{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:44:35Z","timestamp":1790747075530,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"11-12","funder":[{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["W81XWH-15-2-0041"],"award-info":[{"award-number":["W81XWH-15-2-0041"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Clinical knowledge surrounding functional outcomes of a powered knee\u2013ankle (PKA) device is limited, particularly among younger and active populations with limb loss. Here, three service members (SM) with unilateral transfemoral limb loss received an optimally tuned PKA prosthesis and device-specific training.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Once proficiency with the PKA device was demonstrated on benchmark activities, and outcomes with the PKA and standard-of-care (SoC) prostheses were obtained via a modified graded treadmill test, 6-minute walk test, and overground gait assessment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All SM demonstrated proficiency with the PKA prosthesis within the minimum three training sessions. With the PKA versus SoC prosthesis, cost of transport during the modified graded treadmill test was 4.0%\u2009\u00b1\u20095.2% lower at slower speeds (i.e., 0.6-1.2\u2009m\/s), but 7.0%\u2009\u00b1\u20095.1% greater at the faster walking speeds (i.e., \u22651.4\u2009m\/s). For the 6-minute walk test, SM walked 83.9\u2009\u00b1\u200913.2\u2009m shorter with the PKA versus SoC prosthesis. From the overground gait assessment, SM walked with 20.6%\u2009\u00b1\u200910.5% greater trunk lateral flexion and 31.8%\u2009\u00b1\u200912.8% greater trunk axial rotation ranges of motion, with the PKA versus SoC prosthesis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Compared to prior work with the PKA in a civilian cohort, although SM demonstrated faster device proficiency (3 versus 12 sessions), SM walked with greater compensatory motions compared to their SoC prostheses (contrary to the civilian cohort). As such, it is important to understand patient-specific factors among various populations with limb loss for optimizing device-specific training and setting functional goals for occupational and\/or community reintegration, as well as reducing the risk for secondary complications over the long term.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usac231","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T16:09:23Z","timestamp":1658938163000},"page":"3432-3438","source":"Crossref","is-referenced-by-count":2,"title":["Functional Performance Outcomes of a Powered Knee\u2013Ankle Prosthesis in Service Members With Unilateral Transfemoral Limb Loss"],"prefix":"10.1093","volume":"188","author":[{"given":"Ashley D","family":"Knight","sequence":"first","affiliation":[{"name":"Research & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence , Bethesda, MD 20889, USA"},{"name":"Department of Rehabilitation, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"},{"name":"Department of Rehabilitation Medicine, Uniformed Services of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrasekaran","family":"Jayaraman","sequence":"additional","affiliation":[{"name":"Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Center for Bionic Medicine, Shirley Ryan AbilityLab , Chicago, IL 60611, USA"},{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University , Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M","family":"Elrod","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. , Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barri L","family":"Schnall","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt S","family":"McGuire","sequence":"additional","affiliation":[{"name":"Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Center for Bionic Medicine, Shirley Ryan AbilityLab , Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd J","family":"Sleeman","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Walter Reed National Military Medical Center , Bethesda, MD 20889, 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