طب جانباز (Jan 2011)
A comparison on quality of life in unilateral transfemoral amputees who use either intelligent or simple mechanical knee joint.
Abstract
Introduction : Major amputations are a main source of disability and affect the amputeechr('39')s quality of life. Despite the improvement in designing, prosthesis manufacturing techniques and rehabilitation methods, lower limb amputation effects on the quality of life is persistent. As the quality of the prosthesis is a key factor for amputees to return to the society, different proficiencies such medical engineers, mechanical, electronic engineers and prosthetists are attempting to improve the quality prostheses. In this direction prosthetic intelligent knee joints with the kinetics and kinematics principles which simulate the normal knee joint are available to the market. Designation and manufacturing these types of the knee joints with a high level of function needs to be light, delicate, strong and durable which requires spending enough time and budget leads to increasing the cost of intelligent knee joints comparing to the mechanical ones.However despite many efforts on designing new components, there are few studies to determine the effects and consequences of the new concepts and components on the satisfaction of the amputees and ultimately their quality of life. In this study it is aimed to determine the effects of two different prosthetic knee joints (i.e. Mechanical and intelligent) on the quality of life of the transfemoral amputees. Material & methods : This was a cross-sectional study. the quality of life have been evaluated according to the Trinity Amputation And Prosthesis Experience Scales(TAPES) questionnaire in two groups, each one composing of 20 traumatic unilateral transfemoral amputees of veteran using two types of intelligent knee joint and simple mechanical one who were referred to Tehran Kowsar Orthotics and Prosthetics Center. This questionnaire was originally developed in 1999 by P. Gallagher and Maclachan for a better understanding about the adjustment of the amputee with his /her prosthesis in the lower limb amputees and improving higher quality of services. The results of recent studies on TAPES by the developers showed this questionnaire has a high psychometric properties and it is suitable for evaluating the psychosocial adjustment, Athletic activity restriction and satisfaction with prosthesis. Moreover the statistical tests like ANOVAs and independent Test have been done for the two groups. Results : Forty traumatic amputees participated in this study. The results of the statistical tests revealed that the average score of psychosocial adjustment and satisfaction with prosthesis was nearly equal (not significant) but the athletic activity restriction and functional restriction were lower respectively (P-Value= 0.040) and (P-Value=0.008) in the intelligent knee joint users comparing to the mechanical group. Conclusion : The survey of the statistical outcomes in the three items of psychosocial adjustment, athletic activity restriction and satisfaction with prosthesis showed nearly equal score for the intelligent knee joint user group at psychosocial adjustment and satisfaction with their prostheses and lower score for the athletic activity restriction comparing to the mechanical knee joint user group. Also it was proved that the quality of life in the intelligent knee joint users is higher than the mechanical user group.
