How Well Do the Sample Populations in Microprocessor-Controlled Prosthetic Knee Technology Research Represent People with Limb Absence? A Systematic Review

Background/Objectives: Studies consistently demonstrate that microprocessor-controlled prosthetic knees (MPKs) improve mobility and quality of life for people with lower limb loss or absence by enhancing balance and reducing falls. However, the extent to which these benefits apply across demographic groups remains unclear. Therefore, we conducted a literature review to evaluate how representative and transferable research on MPKs is across different populations, and which factors influence this. Methods: Using systematic review principles and PRISMA guidelines, 27 studies were analysed from databases including Cochrane, CINAHL, MEDLINE, and PubMed, as of 20th September 2025. The included studies primarily focused on young-to-middle-aged adults, men, individuals with trauma-related amputation, and higher mobility levels. Results: We found that older adults, women, and individuals with amputation caused by vascular disease or diabetes were under-represented in MPK research. Moreover, variability in time since amputation complicates the generalisability of findings, as this factor significantly influences adaptation and functional outcomes. Conclusions: While evidence supports MPKs’ effectiveness in enhancing mobility and reducing the risk of falls, their benefits may not fully apply to under-represented groups, such as older adults, women, or low-activity users. Future research should prioritise more diverse participant samples to improve the generalisation of MPK outcomes across different demographics and functional levels.