Effect of step frequency on leg stiffness during running in unilateral transfemoral amputees

Biomechanical determinants of top running speeds in para-athletes with unilateral transfemoral amputation

BACKGROUND

An increased understanding of biomechanical determinants that influence the sprint performance of para-athletes with a unilateral transfemoral amputation will provide us with a basis for better evaluating athletes' sprint performance and would be expected to aid in the development of more effective training methods and running-specific prosthesis selection guidelines.

OBJECTIVES

The aim of this study was to investigate the relative contributions of mechanical determinants to the top running speeds of para-athletes with unilateral transfemoral amputation wearing a running-specific prosthesis.

STUDY DESIGN

Observational study within the subject.

METHODS

Nine para-athletes with unilateral transfemoral amputation wearing a running-specific prosthesis were recruited in this study. They were asked to run at their respective constant top speeds on an instrumented treadmill. From the ground reaction force and spatiotemporal parameters, three mechanical variables-step frequency, mass-specific averaged vertical ground-reaction force, and contact length-were determined for both the affected and unaffected limbs.

RESULTS

Stepwise regression analysis showed that the contact length of the affected limb was significant and an independent factor of top running speed ( β = 0.760, P < 0.05), with a coefficient of determination ( R2 ) of 0.577 ( P < 0.05), whereas the other variables were not associated.

CONCLUSION

These results suggest that prosthetic components and alignment are crucial to determining the maximal sprinting performance in uTFA.

Spring-mass behavioural adaptations to acute changes in prosthetic blade stiffness during submaximal running in unilateral transtibial prosthesis users

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.

Effects of step frequency during running on the magnitude and symmetry of ground reaction forces in individuals with a transfemoral amputation

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.

Biomechanical factors affecting individuals with lower limb amputations running using running-specific prostheses: A systematic review

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.

Using statistical parametric mapping to assess the association of duty factor and step frequency on running kinetic

Duty factor (DF) and step frequency (SF) were previously defined as the key running pattern determinants. Hence, this study aimed to investigate the association of DF and SF on 1) the vertical and fore-aft ground reaction force signals using statistical parametric mapping; 2) the force related variables (peaks, loading rates, impulses); and 3) the spring-mass characteristics of the lower limb, assessed by computing the force-length relationship and leg stiffness, for treadmill runs at several endurance running speeds. One hundred and fifteen runners ran at 9, 11, and 13 km/h. Force data (1000 Hz) and whole-body three-dimensional kinematics (200 Hz) were acquired by an instrumented treadmill and optoelectronic system, respectively. Both lower DF and SF led to larger vertical and fore-aft ground reaction force fluctuations, but to a lower extent for SF than for DF. Besides, the linearity of the force-length relationship during the leg compression decreased with increasing DF or with decreasing SF but did not change during the leg decompression. These findings showed that the lower the DF and the higher the SF, the more the runner relies on the optimization of the spring-mass model, whereas the higher the DF and the lower the SF, the more the runner promotes forward propulsion.