Abstract
Altered biomechanics due to amputation can contribute to substantial limitations, influencing sporting activities. Individuals with lower extremity amputations or congenital lower limb deficiency are encouraged to participate in para-sports. However, to compete in Paralympic sports, the candidate must have an impairment that results in lower extremity loss of function and meets or exceeds the sport's minimum impairment criteria (MIC). This review will focus on the MIC for competitive wheelchair tennis. Limb deficiency is known as one of the MIC used to regulate participation in competitive para-sports since it impacts gait, kinematics, and biomechanics of both the upper and lower body. Notwithstanding, it is questionable whether the MIC concerning limb deficiency is set at the correct level for determining eligibility for participating in Paralympic sports. This study aims to provide an overview of the evidence examining the impact of different partial foot amputation (PFA) levels on gait as a proxy for sporting performance. This scoping review will be based on a 6-step methodological framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis, extension for scoping reviews (PRISMA-ScR). Studies will be selected from PubMed, Embase, CINAHL, and SPORTDiscus. Two authors will screen the titles/abstracts independently. Selected studies will be scrutinised, and the same authors will extract data. Findings will be relevant to informing the evidence-based development of MIC for lower limb impairment after PFA and may be extrapolated to specific Paralympic sports, including wheelchair tennis. Results will be disseminated through scientific publications and conferences to audiences interested in Paralympic sports.
Highlights
Lower extremity amputation is a condition associated with a significant impact on quality of life, morbidity, and mortality.[1]
Limb deficiency is currently known as one of the Minimum Impairment Criteria (MIC) used to regulate participation in competitive parasports since it impacts gait, kinematics, and biomechanics of both the upper and lower body. Notwithstanding, it is questionable whether the minimum impairment criteria (MIC) concerning limb deficiency is set at the correct level for determining eligibility for participating in Paralympic sports
Using a scoping review methodology,[11] this study aims to provide an overview of the evidence examining the impact of different partial foot amputation levels on gait as a proxy for sporting performance
Summary
Lower extremity amputation is a condition associated with a significant impact on quality of life, morbidity, and mortality.[1] Chronic degenerative disease complications, including vascular disease due to Type I and Type II diabetes, peripheral vascular disease, and infection, are the most frequent indication for lower-extremity amputation,[2] with diabetes and associated comorbidities accounting for more than 50% of all lower-limb amputations globally.[3] In children and young adults, the most common causes include trauma (75%), malignancy (5%), and congenital limb deficiency (5%).[2] Even though children and young adults have a lower incidence of amputation than older adults, children and young adults contribute significantly to the overall prevalence of lower limb loss due to their longer life expectancy.[3] One-year mortality rates range from 23% to 53%, depending on the anatomical level of amputation, patient age, and underlying illness.[4]. Less common levels are ankle disarticulations (Syme), through-knee amputations, hip disarticulation, and hemipelvectomy (combined 1.5%).[1,4]
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