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NIH grant 1I01RD000446-01A1: Does a Microprocessor-Controlled Prosthetic Knee Joint Improve Mobility and Quality of Life in K2-Level Veteran Ambulators?
Institute: {'code': 'VA', 'abbreviation': 'VA', 'name': 'Veterans Affairs', 'admin_org_id': '12500964', 'admin_funding_url': ''}. PI: Steven A. Gard. Award: $.
Start: 2026-10-01T00:00:00.
Significance to VA: Limb loss is a potentially devastating event in a person's life, often resulting in profound
physical, psychological, and vocational consequences (2). A transfemoral amputation results in greater physical
and functional impairment and an increased risk of falling in patients as compared to someone with a transtibial
amputation (3-7). Furthermore, balance confidence and fear of falling appears to be a persistent and pervasive
problem among lower-limb prosthesis users (4, 6, 7), which adversely affects mobility and quality of life. During
the past 30 years there have been several major developments in prosthetic knee mechanisms that incorporate
microprocessors to improve swing-phase characteristics and provide greater stability during stance phase.
Microprocessor-controlled knees (MPKs) automatically adjust resistance or damping in the joint to improve
swing- and/or stance-phase control as appropriate for the user during gait.
Innovation and Impact: There are numerous reported benefits of MPKs over non-microprocessor controlled
knees (NMPKs), including faster self-selected walking speeds (8-13), reduced cognitive burden while walking
(14-18), fewer stumbles and falls (3, 11, 14-16, 19-25), and increased perceptions of confidence and safety while
ambulating (3, 8-10, 12, 16, 22, 26, 27). Nonetheless, MPKs are not typically prescribed or fitted on lower
functioning ambulators, which is the activity classification of most Veteran patients.
Specific Aims: The purpose of this proposed investigation is to determine if there are substantial physical and
psychological benefits to fitting lower functioning Veteran ambulators having transfemoral amputations with an
MPK compared with a NMPK. The specific aims and hypotheses of this project are:
Aim 1: To determine the effects of the College Park Icon on the mobility of unilateral, transfemoral
prosthesis users. We hypothesize that the MPK will enable users to 1) increase their freely-selected
(i.e., normal) walking speed, and 2) walk over a wider range of speeds. Furthermore, we hypothesize
that 3) participants will report fewer falls with the MPK.
Aim 2: To determine the effects of the College Park Icon on the psychological well-being of unilateral,
transfemoral prosthesis users. We hypothesize that subjects will improve their scores on patient-
reported outcome assessments [including the ABC, OPUS, and PLUS-M] with the MPK.
Aim 3: To determine subjects’ preference for the College Park Icon compared to their conventional
NMPK. At the completion of the study, we will ask participants which prosthetic knee type they
preferred. We hypothesize that the majority of participants will prefer using the MPK over the NMPK.
Those subjects who prefer the MPK will be permitted to keep the component in their prosthesis, while
those who prefer their NMPK will have their prosthesis returned to its original configuration.
Methodology: Using a cross-sectional experimental design, approximately 20 Veterans who are low functioning
ambulators with unilateral, transfemoral amputations will be evaluated on two separate occasions at the Jesse
Brown VA Medical Center or the Edward Hines, Jr. VA Hospital, first with their conventional NMPK and then
again after a two-month accommodation period with the College Park Icon MPK.
Path to Translation/Implementation: This work is directly applicable to VHA’s Patient Care Mission because
the results may justify the fitting of MPKs on low-level ambulators within the VA system and substantially
improve the mobility of Veterans with lower limb amputations while increasing their quality of life.document fetched 2026-10-24 02:46