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Abstract
A number of individuals with unilateral transfemoral amputation (TFA) run in a prosthesis with an unlocked prosthetic knee, while others choose to run with a locked prosthetic knee to increase stability. Research regarding running with an unlocked knee (UK) versus a locked knee (LK), with respect to energy efficiency, is limited and might be enhanced by characterization of the impact of knee condition on kinematics. To investigate the effect of an UK versus LK on hip kinematics, energy efficiency, and running speed. Five male novice runners with unilateral TFA completed one three-minute self-selected running speed (SSRS) trial and three peak speed trials per knee condition. Hip kinematics, energy efficiency, and running speed were compared between conditions. Four of the five subjects exhibited a fast walk, rather than a consistent run. Hip flexion increased for all subjects and hip abduction decreased for four subjects during swing phase for the UK condition. Hip kinematic asymmetry was reduced for the UK condition in the sagittal plane for four individuals; hip kinematic asymmetry was also reduced in the frontal plane for the UK condition for three of these individuals. Mean energy efficiency was better for the UK condition (UK: 0.282 mLO2/kg/m, LK: 0.328 mLO2/kg/m). Peak running speed did not differ significantly between knee conditions (UK: 1.47m/s, LK:1.32m/s). For novice recreational runners with unilateral transfemoral amputation, the UK condition resulted in improved energy efficiency and enhanced kinematic symmetry, despite comparable peak speed relative to the LK condition. Therefore the UK condition may be advantageous for mid-range distance running.
Highlights
When using a running specific prosthesis (RSP) at fixed speeds on a treadmill, individuals with a transfemoral amputation (TFA) consume 45-78% more oxygen than agematched able-bodied runners.1 Some individuals with TFA CPOJ ISSN: 2561-987XBlakeley et al 2020 EFFECTS OF PROSTHETIC KNEE CONDITION DURING ATTEMPTED RUNNINGThe effect of knee condition on oxygen consumption and running speed has been minimally investigated and results to date have been contradictory
For novice recreational runners with unilateral transfemoral amputation, the unlocked knee (UK) condition resulted in improved energy efficiency and enhanced kinematic symmetry, despite comparable peak speed relative to the locked knee (LK) condition
The UK condition may be advantageous for mid-range distance running
Summary
For two experienced runners with TFA wearing RSPs, Wening and Stockwell reported that running without a prosthetic knee (no-knee condition) is more efficient based on level treadmill running trials at progressively increasing speeds.. For two experienced runners with TFA wearing RSPs, Wening and Stockwell reported that running without a prosthetic knee (no-knee condition) is more efficient based on level treadmill running trials at progressively increasing speeds.3 Both subjects ran for a prolonged period and achieved faster peak speeds when running in the no-knee condition. The potential variation in oxygen consumption with knee condition for runners with unilateral TFA may be related to hip kinematics as circumduction and increased hip abduction decrease energy efficiency due to the lateral shift in the center of gravity.. Research regarding running with an unlocked knee (UK) versus a locked knee (LK), with respect to energy efficiency, is limited and might be enhanced by characterization of the impact of knee condition on kinematics
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