Energy transfer mechanisms as a compensatory strategy in below knee amputee runners

Abstract

Below knee amputee runners exhibit abnormalities in the mechanical work characteristics of the lower extremity musculature during stance phase. The most significant abnormality is a marked reduction in the mechanical work done in the stance prosthetic limb. Energy transfer across the hip joint to the trunk during deceleration of the swing phase leg may be an important energy distribution mechanism to compensate for the reduced work done during prosthetic stance phase. Five unilateral below knee amputee runners wearing the SACH prosthetic foot and 5 normal subjects were studied. All subjects ran at a controlled velocity of 2.8 m s −1 while kinematic and ground reaction force data were collected. Using a four segment linked segment model and an inverse dynamics approach joint moments, muscle power outputs, mechanical work values and energy transfers across the hip were calculated. The total amount of energy transferred during swing phase and the energy transferred out of the swing phase leg into the trunk were both significantly greater than normal. Energy transfer mechanisms are important in influencing the lower extremity energetics during swing phase. In addition, the 74% increase in energy transfer out of the intact swing phase limb combined with the temporal characteristics of this energy flow suggests that energy transfer may be an adaptive mechanism that allows energy redistribution to the trunk which may partially compensate for the reduced power output of the stance phase prosthetic limb.