Authors' objectives:

The aim of this review was:

To conduct a systematic review on the effectiveness of C-leg as compared to mechanical prosthetics or other brands of computer-controlled prosthetics;

2. To identify the characteristics of above knee amputees that may benefit most from the use of C-leg;

3. To provide a cost analysis among WCB of BC claimants with C-leg and mechanical above knee prosthetics; and

4. To make recommendations to the Evidence Based Practice Group Steering Committee.

Authors' recommendations: To date, the published research on computerized knee prosthesis is very limited. Less than 3% of published and indexed research represents structured research. Most published articles are purely descriptive or promotional in nature. Most of the available structured research is based on a slightly different microprocessor controlled prosthesis (Blatchford's Intelligent Prosthesis). However, this prosthesis is associated with many of the same potential benefits as the C-leg. Published studies enrolled highly selected sample of amputees who did not have additional medical problems and who were fit and active. These characteristics have been shown to be independently predictive of successful rehabilitation or return to ,normal- living after amputation. Thus, these variables are most likely to confound the results of the non-randomized, uncontrolled studies on microprocessor controlled knee prosthesis that have been published to date. At present, the small number of studies on computerized knee prostheses does not conclusively show the effectiveness of the prostheses in (Evidence level 1): - reducing energy expenditure particularly in normal speed walking - improving ability to walk on uneven terrain - improving ability to climb and descend stairs - increasing walking distance Given the nature of the evidence to date, the EBPG has outlined various options to its Steering Committee. The option accepted is as follows: - The WCB will accept responsibility for Physical Medicine and Rehabilitation specialist prescribed microprocessor-controlled knee prostheses using the parameters and guidelines developed by the U.S. Department of Veterans Affairs.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.worksafebc.com/health_care_providers/related_information/evid ence_based_medicine/default.asp

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

Copyright: WorkSafe BC