Running Powered Ankle-Foot Prostheses

Studying the effects of prostheses on gait, such as running, allows us to understand how the technologies we develop affect the users.

Leg stiffness of sprinters using running-specific prostheses -- Running-specific prostheses (RSF) are designed to replicate the spring-like nature of biological legs (bioL) during running. However, it is not clear how these devices affect whole leg stiffness characteristics or running dynamics over a range of speeds. We used a simple spring–mass model to examine running mechanics across a range of speeds, in unilateral and bilateral transtibial amputees and performance-matched controls. We found significant differences between the affected leg (AL) of unilateral amputees and both ALs of bilateral amputees compared with the bioL of non-amputees for nearly every variable measured. Leg stiffness remained constant or increased with speed in bioL, but decreased with speed in legs with RSPs. The decrease in leg stiffness in legs with RSPs was mainly owing to a com- bination of lower peak ground reaction forces and increased leg compression with increasing speeds. Leg stiffness is an important parameter affecting contact time and the force exerted on the ground. It is likely that the fixed stiffness of the prosthesis coupled with differences in the limb posture required to run with the prosthesis limits the ability to modulate whole leg.

Running-specific prostheses limit ground-force during sprinting -- Running-specific prostheses (RSP) emulate the spring-like behaviour of biological limbs during human running, but little research has examined the mechanical means by which amputees achieve top speeds. To better understand the biomechanical effects of RSP during sprinting, we measured ground reaction forces (GRF) and stride kinematics of elite unilateral trans-tibial amputee sprinters across a range of speeds including top speed. Unilateral amputees are ideal subjects because each amputee’s affected leg (AL) can be compared with their unaffected leg (UL). We found that stance average vertical GRF were approximately 9 per cent less for the AL compared with the UL across a range of speeds including top speed (p < 0.0001). In contrast, leg swing times were not significantly different between legs at any speed (p = 0.32). Additionally, AL and UL leg swing times were similar to those reported for non-amputee sprinters. We infer that RSP impair force generation and thus probably limit top speed. Some elite unilateral trans-tibial amputee sprinters appear to have learned or trained to compensate for AL force impairment by swinging both legs rapidly.

The fastest runner on artificial legs: Different limbs, similar function? -- The recent competitive successes of a bilateral, transtibial amputee sprint runner who races with modern running prostheses has triggered an international controversy regarding the relative function provided by his artificial limbs. Here, we conducted three tests of functional similarity between this amputee sprinter and competitive male runners with intact limbs: the metabolic cost of running, sprinting endurance, and running mechanics. Metabolic and mechanical data, respectively, were acquired via indirect calorimetry and ground reaction force measurements during constant-speed, level treadmill running. First, we found that the mean gross metabolic cost of transport of our amputee sprint subject (174.9 ml O2/kg/km; speeds: 2.5–4.1 m/s) was only 3.8% lower than mean values for intact-limb elite distance runners and 6.7% lower than for subelite distance runners but 17% lower than for intact-limb 400-m specialists [210.6 (SD 13.2) ml O2/kg/km]. Second, the speeds that our amputee sprinter maintained for six all-out, constant-speed trials to failure (speeds: 6.6–10.8 m/s; durations: 2–90 s) were within 2.2 (SD 0.6)% of those predicted for intact-limb sprinters. Third, at sprinting speeds of 8.0, 9.0, and 10.0 m/s, our amputee subject had longer foot-ground contact times [14.7 (SD 4.2)%], shorter aerial [26.4 (SD 9.9)%] and swing times [15.2 (SD 6.9)%], and lower stance-averaged vertical forces [19.3 (SD 3.1)%] than intact-limb sprinters [top speeds 10.8 vs. 10.8 (SD 0.6) m/s]. We conclude that running on modern, lower-limb sprinting prostheses appears to be physiologically similar but mechanically different from running with intact limbs.