与健康肢体的正常步态模式相近。此外，研究观察到，使用PKA可降低机械负荷与肌肉激活层面的不对称程度，尤其在腰背脊柱区域与下肢肌肉方面。进一步而言，相较于受试者此前使用的MPK，PKA可让受试者实现更广的步频范围，使其能够在多变环境中安全行走，并动态调整步行速度。基于本系列病例研究的结果，主动式假肢部件在为膝上截肢患者提供安全高效步态方面，展现出可观的应用潜力。