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Bhatt S, Joshi D, Rakesh PK, Godiyal AK. Advances in additive manufacturing processes and their use for the fabrication of lower limb prosthetic devices. Expert Rev Med Devices 2023; 20:17-27. [PMID: 36637907 DOI: 10.1080/17434440.2023.2169130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Traditional methods of prosthesis fabrication are not efficient and user centric and are made for common purposes without focusing on individual demands of user which leads to rejection of prosthesis for long-term use. Utilizing advanced additive manufacturing techniques for fabrication of prosthesis makes the development process user centric and covers all the user demands thus providing better fit, comfort, and more stable gait rehabilitation for the user. AREAS COVERED The articles reporting fabrication of lower limb prosthesis and its socket are included in the study. Standard fabrication and additive manufacturing method are both systematically assessed by the reviewers. The review also covers the advanced methods of additive manufacturing that are presently being used for fabrication of rehabilitation devices. EXPERT OPINION Additive manufacturing method of fabrication of prosthesis provides more flexibility for manufacturing prosthesis parts as per demand of the user. The fabrication method takes into account the residual limb and thus makes the prosthesis user-specific providing better comfort and fit.
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Affiliation(s)
- Shaurya Bhatt
- Department of Mechanical Engineering, National Institute of Technology Uttarakhand, Srinagar Garhwal, India
| | - Deepak Joshi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, India
| | - Pawan Kumar Rakesh
- Department of Mechanical Engineering, National Institute of Technology Uttarakhand, Srinagar Garhwal, India
| | - Anoop Kant Godiyal
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Science, Delhi, India
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Hadj-Moussa F, Zahid HB, Wright FV, Kelland K, Andrysek J. 'It's more than just a running leg': a qualitative study of running-specific prosthesis use by children and youth with lower limb absence. Disabil Rehabil 2022; 44:7190-7198. [PMID: 34665069 DOI: 10.1080/09638288.2021.1986748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE The purpose of this study was to investigate the use of running-specific prostheses (RSPs) by children with lower limb absence (LLA) along with the benefits and challenges of RSPs. MATERIALS AND METHODS In this descriptive qualitative study, eight children (ages 8-20 years) and their parents participated in semi-structured interviews. The interviews were audio-recorded and transcribed. Coded data were the foundation for central theme development. RESULTS Three main themes were generated. "Run faster, jump higher, do more" (the benefits of RSP use), "Every leg serves its purpose" (comparing functionality between daily use prostheses and RSPs), and "A lot more to think about" (additional considerations with RSP use). CONCLUSIONS RSPs have a positive impact in promoting children's engagement in sports and physical activities. While some children used their RSP primarily for running, others wore it for a broader range of physical activities. Issues with balance and discomfort caused by leg length discrepancies and/or ill-fitting sockets limited daily wear time. Limitations related to current RSP designs and clinical implementation should be addressed to optimize the functional potential of children with unilateral or bilateral LLA.Implications for rehabilitationRunning-specific prostheses (RSPs) positively impacted children's ability to participate in some sports with peers promoting their physical and social well-being.The main issues that children faced were discomfort, difficulty balancing, and inability to use RSPs for certain sports, while parents' issues focused on supporting prosthesis use and transport, and adjustments of different prostheses to keep up with their child's growth.Clinicians should be aware of the challenges of RSP use to best support children and their families.Designers should focus on addressing limitations with current RSPs to facilitate the diverse needs of pediatric users.
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Affiliation(s)
- Firdous Hadj-Moussa
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Hafsa B Zahid
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - F Virginia Wright
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Physical Therapy, University of Toronto, Toronto, Canada
| | - Kerri Kelland
- Physical Therapy, University of Toronto, Toronto, Canada.,Department of Orthotics and Prosthetics, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Jan Andrysek
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
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Barnett CT, De Asha AR, Skervin TK, Buckley JG, Foster RJ. Spring-mass behavioural adaptations to acute changes in prosthetic blade stiffness during submaximal running in unilateral transtibial prosthesis users. Gait Posture 2022; 98:153-159. [PMID: 36126535 DOI: 10.1016/j.gaitpost.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/20/2022] [Accepted: 09/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with lower-limb amputation can use running specific prostheses (RSP) that store and then return elastic energy during stance. However, it is unclear whether varying the stiffness category of the same RSP affects spring-mass behaviour during self-selected, submaximal speed running in individuals with unilateral transtibial amputation. RESEARCH QUESTION The current study investigates how varying RSP stiffness affects limb stiffness, running performance, and associated joint kinetics in individuals with a unilateral transtibial amputation. METHODS Kinematic and ground reaction force data were collected from eight males with unilateral transtibial amputation who ran at self-selected submaximal speeds along a 15 m runway in three RSP stiffness conditions; recommended habitual stiffness (HAB) and, following 10-minutes of familiarisation, stiffness categories above (+1) and below (-1) the HAB. Stance-phase centre of mass velocity, contact time, limb stiffness' and joint/RSP work were computed for each limb across RSP stiffness conditions. RESULTS With increased RSP stiffness, prosthetic limb stiffness increased, whilst intact limb stiffness decreased slightly (p<0.03). Centre of mass forward velocity during stance-phase (p<0.02) and contact time (p<0.04) were higher in the intact limb and lower in the prosthetic limb but were unaffected by RSP stiffness. Intact limb hip joint positive work increased for both the +1 and -1 conditions but remained unchanged across conditions in the prosthetic limb (p<0.02). SIGNIFICANCE In response to changes in RSP stiffness, there were acute increased mechanical demands on the intact limb, reflecting a reliance on the intact limb during running. However, overall running speed was unaffected, suggesting participants acutely adapted to an RSP of a non-prescribed stiffness.
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Affiliation(s)
- C T Barnett
- School of Science and Technology, Nottingham Trent University, Nottingham, UK.
| | - A R De Asha
- School of Science and Technology, Nottingham Trent University, Nottingham, UK; C-Motion, Inc., Germantown, MD, USA
| | - T K Skervin
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - J G Buckley
- Department of Biomedical & Electronics Engineering, University of Bradford, Bradford, UK
| | - R J Foster
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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Kobayashi T, Koh MWP, Hu M, Murata H, Hisano G, Ichimura D, Hobara H. Effects of step frequency during running on the magnitude and symmetry of ground reaction forces in individuals with a transfemoral amputation. J Neuroeng Rehabil 2022; 19:33. [PMID: 35321725 PMCID: PMC8944140 DOI: 10.1186/s12984-022-01012-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals with unilateral transfemoral amputation are prone to developing health conditions such as knee osteoarthritis, caused by additional loading on the intact limb. Such individuals who can run again may be at higher risk due to higher ground reaction forces (GRFs) as well as asymmetric gait patterns. The two aims of this study were to investigate manipulating step frequency as a method to reduce GRFs and its effect on asymmetric gait patterns in individuals with unilateral transfemoral amputation while running. METHODS This is a cross-sectional study. Nine experienced track and field athletes with unilateral transfemoral amputation were recruited for this study. After calculation of each participant's preferred step frequency, each individual ran on an instrumented treadmill for 20 s at nine different metronome frequencies ranging from - 20% to + 20% of the preferred frequency in increments of 5% with the help of a metronome. From the data collected, spatiotemporal parameters, three components of peak GRFs, and the components of GRF impulses were computed. The asymmetry ratio of all parameters was also calculated. Statistical analyses of all data were conducted with appropriate tools based on normality analysis to investigate the main effects of step frequency. For parameters with significant main effects, linear regression analyses were further conducted for each limb. RESULTS Significant main effects of step frequency were found in multiple parameters (P < 0.01). Both peak GRF and GRF impulse parameters that demonstrated significant main effects tended towards decreasing magnitude with increasing step frequency. Peak vertical GRF in particular demonstrated the most symmetric values between the limbs from - 5% to 0% metronome frequency. All parameters that demonstrated significant effects in asymmetry ratio became more asymmetric with increasing step frequency. CONCLUSIONS For runners with a unilateral transfemoral amputation, increasing step frequency is a viable method to decrease the magnitude of GRFs. However, with the increase of step frequency, further asymmetry in gait is observed. The relationships between step frequency, GRFs, and the asymmetry ratio in gait may provide insight into the training of runners with unilateral transfemoral amputation for the prevention of injury.
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Affiliation(s)
- Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mark W P Koh
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mingyu Hu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hiroto Murata
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Waterfront 3F, 2-3-26, Aomi, Koto-ku, Tokyo, 135-0064, Japan.,Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Genki Hisano
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Waterfront 3F, 2-3-26, Aomi, Koto-ku, Tokyo, 135-0064, Japan.,Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan.,Research Fellow of Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Daisuke Ichimura
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Waterfront 3F, 2-3-26, Aomi, Koto-ku, Tokyo, 135-0064, Japan
| | - Hiroaki Hobara
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Waterfront 3F, 2-3-26, Aomi, Koto-ku, Tokyo, 135-0064, Japan.
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Hadj-Moussa F, Ngan CC, Andrysek J. Biomechanical factors affecting individuals with lower limb amputations running using running-specific prostheses: A systematic review. Gait Posture 2022; 92:83-95. [PMID: 34837772 DOI: 10.1016/j.gaitpost.2021.10.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 10/10/2021] [Accepted: 10/28/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Running-specific prostheses (RSPs) are biomechanically designed to enable individuals with lower limb amputations to engage in high level sports. RESEARCH QUESTION What is the influence of RSP use on the running biomechanics of individuals with lower limb amputations? METHODS An article search was conducted in six databases since their inception to July 2021. Two independent reviewers assessed the title, abstract and full texts in the review process. The quality of the papers was appraised. The review included a total of 35 articles. RESULTS Main findings indicate force production is a limitation of RSPs. Individuals with lower limb absence employ a variety of compensatory strategies such as adjusting their step frequency, contact length and joint kinetics to improve their running performance. Leg stiffness modulation and external factors relating to the RSP design and fitting play important roles in RSP biomechanics. For individuals with unilateral amputations, the increased loading of the intact limb could increase the risk of acute injury or chronic joint degradation. SIGNIFICANCE To improve their running performance, runners with lower limb amputations employ various compensatory strategies, such as altering the spatiotemporal and kinetic parameters. Factors relating to RSP height, stiffness, shape, and alignment also play an important role in terms of running biomechanics and should be considered in RSP design and fitting. Future studies should focus on the use of RSPs for recreation, in pediatric populations, with certain amputation levels, as well as the impact of training and running techniques.
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Affiliation(s)
- Firdous Hadj-Moussa
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Calvin C Ngan
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Jan Andrysek
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada.
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Effect of step frequency on leg stiffness during running in unilateral transfemoral amputees. Sci Rep 2020; 10:5965. [PMID: 32249808 PMCID: PMC7136227 DOI: 10.1038/s41598-020-62964-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/23/2020] [Indexed: 11/08/2022] Open
Abstract
Spring-like leg behavior is a general feature of mammalian bouncing gaits, such as running and hopping. Although increases in step frequency at a given running speed are known to increase the stiffness of the leg spring (kleg) in non-amputees, little is known about stiffness regulation in unilateral transfemoral amputees. In this study, we investigated stiffness regulation at different step frequencies at a given running speed in unilateral transfemoral amputees. We recruited nine unilateral transfemoral amputees wearing running-specific prostheses. They were asked to perform the action of running across a range of step frequencies (±20, ±15, ±10, ±5, and 0% of their preferred step frequency) at a given speed on an instrumented treadmill. The kleg values were calculated using ground reaction force data in both the affected and unaffected limbs. It was found that kleg increased with increasing step frequency for the unaffected limb, but not for the affected limb. Consequently, the unilateral transfemoral amputees attained the desired step frequency in the unaffected limb, but were unable to match the three highest step frequencies using their affected limbs. These results suggest that the stiffness regulation strategy during running differs between the affected and unaffected limbs.
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Groothuis A, Houdijk H. The Effect of Prosthetic Alignment on Prosthetic and Total Leg Stiffness While Running With Simulated Running-Specific Prostheses. Front Sports Act Living 2019; 1:16. [PMID: 33344940 PMCID: PMC7739705 DOI: 10.3389/fspor.2019.00016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/07/2019] [Indexed: 12/05/2022] Open
Abstract
Running-specific prostheses (RSP) are designed to replicate the spring-like behavior of the biological leg in people with a lower limb amputation. Running performance strongly depends on stiffness of the RSP. The aim of this study was to investigate the effects of angle of alignment of the RSP on its stiffness, and how this affects total leg stiffness and the gait pattern during running. Ten able-bodied athletes performed eight trials on a treadmill with running-specific prosthetic simulators, while the alignment of the blades relative to the socket was set in four different angles (0, 5, 10, and 15°) during two different step frequency conditions (free and imposed). RSP stiffness, total leg stiffness, residual leg stiffness, and spatiotemporal parameters were measured. In both step frequency conditions, the RSP stiffness decreased linearly with increasing angle of alignment. Able bodied athletes were able to compensate for the decreased RSP stiffness, and keep total leg stiffness almost invariant, by increasing residual leg stiffness through a more straight the knee at initial contact. This study confirms that alignment is an important factor to take into account when optimizing the RSP. Whether the observed compensations are feasible in amputee athletes needs further investigation.
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Affiliation(s)
- Ashley Groothuis
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Han Houdijk
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Department of Research and Development, Heliomare Rehabilitation, Wijk aan Zee, Netherlands
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8
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Hobara H, Hashizume S, Funken J, Willwacher S, Müller R, Grabowski AM, Potthast W. Vertical stiffness during one-legged hopping with and without using a running-specific prosthesis. J Biomech 2019; 86:34-39. [PMID: 30770198 DOI: 10.1016/j.jbiomech.2019.01.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 01/17/2019] [Accepted: 01/17/2019] [Indexed: 11/25/2022]
Abstract
Although athletes with unilateral below-the-knee amputations (BKAs) generally use their affected leg, including their prosthesis, as their take-off leg for the long jump, little is known about the spring-like leg behavior and stiffness regulation of the affected leg. The purpose of this study was to investigate vertical stiffness during one-legged hopping in an elite-level long jump athlete with a unilateral BKA. We used the spring-mass model to calculate vertical stiffness, which equals the ratio of maximum vertical ground reaction force to maximum center of mass displacement, while the athlete with a BKA hopped on one leg at a range of frequencies. Then, we compared the vertical stiffness of this athlete to seven non-amputee elite-level long-jumpers. We found that from 1.8 to 3.4 Hz, the vertical stiffness of the unaffected leg for an athlete with a BKA increases with faster hopping frequencies, but the vertical stiffness of the affected leg remains nearly constant across frequencies. The athlete with a BKA attained the desired hopping frequencies at 2.2 and 2.6 Hz, but was unable to match the lowest (1.8 Hz) and two highest frequencies (3.0 and 3.4 Hz) using his affected leg. We also found that at 2.5 Hz, unaffected leg vertical stiffness was 15% greater than affected leg vertical stiffness, and the vertical stiffness of non-amputee long-jumpers was 32% greater than the affected leg vertical stiffness of an athlete with a BKA. The results of the present study suggest that the vertical stiffness regulation strategy of an athlete with a unilateral BKA is not the same in the unaffected versus affected legs, and compared to non-amputees.
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Affiliation(s)
- Hiroaki Hobara
- National Institute of Advanced Industrial Science & Technology (AIST), Tokyo, Japan.
| | - Satoru Hashizume
- National Institute of Advanced Industrial Science & Technology (AIST), Tokyo, Japan
| | | | - Steffen Willwacher
- German Sport University Cologne, Cologne, Germany; Institute of Functional Diagnostics, Cologne, Germany
| | - Ralf Müller
- German Sport University Cologne, Cologne, Germany
| | - Alena M Grabowski
- Integrative Physiology Department, University of Colorado Boulder, CO, USA; Eastern Colorado Healthcare System, Department of Veterans Affairs, Denver, CO, USA
| | - Wolfgang Potthast
- German Sport University Cologne, Cologne, Germany; ARCUS Clinics Pforzheim, Pforzheim, Germany
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Noroozi S, Ong ZC, Khoo SY, Aslani N, Sewell P. Dynamic characterisation of Össur Flex-Run prosthetic feet for a more informed prescription. Prosthet Orthot Int 2019; 43:62-70. [PMID: 30051756 DOI: 10.1177/0309364618789449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND: The current method of prescribing composite running-specific energy-storing-and-returning feet is subjective and is based only on the amputee's static body weight/mass. OBJECTIVES: The aim was to investigate their dynamic characteristics and create a relationship between these dynamic data and the prescription of foot. STUDY DESIGN: Experimental Assessment. METHODS: This article presents the modal analysis results of the full range of Össur Flex-Run™ running feet that are commercially available (1LO-9LO) using experimental modal analysis technique under a constant mass at 53 kg and boundary condition. RESULTS: It was shown that both the undamped natural frequency and stiffness increase linearly from the lowest to the highest stiffness category of foot which allows for a more informed prescription of foot when tuning to a matched natural frequency. The low damping characteristics determined experimentally that ranged between 1.5% and 2.0% indicates that the feet require less input energy to maintain the steady-state cyclic motion before take-off from the ground. An analysis of the mode shapes also showed a unique design feature of these feet that is hypothesised to enhance their performance. CONCLUSION: A better understanding of dynamic characteristics of the feet can help tune the feet to the user's requirements in promoting a better gait performance. CLINICAL RELEVANCE The dynamic data determined from this study are needed to better inform the amputees in predicting the natural frequency of the foot prescribed. The amputees can intuitively tune the cyclic body rhythm during walking or running to match with the natural frequency. This could eventually promote a better gait performance.
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Affiliation(s)
- Siamak Noroozi
- 1 Department of Design and Engineering, Faculty of Science and Technology, Bournemouth University, Poole, UK
| | - Zhi Chao Ong
- 2 Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Shin Yee Khoo
- 2 Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Navid Aslani
- 1 Department of Design and Engineering, Faculty of Science and Technology, Bournemouth University, Poole, UK
| | - Philip Sewell
- 1 Department of Design and Engineering, Faculty of Science and Technology, Bournemouth University, Poole, UK
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10
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Leg stiffness in unilateral transfemoral amputees across a range of running speeds. J Biomech 2019; 84:67-72. [DOI: 10.1016/j.jbiomech.2018.12.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/22/2022]
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Beck ON, Grabowski AM. Athletes With Versus Without Leg Amputations: Different Biomechanics, Similar Running Economy. Exerc Sport Sci Rev 2019; 47:15-21. [PMID: 30334850 DOI: 10.1249/jes.0000000000000174] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Athletes with transtibial amputations use carbon-fiber prostheses to run. Compared with biological legs, these devices differ in structure and function, and consequently yield affected leg running biomechanics that are theoretically more economical than those of nonamputees. However, experimental data indicate that athletes with unilateral and bilateral transtibial amputations exhibit running economy values that are well within the range of nonamputee values.
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Affiliation(s)
- Owen N Beck
- The George W. Woodruff School of Mechanical Engineering, and.,School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA
| | - Alena M Grabowski
- Department of Integrative Physiology, University of Colorado, Boulder.,Department of Veterans Affairs, Eastern Colorado Healthcare System, Denver, CO
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12
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Beck ON, Taboga P, Grabowski AM. How do prosthetic stiffness, height and running speed affect the biomechanics of athletes with bilateral transtibial amputations? J R Soc Interface 2017; 14:rsif.2017.0230. [PMID: 28659414 DOI: 10.1098/rsif.2017.0230] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/01/2017] [Indexed: 11/12/2022] Open
Abstract
Limited available information describes how running-specific prostheses and running speed affect the biomechanics of athletes with bilateral transtibial amputations. Accordingly, we quantified the effects of prosthetic stiffness, height and speed on the biomechanics of five athletes with bilateral transtibial amputations during treadmill running. Each athlete performed a set of running trials with 15 different prosthetic model, stiffness and height combinations. Each set of trials began with the athlete running on a force-measuring treadmill at 3 m s-1, subsequent trials incremented by 1 m s-1 until they achieved their fastest attainable speed. We collected ground reaction forces (GRFs) during each trial. Prosthetic stiffness, height and running speed each affected biomechanics. Specifically, with stiffer prostheses, athletes exhibited greater peak and stance average vertical GRFs (β = 0.03; p < 0.001), increased overall leg stiffness (β = 0.21; p < 0.001), decreased ground contact time (β = -0.07; p < 0.001) and increased step frequency (β = 0.042; p < 0.001). Prosthetic height inversely associated with step frequency (β = -0.021; p < 0.001). Running speed inversely associated with leg stiffness (β = -0.58; p < 0.001). Moreover, at faster running speeds, the effect of prosthetic stiffness and height on biomechanics was mitigated and unchanged, respectively. Thus, prosthetic stiffness, but not height, likely influences distance running performance more than sprinting performance for athletes with bilateral transtibial amputations.
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Affiliation(s)
- Owen N Beck
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA
| | - Paolo Taboga
- Department of Kinesiology and Health Science, Sacramento State University, Sacramento, CA, USA
| | - Alena M Grabowski
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.,Department of Veterans Affairs, Eastern Colorado Healthcare System, Denver, CO, USA
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Kiernan D, Miller RH, Baum BS, Kwon HJ, Shim JK. Amputee locomotion: Frequency content of prosthetic vs. intact limb vertical ground reaction forces during running and the effects of filter cut-off frequency. J Biomech 2017; 60:248-252. [DOI: 10.1016/j.jbiomech.2017.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 04/28/2017] [Accepted: 06/13/2017] [Indexed: 11/28/2022]
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14
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Beck ON, Taboga P, Grabowski AM. Prosthetic model, but not stiffness or height, affects the metabolic cost of running for athletes with unilateral transtibial amputations. J Appl Physiol (1985) 2017; 123:38-48. [PMID: 28360121 DOI: 10.1152/japplphysiol.00896.2016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 03/27/2017] [Accepted: 03/27/2017] [Indexed: 11/22/2022] Open
Abstract
Running-specific prostheses enable athletes with lower limb amputations to run by emulating the spring-like function of biological legs. Current prosthetic stiffness and height recommendations aim to mitigate kinematic asymmetries for athletes with unilateral transtibial amputations. However, it is unclear how different prosthetic configurations influence the biomechanics and metabolic cost of running. Consequently, we investigated how prosthetic model, stiffness, and height affect the biomechanics and metabolic cost of running. Ten athletes with unilateral transtibial amputations each performed 15 running trials at 2.5 or 3.0 m/s while we measured ground reaction forces and metabolic rates. Athletes ran using three different prosthetic models with five different stiffness category and height combinations per model. Use of an Ottobock 1E90 Sprinter prosthesis reduced metabolic cost by 4.3 and 3.4% compared with use of Freedom Innovations Catapult [fixed effect (β) = -0.177; P < 0.001] and Össur Flex-Run (β = -0.139; P = 0.002) prostheses, respectively. Neither prosthetic stiffness (P ≥ 0.180) nor height (P = 0.062) affected the metabolic cost of running. The metabolic cost of running was related to lower peak (β = 0.649; P = 0.001) and stance average (β = 0.772; P = 0.018) vertical ground reaction forces, prolonged ground contact times (β = -4.349; P = 0.012), and decreased leg stiffness (β = 0.071; P < 0.001) averaged from both legs. Metabolic cost was reduced with more symmetric peak vertical ground reaction forces (β = 0.007; P = 0.003) but was unrelated to stride kinematic symmetry (P ≥ 0.636). Therefore, prosthetic recommendations based on symmetric stride kinematics do not necessarily minimize the metabolic cost of running. Instead, an optimal prosthetic model, which improves overall biomechanics, minimizes the metabolic cost of running for athletes with unilateral transtibial amputations.NEW & NOTEWORTHY The metabolic cost of running for athletes with unilateral transtibial amputations depends on prosthetic model and is associated with lower peak and stance average vertical ground reaction forces, longer contact times, and reduced leg stiffness. Metabolic cost is unrelated to prosthetic stiffness, height, and stride kinematic symmetry. Unlike nonamputees who decrease leg stiffness with increased in-series surface stiffness, biological limb stiffness for athletes with unilateral transtibial amputations is positively correlated with increased in-series (prosthetic) stiffness.
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Affiliation(s)
- Owen N Beck
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado; and
| | - Paolo Taboga
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado; and
| | - Alena M Grabowski
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado; and.,Department of Veterans Affairs, Eastern Colorado Healthcare System, Denver, Colorado
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