Functional levels, also known as K-levels, were developed in Germany in 1991 to objectively define prosthetic need and prescribe appropriate prosthetic components. They classify amputees based on their expected functional ability into levels 0 to 4. Level 0 amputees are non-ambulatory and benefit most from a wheelchair. Higher levels indicate greater mobility and need for more advanced prosthetic components, with level 4 amputees being highly active individuals who require components like computer-controlled knees. The functional levels help prosthetists identify the most suitable prosthetic configuration for each amputee.

1. FUNCTIONAL LEVELS
OR
K LEVELS

2. FUNCTIONAL LEVELS
• THE BASIC STRUCTURE OF FUNCTIONAL
LEVELS WERE FIRST DEVELOPED AT THE
FEDERAL SCHOOL OF ORTHOPAEDIC
TECHNOLOGY IN GERMANY IN 1991.
• THEY WERE FURTHER DEVELOPED AND
IMPLEMENTED BY THE PROFESSIONALS IN
UNITED STATES AFTER 1995

3. FUNCTIONAL LEVELS
WHY THESE FUNCTIONAL LEVELS WERE
NEEDED?

4. FUNCTIONAL LEVELS
• TO OBJECTIFY AND IDENTIFY THE
CRITERIA FOR THE PRESCRIPTION OF
PROSTHETIC DEVICES.

5. FUNCTIONAL LEVELS
• PROSTHETISTS WANTS MAXIMUM
POTENTIAL BENEFIT BUT CANNOT
PROVIDE MORE TECHNICALITY FOR WHAT
IS BEING PAID FOR.
• SO, HOW CAN THE “OBJECTIVE
PROSTHETIC NEED” OF AN AMPUTEE BE
DEFINED?

6. FUNCTIONAL LEVELS
• TRUE OBJECTIFICATION IS DIFFICULT.
• AS IT DEPENDES ON MANY FACTORS SUCH
AS PERSONAL, PSYCHOLOGICAL, AND
ENVIRONMENTAL CIRCUMSTANCES.
• SPECIFIC NEEDS OF THE AMPUTEES.
• FUNCTIONAL CAPABILITIES OF THE
AMPUTEES.

7. FUNCTIONAL LEVELS
• HOWEVER, A REASONABLY “EXPECTED
FUNCTIONAL LEVEL” CAN BE DESIGNED
BY CLASSIFYING THE RANGE OF
PROSTHETIC COMPONENTS.
• THESE FUNCTIONAL LEVELS HELP
IDENTFYING THE MOST SUITABLE
COMPONENTS FOR THE AMPUTEES.
• AT THE SAME TIME, THOSE COMPONENTS
THAT ARE NOT REQUIRED, CAN BE
EXCLUDED.

8. FUNCTIONAL LEVELS
• SO FUNCTIONAL LEVELS ARE DESIGNED
TO OBJECTIFY AND IDENTFY THE
CRITERIA FOR PRESRIPTION OF
PROSTHETIC COMPONENTRY.
• FUNCTIONAL LEVELS HELP TO DEFINE A
RANGE OF PROSTHETIC COMPONENTS THAT
MAY BE BENEFICIAL TO SERVE THE
FUNCTIONAL IDENTITY.

9. FUNCTIONAL LEVELS 0 OR K 0

10. FUNCTIONAL LEVELS 0 OR K 0
EXPLANATIONS:
• AMPUTEES AT K-O WILL NOT HAVE A
BENEFIT OF A PROSTHESIS.
• THEY WILL BE BETTER WITH WHEELCHAIR
OR OTHER MOBILITY AIDS.
• CAN BE UPGRADED TO HIGHER LEVEL AT A
LATER STAGE.

11. FUNCTIONAL LEVELS 1 OR K 1

12. FUNCTIONAL LEVELS 1 OR K 1
EXPLANATIONS
• THE BASIC NEED OF LEVEL 1 AMPUTEE
IS SIMPLICITY, SAFETY AND
STABILITY.
• ANY AID TO DON THE PROSTHEIS
INDEPENDENTLY IS AN ASSET.
• THE KNEE JOINT MUST HAVE A LOCK.

13. FUNCTIONAL LEVELS 2 OR K 2

14. FUNCTIONAL LEVELS 2 OR K 2
EXPLANATIONS
• THE PROSTHESIS SHOULD BE LIGHT
WEIGHT AND FUNCTIONALLY SAFE ON
UNEVEN GROUNDS.
• A WEIGHT ACTIVATED SAFETY KNEE IS
APPROPRIATE AS ARE SAFE THE
POLYCENTRIC KNEE JOINTS.

15. FUNCTIONAL LEVELS 3 OR K 3

16. FUNCTIONAL LEVELS 3 OR K 3
EXPLANATIONS
• A LEVEL THREE AMPUTEE IS TYPICALLY
MID-AGE, HEALTHY, ACTIVE PERSON.
• AMPUTATION IS NOT CONSIDERED A
LIMITING FACTOR.
• NEED ACTIVE COMPONENTS

17. FUNCTIONAL LEVELS 3 OR K 3
• A VOLUNTARY CONTROL JOINT, OR ANY
PNEUMATIC OR HYDRAULIC CONTROL KNEE
MECHANISM IS INDICATED TO CONTROL
THE VARYING WALKING SPEED.

18. FUNCTIONAL LEVELS 4 OR K 4

19. FUNCTIONAL LEVELS 4 OR K 4
EXPLANATIONS
• AMPUTEE IS YOUNG TO MIDDLE AGE.
• HEALTHY AND VERY ACTIVE PERSON.
• NOT INCLINED TO GIVE ANY PRIOR
ACTIVITIES.
• OR LIFE STYLE.
• THE AMPUTATION IS NOT AT ALL A
LIMITING FACTOR.

20. FUNCTIONAL LEVELS 4 OR K 4
EXPLANATIONS
• COMPARE TO EARLIER LEVELS
• LEVEL 4 AMPUTEE NEEDS HIGHLY ACTIVE
AND STURDY, IMPACT RESISTANT
COMPONENTS.
• A FLUID OR COMPUTER CONTROLLED KNEE
MECHANISM IS INDICATED TO COPE WITH
THE QUICKLY CHANGING SPEEDS AND
LOADING SITUATIONS.

21. THANK YOU