Mileusnic M, Rettinger L, Highsmith M.J, Hahn A. BENEFITS OF GENIUM MICROPROCESSOR CONTROLLED KNEE ON AMBULATION, MOBILITY, ACTIVITIES OF DAILY LIVI NG AND QUALITY OF LIFE: A SYSTEMATIC REVIEW. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018.DOI: https://doi.org/10.33137/cpoj.v1i2.32033 1 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (ORAL PRESENTATION) BENEFITS OF GENIUM MICROPROCESSOR CONTROLLED KNEE ON AMBULATION, MOBILITY, ACTIVITIES OF DAILY LIVING AND QUALITY OF LIFE: A SYSTEMATIC REVIEW Milana Mileusnic1* , Lena Rettinger1, Michael Jason Highsmith2, Andreas Hahn1 1 Department of Clinical Research and Services, Otto Bock HealthCare Products GmbH, Austria. 2 Extremity Trauma & Amputation Center of Excellence. U.S. Department of Veteran Affairs, Tampa, FL, USA. * Email: Milana.Mileusnic@ottobock.com DOI: https://doi.org/10.33137/cpoj.v1i2.32033 INTRODUCTION Several years ago, a new microprocessor controlled knee (MPK), Genium, was introduced containing sensors, algorithms and technical solutions that enable a range of new functions to lower limb amputees. We conducted a systematic review to evaluate the effect of the knee on ambulation, mobility, activities of daily living (ADLs) and quality of life (QoL). METHODS The systematic review was conducted according to the Prisma Guidelines and recommendations of the State-of- Science Evidence Report Guidelines of the AAOP. Three reviewers conducted the quality assessment independently. RESULTS Twelve articles were included in the review and reported of active subjects transitioning from C-Leg to Genium. The overall validity of the evidence was mostly medium and high (Figure 1). Common validity concerns included lack of blinding, incomplete reporting (fatigue & learning effect, attrition rate), effect size calculation, etc. Nine articles focused on ambulation, in particular on level walking, stairs and ramps 1-9. Biomechanical analysis reported of more physiological and symmetrical gait as well as reduction of loading and compensatory motion on sound side. Four square step test, Amputee Mobility Predictor and step activity derived functional level assessing the mobility were significantly improved6. Four publications addressing ADLs reported of significant improvements with values closer to able- bodies subjects (i.e. domains upper-and lower-body strength, balance, coordination, endurance)6,9,11,12. Two articles reported of significant effect of Genium on QoL6,10. Figure 1. Number and quality of evidence across categories. CONCLUSION Quality of evidence is predominantly moderate and high. Genium resulted in more physiological gait, more evenly distributed loading and reduction in compensatory movements. Significant improvements are reported in mobility, QoL and especially safety and ability to conduct ADLs. SIGNIFICANCE Additional benefits could be observed with Genium in above knee amputees when compared to standard MPKs. Gait optimization could be relevant considering the long- term risk of secondary physical conditions in the prosthetic wearers. REFERENCES 1. Aldridge Whitehead JM, et al. Does a Microprocessor- controlled Prosthetic Knee Affect Stair Ascent Strategies in Persons With Transfemoral Amputation? Clin Orthop Relat Res; 472, 3093-3101, 2014. DOI:10.1007/s11999-014-3484-2 mailto:Milana.Mileusnic@ottobock.com https://doi.org/10.33137/cpoj.v1i2.32033 https://doi.org/10.1007/s11999-014-3484-2 Mileusnic M, Rettinger L, Highsmith M.J, Hahn A. 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J Prosthet Orthot; 25, 110-117, 2013. doi: 10.1097/JPO.0b013e31829c221f DISCLOSURE M Mileusnic, L Rettinger and A Hahn are affiliated with Otto Bock Healthcare Products. https://doi.org/10.1016/j.clinbiomech.2016.01.008 https://doi.org/10.1016/j.apmr.2011.10.017 https://doi.org/10.1515/bmt-2011-0029 https://doi.org/10.1016/j.clinbiomech.2014.12.003 https://doi.org/10.21300/18.2-3.2016.139 https://dx.doi.org/10.21300%2F18.2-3.2016.151 https://dx.doi.org/10.21300%2F18.2-3.2016.151 https://doi.org/10.3727/194982413X13844488879302 https://doi.org/10.1097/MD.0000000000005386 https://doi.org/10.1682/JRRD.2014.06.0149