How should we assess the mechanical properties of lower-limb prosthesis technology used in elite sport?: An initial investigation

Despite recent controversy, it is not yet formally recognised how lower-limb prosthesis should be assessed for their performance. To assist in this process, experiments are undertaken to investigate the linearity, stiffness and assessment of feet based energy return prosthesis technology typically used for elite level high speed running. Through initial investigations, it is concluded that static load testing would not be recommended to specify or regulate energy return prostheses for athletes with a lower-limb amputation. Furthermore, an assessment of energy return technology when loaded under dynamic conditions demonstrates changes in mechanical stiffness due to bending and effective blade length variation during motion. Such radical changes of boundary conditions due to loading suggest that any assessment of lower-limb prosthesis technology in the future should use methods that do not assume linear mechanical stiffness. The research into such effects warrants further investigation in the future

The controversy of sports technology: a systematic review

Changes or introductions of technology or equipment can affect how a sport is played or influence its performances. This article conducted a systematic review of peer-reviewed literature to identify any case studies of controversial events surrounding the implementation or use of sports technology. 56 articles were identified that highlighted 31 different case studies found over a three decade time period. Thematic analysis revealed six distinctive themes when reviewing the articles. Whilst the sport of golf had the highest number of case studies, it was found that a significant level of attention had been recorded in the cases of Oscar Pistorius use of prosthetic legs in athletics and the use of full length swimsuits in swimming. The trend surrounding the number of articles was shown to be initially intermittent but saw a peak period from 2008 to 2010. However, the frequency of such articles since this peak has been more consistent. It is proposed that long periods of time without intervention or resolution by a governing body often increases the peer-reviewed attention paid to such cases in examples such as those identified in this systematic review

An insight into the use & assessment of lower-limb running prostheses in sport with a disability: a mixed method approach

In able-bodied sport, controversy has occasionally been caused through the adoption or introduction of sports technology. However, scant attention has specifically been paid to sport with a disability with respect to such concerns. This article therefore investigates the use of lower limb running prostheses (LLRPs) in competition by below-knee amputees. This study uses a four-phase mixed method approach to investigate the nature, use and assessment of LLRPs. The first phase conducted a statistical analysis of the sports time series data to ascertain the progression of the sport when considering the impact of sports technology. The second phase performed a stakeholder assessment of the sport using the Delphi method and provided a proposed series of guidelines for lower limb prostheses technology inclusion. The third phase assessed the behaviour of LLRPs in a competitive environment. Ultimately, the three previous phases provided information that led to the fourth phase. This phase investigated the use of a dynamic drop jump technique as an assessment strategy for further development in the future. This information would prove of intrinsic value when developing sports policy in the future

An Insight into the acceptable use and assessment of lower-limb running prostheses in disability sport.

Sports technology can be any product or system used to facilitate, train or influence an athlete’s performance. The role of prostheses used for disability sport was initially to help facilitate exercise and then ultimately, competition. In able-bodied sport, controversy has occasionally been caused through the adoption or introduction of sports technology. However, scant attention has been paid to sport with a disability with respect to such concerns. This research project provides a novel contribution to knowledge by investigating the use of lower-limb running prostheses in competition by trans-tibial amputees. A novel study using a mixed method approach has investigated the nature, use and assessment of lower-limb running prostheses. It has proposed that the unchecked introduction of such technology has affected the sport negatively. From this, the study conducted a stakeholder assessment of the sport and provided a proposed series of guidelines for lower-limb prostheses technology inclusion. Finally, the recommendation was made that a proactive approach to such technologies’ inclusion in the future should be implemented. These guidelines were further developed by assessing symmetrical and nonsymmetrical lower-limb function and proposed that single and double lowerlimb amputees should be separated in competition in the future. To this end, it was proposed that lower-limb symmetry, stiffness and energy return were important means of monitoring prosthesis performance. Ultimately, a dynamic technique which assesses these qualities was proposed as an assessment strategy for further development in the future

An aging cyclist's time trial performances over four decades: a case study

Previous research has often highlighted the physiological decline an athlete will be subjected to as they age. However, whilst some studies have evaluated a large sample of athletes at a given age, few studies have evaluated a single athlete over a much longer period of time in sports such as cycling. This study assessed the time trial performances of a multiple national record holding male amateur cyclist from when they were aged between 37 to 75 years of age. 488 of their individual performances over nearly four decades were contrasted against a statistically generated baseline of athletes that they competed against during these events. The results indicated a relatively stable level of performance from aged 37-52 years of age. However, a noticeable decline began to take place at aged 61 which then degraded sharply at aged 70. Interestingly, the athlete did not exhibit a permanent reduction in their average velocity in their best 16.1km and 40.2km time trial performances until aged 70. This suggests that despite the physiological decline that will eventually reduce a riders competitiveness, this case study demonstrated that it is feasible to continue the pursuit of personal records until relatively late in life

An investigation into the relationship between paracycling athletes and their prosthetics technology: a proposed design framework.

Objective: Product attachment has been stated as an emotional relationship an end-user may develop with a tangible product or artefact. The objective of this study is to investigate this relationship with athletes who possess limb absence and utilise assistive sports technology competitively. Method: Five elite paracyclists were surveyed using a modified 31 question product attachment survey. The survey comprised the ability to capture both closed-ended and open-ended data. The survey design itself was derived from three previously validated product relationship questionnaires. Results: Four elite athletes with limb absence did not provide any firm evidence or indication to support the concept of a non-physical relationship with their prosthetic device. However, some respondents had (or wished) to incorporate some form of aesthetic-based prosthetic personalisation or customisation, as long as this did not impact on the prostheses functional performance. Furthermore, a thematic analysis of the participant’s responses yielded a four-point assistive technology design philosophy framework. The emerging thematic areas were 1) The identification of the factors that influence performance in the athletes chosen sport; 2) To consider an ‘appearance follows performance’ approach; 3) To conduct sports specific trials of the prosthetic limb; and 4) To identify any need for prostheses decorative personalisation. Conclusions: The survey revealed some anecdotes of a sports technology to user relationship but this will require further exploration with different and larger sample populations. Use of the proposed four-point framework may help inform practitioners of what considerations could provide greater end-user satisfaction when designing and developing specialised prosthetic limbs for elite-level sport

Validation of the virtual elevation field test method when assessing the aerodynamics of para-cyclists with a uni-lateral trans-tibial amputation

Lower-limb amputees typically require some form of prosthetic limb to ride a bicycle for recreation or when competing. At elite-level racing speeds, aerodynamic drag can represent the majority of the resistance acting against a cyclists’ forward motion. As a result, the reduction of such resistance is beneficial to an amputee whereby the form and function of the prosthetic limb can be optimized through engineering. To measure the performance of such limbs, field testing provides a cost-effective and context-specific method of aerodynamic drag measurement. However, few methods have been formally validated and none have been applied to amputees with lower-limb amputations. In this paper, an elite level para-cyclist wore two different prosthetic limb designs and had their total aerodynamic drag of a wind tunnel reference method statistically correlated against a velodrome-based virtual elevation field test method. The calculated coefficient of variation was in the range of 0.7–0.9% for the wind tunnel method and 2–3% for the virtual elevation method. A 0.03 m2 difference was identified in the absolute values recorded between the two methods. Ultimately, both methods exhibited high levels of precision, yet relative results to each other. The virtual elevation method is proposed as a suitable technique to assess the aerodynamic drag of amputee para-cyclists. Implications for rehabilitation This assessment method will provide practitioners a reliable means of assessing the impact of changes made to prosthetics design for cyclists with limb absence. The proposed method offers a low cost and geographically accessible solution compared to others proposed in the past. This assessment method has significant potential for impact among prosthetic limb users looking to improve their cycling performance whereas previous attention in this field has been extremely limited

The aerodynamic impact of a range of prostheses designs when cycling with a trans-tibial amputation

Previous studies have proposed that an aerodynamically optimised prosthetic limb could provide performance enhancement for competitive paracyclists. Four different designs of prosthetic limbs were assessed for their impact upon the aerodynamic drag of an elite cyclist with a lower-limb amputation. The pylon area acted as the controlled location for the differences in design between the test prostheses. A validated field test method was used to derive the participant’s total aerodynamic drag when using the prostheses designs. The field test method produced a repeatable experimental process and demonstrated that small changes in form made to the pylon region resulted in measurable differences to the participant’s cycling performance. In addition, statistical significance was obtained between a baseline design and the prostheses prototype with the greatest aspect ratio (p=<0.05). The magnitude of improvements recorded in this study could potentially influence a rider’s finishing time at international sporting events like the Paralympic Games