Introduction

Running Gait Cycle
Running Gait Cycle



Importance of Good Biomechanics

  • Improve economy
    • Minimise the cost of force absorption and generation
    • Storage and return of elastic energy


  • Reduce injury risk
    • Reduce stress on the musculoskeletal system
    • Maximise training time



Breakdown of Gait

Centre of Mass Movement

Trunk Forward Lean


Initial Contact


Mid Stance


Toe Off


Toe Off



Kinematics Charts

Pelvis


Hip


Knee


Ankle



Foot Strike Patterns



Amputee Locomotion

Baum et al. 2016

Non-amputated limbs experience increased mechanical loading compared with prosthetic and control limbs.

Individuals with amputation may be at an increased risk of acute injury or joint degeneration in their intact limb.

Individuals with amputation produced propulsive impulses equivalent to intact and control limbs by generating longer periods of positive impulse and thus adapted to the force production limitations of a running-specific prosthesis.



Sports high activity prostheses

Key Principles and Challenges

  • Weight (of user)
  • Activity level
  • Environment
  • Materials
  • Design
  • Perceptions
  • Safety



The Flex Foot

  • Designed in 1985 by amputee and engineer Van Philips -> Phillips, V.L., Flex Foot, Inc., 1985. Composite prosthetic foot and leg. U.S. Patent 4,547,913.
  • Now commonly associated with the Paralympic games and sports prosthetics
  • Energy storing / return type of prosthetic foot



Sport and High Activity Knees



Key Points from Previous Surveys

Deans, S., Burns, D., McGarry, A., Murray, K. and Mutrie, N., 2012. Motivations and barriers to prosthesis users participation in physical activity, exercise and sport: a review of the literature. Prosthetics and orthotics international, 36(3), pp.260-269)

General paucity in the amount of literature available on this area

Lack of activity in amputees and prosthesis users with regard to sports and activities

Kars C, Hofman M, Geertzen J, Pepping G and Dekker R., 2009. Participation in sports by lower limb amputees in the Province of Drenthe, Netherlands. Prosthet Orthot Int 33(4): pp 356–367.

68% of amputees inactive

Bragaru, M., Dekker, R., Geertzen, J.H. and Dijkstra, P.U., 2011. Amputees and sports. Sports medicine, 41(9), pp.721-740.

Sports were associated with a beneficial effect on the cardiopulmonary system, psychological well-being, social reintegration and physical functioning



LimbPower 2016

Current Prostheses Provision


Activities undertaken / Participant %


Factors Important to Prosthesis Use in Sports


Increasing Participation


Task Specific Prostheses: Key Considerations for Cycling

Safety and performance!

We need to understand what is required to cycle effectively, and link this knowledge to the optimum prosthesis design Think about prosthesis position and/or attachment to the cycle, socket design, prosthesis alignment, the transmission of power and the flexibility (or otherwise) of the joints at key points during the ‘cycle’



References

  • Dorn, T. W., A. G. Schache and M. G. Pandy (2012). “Muscular strategy shift in human running: dependence of running speed on hip and ankle muscle performance.” J Exp Biol 215(Pt 11): 1944-1956.

  • Baum, B. S., H. Hobara, Y. H. Kim and J. K. Shim (2016). “Amputee Locomotion: Ground Reaction Forces During Submaximal Running With Running-Specific Prostheses.” 32(3): 287.

  • Hobara, H., B. S. Baum, H.-J. Kwon, A. Linberg, E. J. Wolf, R. H. Miller and J. K. Shim (2014). “Amputee locomotion: Lower extremity loading using running-specific prostheses.” Gait & Posture 39(1): 386-390.

  • Kehler, A. L., E. Hajkova, H. C. Holmberg and R. Kram (2014). “Forces and mechanical energy fluctuations during diagonal stride roller skiing; running on wheels?” Journal of Experimental Biology 217(21): 3779-3785.

  • Kulmala, J.-P., J. Kosonen, J. Nurminen and J. Avela (2018). “Running in highly cushioned shoes increases leg stiffness and amplifies impact loading.” Scientific Reports 8(1): 17496.

  • Lieberman, D. E., M. Venkadesan, W. A. Werbel, A. I. Daoud, S. D’Andrea, I. S. Davis, R. O. Mang’Eni and Y. Pitsiladis (2010). “Foot strike patterns and collision forces in habitually barefoot versus shod runners.” Nature 463(7280): 531-535.

  • Zahedi, S. (Proceedings of the XII International Congress of INTERBOR; Sept 22-25; Lisbon (Portugal))The results of the field trial of the Endolite Intelligent Prosthesis. ; 1993