Amputee locomotion: Lower extremity loading using running-specific prostheses

Abstract

Carbon fiber running-specific prostheses (RSPs) have allowed individuals with lower extremity amputation (ILEA) to actively participate in sporting activities including competitive sports. In spite of this positive trait, the RSPs have not been thoroughly evaluated regarding potential injury risks due to abnormal loading during running. Vertical impact peak (VIP) and average loading rate (VALR) of the vertical ground reaction force (vGRF) have been associated with running injuries in able-bodied runners but not for ILEA. The purpose of this study was to investigate vGRF loading in ILEA runners using RSPs across a range of running speeds. Eight ILEA with unilateral transtibial amputations and eight control subjects performed overground running at three speeds (2.5, 3.0, and 3.5m/s). From vGRF, we determined VIP and VALR, which was defined as the change in force divided by the time of the interval between 20 and 80% of the VIP. We observed that VIP and VALR increased in both ILEA and control limbs with an increase in running speed. Further, the VIP and VALR in ILEA intact limbs were significantly greater than ILEA prosthetic limbs and control subject limbs for this range of running speeds. These results suggest that (1) loading variables increase with running speed not only in able-bodied runners, but also in ILEA using RSPs, and (2) the intact limb in ILEA may be exposed to a greater risk of running related injury than the prosthetic limb or able-bodied limbs.