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Evidence Essentials: C-Leg MPK

Mobility need or deficit of the patient Evidence for benefits of the C-Leg vs. NMPK
Safety Patient stumbles and/or falls repeatedly

Patient avoids activities due to fear of falling

Patient sustained fall-related injuries

Significant reduction in falls of up to 80%
(Hafner et al., 2007 and 2009; Highsmith et al., 2010; Kahle et al., 2008; Kannenberg et al., 2014, Kaufman et al., 2018)

Significant reduction in stumbles of up to 57%
(Hafner et al., 2009; Highsmith et al., 2010; Kahle et al., 2008; Kannenberg et al., 2014)

Significant improvements in balance and indicators for the risk of falling, such as Timed-up-and-go-test, forced gait perturbations in the gait lab, ABC scale, etc.
(Blumentritt et al., 2009; Burnfield et al., 2012; Hafner et al., 2007 and 2009; Kannenberg et al., 2014; Kaufman et al., 2007; Lansade et al., 2018)

Mobility Patient has difficulty negotiating slopes/hills Significant improvement in quality of slope/hill descent towards natural, reciprocal (step-over-step) gait pattern
(Hafner et al.; 2007 and 2009; Highsmith et al., 2013; Kannenberg et al., 2014)

Significant increase in downhill walking speed of up to 40%
(Burnfield et al., 2012; Hafner et al., 2007 and 2009; Highsmith et al, 2013; Kannenberg et al., 2014)

Mobility Patient has difficulty negotiating uneven terrain and obstacles Significant increase in walking speed on uneven terrain and obstacle courses of up to 21%
(Kahle et al., 2008; Seymour et al., 2007)

Mobility Patient has difficulty descending stairs with reciprocal (step-over-step) gait Significant improvement in quality of stair descent towards natural, reciprocal (step-over-step) gait pattern
(Hafner et al., 2007 and 2009; Kahle et al., 2008; Kannenberg et al., 2014; Schmalz et al., 2007)

Mobility Patient has difficulty with dual tasking while walking with the prosthesis Significant reduction in cognitive demand while walking with the prosthesis
(Hafner et al., 2007 and 2009; Seymour et al., 2007; Williams et al., 2006)

Significantly reduction in cortical brain activity and perfusion during dual-tasking
(Möller et al., 2019; Ramstrand et al, 2020)

Significantly improved capacity and performance in executing a concurrent task while walking with the prosthesis
(Hafner et al., 2007 and 2009; Morgan et al., 2015; Seymour et al., 2007; Williams et al., 2006)

Mobility Patient is limited in his/her mobility About 50% of K2 patients are able to improve their overall mobility level to K3
(Hafner et al. 2009; Kahle et al., 2008; Kannenberg et al., 2014)
Musculo-skeletal pain Patient suffers from joint and back pain due to gait asymmetry and excessive loading Significant improvement in gait symmetry and, thus, loading of the locomotor system
(Kaufman et al, 2007 and 2012; Segal 2006)

Significant stance knee flexion that results in shock absorption to unload proximal joints and the spine
(Kaufman et al., 2007; Segal et al., 2006)

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