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Introduction: Bilateral microprocessor-controlled prosthetic knee (MPK) users have unique needs in traversing environmental barriers compared to unilateral users. An enhancement to the GeniumTM/Genium X3TM MPK which included an updated ruleset, hydraulics, and new bilateral parameter presets was made to improve safety while stumbling and the smoothness of gait for all users while also improving the experience of bilateral users. The purpose of the study was to evaluate the effectiveness of the enhancements in a sample with unilateral and bilateral amputation. Methods: A convenience sample of MPK users was recruited from two sites in the USA in two phases. Assessments included the L-Test of Functional Mobility, Activity-specific Balance Confidence Scale, Prosthetic Limb User Survey of Mobility, a study-specific questionnaire, and the Comparative Activities of Daily Living (ADL) Questionnaire. Statistical significance of extracted data was tested with the Wilcoxon Rank-Sum Test for independent data and Wilcoxon Signed-Rank for paired data with an a priori significance level of p < 0.05. Unilateral subjects were age-matched to the group of bilateral subjects for between-groups and within-groups analyses. Results: Twenty-six subjects (n = 26) were enrolled. Stumble frequency reduced 85% from 16.0 ± 39.7 to 2.4 ± 2.3 (p = 0.008) between baseline and final assessment overall. The bilateral group reported 50% (p = 0.009) and 57% (p = 0.009) greater relative improvement in patient-reported ease and safety, respectively, of completing ADLs compared to the unilateral group. The unilateral group reported residual limb pain and low back pain reduced from 2.3 to 1.4 (p = 0.020) and 3.8 to 1.8 (p = 0.027), respectively, whereas the bilateral group did not. Discussion: Substantial reductions in stumbles, residual limb pain, and back pain were shown overall. These reductions were driven by the unilateral group who also showed improvements in comfort, exertion, and concentration while walking. The enhancements to the knee likely reduced some gait asymmetry for unilateral users. Improvements in patient-reported ease and safety of completing ADLs were shown overall and were driven by the bilateral group. This study shows further improvement in patient experience is achievable through innovation in MPK technology even for patients who appear to be functioning well. [ABSTRACT FROM AUTHOR]

Introduction: Research with multiarticulating prosthetic hands on patient-reported ease of activities of daily living (ADLs) and usefulness is still limited. This study aimed at comparing ease of ADL performance and usefulness of two common multiarticulating prosthetic hands. Methods: Twenty subjects with transradial amputation wearing the bebionic (n = 10) or i-Limb (n = 10) hands were assessed with a hybrid Orthotics and Prosthetics User Survey–Upper Extremity Functional Status (OPUS-UEFS)/Prosthetic Upper Extremity Functional Index (PUFI) outcome measure previously used in a study with another multigrip prosthetic hand. Results: There were no significant differences between the bebionic and i-Limb hands. However, the analysis of individual activities revealed that each multiarticulating hand had specific strengths and weaknesses compared with a historic control group with conventional myoelectric hands. Discussion: Both multiarticulating hands may improve ease of performing ADLs compared with conventional myoelectric hands. However, more grip types available do not necessarily result in greater ease or usefulness compared with advanced hands with fewer grip types. Conclusions: Clinicians must match the patients' functional needs with the differential functional profiles of the available multiarticulating hands. Clinical Relevance: The present study is the first to provide comparative patient-reported outcomes on 3 multigrip prosthetic hands as well as standard myoelectric hands in 23 common ADLs. The distinct patient-reported ease and usefulness profiles of the different hands may inform and support clinicians' decision-making on hand selection for individual patients with transradial amputation. [ABSTRACT FROM AUTHOR]