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Abstract-The performance and movement efficiency of prosthesis users while traversing a multisectional obstacle course (OC) were evaluated using a crossover design with random allocation of three prosthetic knee joints: the SNS (CaTech; Dayton, Ohio) the C-Leg (Otto Bock; Duderstadt, Germany), and the 3R60 (Otto Bock). Twelve users completed the OC twice with each joint, once without and once with a mental loading task (MLT). The performance was objectively assessed using time measurement from digital video recordings, and the Total Heart Beat Index was used to estimate movement efficiency. A 1 mo familiarization period was provided for each knee joint before data collection. It took longer to complete the OC with the 3R60 compared with either the SNS or the C-Leg. No significant time differences were found between the C-Leg and the SNS, but differences between the 3R60 and the SNS (slalom and rock sections) and between the 3R60 and the C-Leg (rock section) were observed. Within the simulated sand section, two participants fell with the C-Leg, one with the 3R60, and none with the SNS. Movement efficiency without MLT was similar between all joints, but with an MLT a significant decrease in movement efficiency was observed with the C-Leg. Previous experience using an SNS had no influence on the results.
Key words: 3R60, C-Leg, maneuverability, mental loading task, movement efficiency, obstacle course, prosthetic knee joint, SNS, Total Heart Beat Index, walking.
Abbreviations: ANOVA = analysis of variance, ECG = electrocardiography, MLT = mental loading task, OC = obstacle course, PCI = Physiological Cost Index, pSNS = previous SNS experience, SWOC = standardized walking OC, THBI = Total Heart Beat Index, VA = Department of Veterans Affairs, VACMARL = VA Chicago Motion Analysis Research Laboratory.
INTRODUCTION
More and more research is now available that demonstrates the effect of microprocessor-controlled prosthetic knee joints on user performance, satisfaction, and experiences. A recent review of the C-Leg (Otto Bock; Duderstadt, Germany) summarized these results [1]. Generally, the majority of available research presents results of studies with a focus on level and/or indoor walking. There are only a few studies available that present in-depth analysis of a particular activity over uneven surfaces, such as obstacle course (OC) performance [2] or stair ascent/descent [3-5], yet many different surface types are...