Hanger Institute recently published the results of Stability and Falls Evaluation after AMPutation (SAFE-AMP), which focused on microprocessor-controlled knee technology for diabetic and dysvascular patients with above-knee amputations. The study was published in Assisted Technology Journal, and was conducted by members of Hanger Clinic’s Clinical and Scientific Affairs Department: Shane Wurdeman, PhD, CP, FAAOP(D); Taavy Miller, PhD, CPO; Phillip Stevens, MEd, CPO, FAAOP; and James Campbell, PhD.
We’re excited to share their findings with the O&P community to assist clinicians in making informed decisions that benefits the limb-loss community.
Results showed that 16.3% of non-MPK users experienced an injurious fall compared to 7.3% of MPK users (p=0.007).
Figure courtesy of Hanger Clinic
Figure 1: Odds Ratios
While accounting for age, sex, time since amputation, and adjusted BMI, it was noted that individuals that are not provided an MPK have 2.52 times increased odds of sustaining an injurious fall over a 6-month period compared to their counterparts that receive an MPK.
- An MPK can decrease odds of an injurious fall by 250% for individuals with amputation due to diabetes or dysvascular disease.
- Balance impairments within the diabetes and dysvascular population puts them at higher risk for falls. Not providing a diabetic patient with an MPK increases their risk of falling, more than the risk associated with aging.
- There is a potential prescription bias based upon etiology. Within the US, the qualification for an MPK is an individual must be at a K3 ambulatory level notwithstanding a few third party payor exceptions. In this study, all 881 individuals qualified for an MPK, yet only 137 individuals were provided one.
- Further work is warranted to better understand how all possible orthotic and prosthetic care solutions can help improve clinical outcomes and quality of life for the diabetic patient population.
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