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Technology and Biomechanics of Adaptive Sports Prostheses

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Adaptive Sports Medicine
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Abstract

New technologies continue to advance and emerge in medicine. In addition to these new treatments, there have also been advances in durable medical equipment to help emphasize maintaining physical fitness for all populations while providing stability and safety. The number of athletes with impairments continues to grow, including those with limb deficiency. Therefore, it is incumbent upon healthcare practitioners to make every effort to inform these individuals of growing and diverse opportunities and encourage their safe exercise and athletic participation through counselling and education. Given these expanded opportunities for participation in sports for persons with a limb deficiency, there has been a correlated demand for new, innovative prosthetic designs. This enhanced demand has challenged the traditional philosophies as well as the clinical and technical expertise of the physicians and prosthetists. When generating a prosthetic prescription, physicians and prosthetists should consider the needs and preferences of the athlete with limb deficiency, as well as the functional demands of the chosen sporting activity. The intent of this chapter is to provide information regarding the current advancements in the technology and biomechanics in the field of adaptive sports prosthetic devices and to assist the clinicians and their patients in facilitating participation in sporting activities.

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References

  1. US Census Bureau. Americans with disabilities: 2020, current population reports. Washington, DC: US Census Bureau; 2022.

    Google Scholar 

  2. De Luigi AJ, Pohlman D, Sports Medicine for Special Groups. PM&R Knowledge NOW/American Academy of Physical Medicine & Rehabilitation. 2013. http://now.aapmr.org/msk/sports-medicine/Pages/Sports-Medicine-for-Special-Groups.aspx. Published: 9/20/2013. Modified: 9/20/2013.

  3. Fitzpatrick KF, De Luigi AJ, Pasquina PF. The disabled athlete. ACSM’s Sports Med: Compr Rev Chap. 2013;117:786–91.

    Google Scholar 

  4. Micheo WF. Concepts in sports medicine. In: Braddom RL, editor. Physical medicine and rehabilitation; 2007. p. 1021–46.

    Google Scholar 

  5. Wu SK, Williams T. Factors influencing sport participation among athletes with spinal cord injury. Med Sci Sports Exerc. 2001;33(2):177. Arch Phys Med Rehabil. 1994;75:519

    Article  PubMed  Google Scholar 

  6. Pasquina PF. National disabled veterans winter sports clinic. J Rehabil Res Dev. 2006;43:xi–v.

    Article  PubMed  Google Scholar 

  7. US Public Health Service, US Department of Health and Human Services. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington DC: DHHS; 1991. DHHS Pub No. PHS 91-50212

    Google Scholar 

  8. US Public Health Service, NIH Consensus Development Panel on Physical Activity and Cardiovascular Health. Physical activity and cardiovascular health. JAMA. 1996;276:241–6.

    Article  Google Scholar 

  9. Kochersberger G, McConnell E, Kuchibhatla MN, Pieper C. The reliability, validity, and stability of a measure of physical activity in the elderly. Arch Phys Med Rehabil. 1996;77:793–5.

    Article  PubMed  Google Scholar 

  10. US Public Health Service, US Department of Health and Human Services. Physical activity and health: a report of the surgeon general. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, The President’s Council on Physical Fitness and Sports; 1996.

    Google Scholar 

  11. Hahn RA, Teutsch SM, Rothenberg RB, Marks JS. Excess deaths from nine chronic diseases in the United States, 1986. JAMA. 1990;264:2654–9.

    Article  PubMed  Google Scholar 

  12. Dearwater SR, LaPorte RE, Robertson RJ, Brenes G, Adams LL, Becker D. Activity in the spinal cord-injured patient: an epidemiologic analysis of metabolic parameters. Med Sci Sports Exerc. 1986;18(5):541–4.

    Article  PubMed  Google Scholar 

  13. Wettenhahn KA, Hanson C, Levy CE. Effect of participation in physical activity on body image of amputees. Am J Phys Med Rehabil. 2002;81(3):194–201.

    Article  Google Scholar 

  14. Eskridge SL, Dougherty AL, Watrous JR, McCabe CT, Cancio JM, Mazzone BJ, Galarneau MR. Prosthesis satisfaction and quality of life in US service members with combat-related major lower-limb amputation. Prosthetics Orthot Int. 2022;46(1):68–74.

    Article  Google Scholar 

  15. Hicks AL, Martin KA, Ditor DS, et al. Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being. Spinal Cord. 2003;41:34–43.

    Article  PubMed  Google Scholar 

  16. Mezghani-Masmoudi M, Guermazi M, Feki H, Ennaouai A, Dammak J, Elleuch MH. The functional and professional future of lower limb amputees with prosthesis. Ann Readapt Med Phys. 2004;47:114–8.

    Article  PubMed  Google Scholar 

  17. Kegel B. Physical fitness: sports and recreation for those with lower limb amputation or impairment. J Rehabil Res Dev Clin Suppl. 1985;1:1–125.

    Google Scholar 

  18. Legro MW, Reiber GE, Czerniecki JM, Sangeorzan BJ. Recreational activities of lower-limb amputees with prostheses. J Rehabil Res Dev. 2001;38:319–25.

    PubMed  Google Scholar 

  19. Chin T, Sawamura S, Fujita H, et al. Physical fitness of lower limb amputees. Am J Phys Med Rehabil. 2002;81:321–5.

    Article  PubMed  Google Scholar 

  20. Fisher G, Antunes D, Volpato A, Sudatti Delevattis R. Metabolic cost and performance of athletes with lower limb amputation and nonamputee matched controls during running: a systematic review. Am J Phys Med Rehabil. 2022;101(6):584–9.

    Article  Google Scholar 

  21. Mizuno N, Aoyama T, Nakajima A, Kasahara T, Takami K. Functional evaluation by gait analysis of various ankle-foot assemblies used by below-knee amputees. Prosthetics Orthot Int. 1992;16:174–82.

    Article  Google Scholar 

  22. Stepien JM, Cavenett S, Taylor L, Crotty M. Activity levels among lower-limb amputees: self-report versus step activity monitor. Arch Phys Med Rehabil. 2007;88:896–900.

    Article  PubMed  Google Scholar 

  23. Fergason JR, Harsch PD. Lower limb prosthetics for sports and recreation. In: Lenhart MK, editor. Care of the combat amputee. Fort Sam Houston TX: Office of the Surgeon General, US Army Medical Department Center and School; 2009. p. 24. Bennet L, Kavner D, Lee BK, Trainor FA. Shear vs pressure as causative factors in skin blood flow occlusion. Arch Phys Med Rehabil 1979;60:309–14.

    Google Scholar 

  24. Sanders JE, Zachariah SG, Baker AB, Greve JM, Clinton C. Effects of changes in cadence, prosthetic componentry, and time on interface pressures and shear stresses of three trans-tibial amputees. Clin Biomech. 2000;15:684–94.

    Article  Google Scholar 

  25. Sanders JE, Zachariah SG, Jacobsen AK, Fergason JR. Changes in interface pressures and shear stresses over time on trans-tibial amputee subjects ambulating with prosthetic limbs: comparison of diurnal and six-month differences. J Biomech. 2005;38:1566–73.

    Article  PubMed  Google Scholar 

  26. Sanders JE, Jacobsen AK, Fergason JR. Effects of fluid insert volume changes on socket pressures and shear stresses: case studies from two trans-tibial amputee subjects. Prosthetics Orthot Int. 2006;30:257–69.

    Article  Google Scholar 

  27. Hadj-Moussa F, Zahid HB, Wright FV, Kelland K, Andrysek J. ‘It’s more than just a running’: a qualitative study of running-specific prosthesis use by children and youth with lower limb absence. Disabl Rehabil. 2022;44(23):7190–8.

    Article  Google Scholar 

  28. Sanders JE, Nicholson BS, Zachariah SG, Cassisi DV, Karchin A, Fergason JR. Testing of elastomeric liners used in limb prosthetics: classification of 15 products by mechanical performance. J Rehabil Res Dev. 2004;41:175–86.

    Article  PubMed  Google Scholar 

  29. Klute GK, Berge JS, Segal AD. Heel-region properties of prosthetic feet and shoes. J Rehabil Res Dev. 2004;41:535–46.

    Article  PubMed  Google Scholar 

  30. Gard SA, Konz RJ. The effect of a shock-absorbing pylon on the gait of persons with unilateral transtibial amputation. J Rehabil Res Dev. 2003;40:109–24.

    Article  PubMed  Google Scholar 

  31. Berge JS, Czerniecki JM, Klute GK. Efficacy of shock-absorbing versus rigid pylons for impact reduction in transtibial amputees based on laboratory, field, and outcome metrics. J Rehabil Res Dev. 2005;42:795–808.

    Article  PubMed  Google Scholar 

  32. Flick KC, Orendurff MS, Berge JS, Segal AD, Klute GK. Comparison of human turning gait with the mechanical performance of lower limb prosthetics transverse rotation adapters. Prosthetics Orthot Int. 2005;29:73–81.

    Article  Google Scholar 

  33. Hafner BJ, Sanders JE, Czerniecki J, Fergason J. Energy storage and return prostheses: does patient perception correlate with biomechanical analysis? Clin Biomech. 2002;17:325–44.

    Article  Google Scholar 

  34. Graham LE, Datta D, Heller B, Howitt J, Pros D. A comparative study of conventional and energy-storing prosthetic feet in high-functioning transfemoral amputees. Arch Phys Med Rehabil. 2007;88:801–6.

    Article  PubMed  Google Scholar 

  35. Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Arch Phys Med Rehabil. 2006;87:1334–9.

    Article  PubMed  Google Scholar 

  36. Lehmann JF, Price R, Fergason J, Okumura R, Koon G. Effect of prosthesis resonant frequency on metabolic efficiency in transtibial amputees: a study in progress (abstract 035). Rehabilitation R&D Progress Reports; 1999.

    Google Scholar 

  37. Soderberg B, Ryd L, Persson BM. Roentgen stereophotogrammetric analysis of motion between the bone and the socket in a transtibial amputation prosthesis: a case study. J Prosthet Orthot. 2003;15:95–9.

    Article  Google Scholar 

  38. Buckley M, Heath G. Design and manufacture of a high performance water-ski seating system for use by an individual with bilateral trans-femoral amputations. Prosthetics Orthot Int. 1995;19:120–3.

    Article  Google Scholar 

  39. Burkett B, Smeathers J, Barker T. Walking and running inter-limb symmetry for paralympic trans-femoral amputees, a biomechanical analysis. Prosthetics Orthot Int. 2003;27:36–47.

    Article  Google Scholar 

  40. Burkett B, Smeathers J, Barker T. Optimising the trans-femoral prosthetic alignment for running, by lowering the knee joint. Prosthetics Orthot Int. 2001;25:210–9.

    Article  Google Scholar 

  41. Childers WL, Kistenberg RS, Gregor RJ. Pedaling asymmetries in cyclists with unilateral transtibial amputation: effect of prosthetic foot stiffness. J Appl Biomech. 2011;27(4):314–21.

    Article  PubMed  Google Scholar 

  42. Nair A, Heffy D, Rose D, Hanspal RS. Use of two torque absorbers in a trans-femoral prosthesis of an amputee golfer. Prosthetics Orthot Int. 2004;28:190–1.

    Article  Google Scholar 

  43. Rogers JP, Strike SC, Wallace ES. The effect of prosthetic torsional stiffness on the golf swing kinematics of a left and a right-sided trans-tibial amputee. Prosthetics Orthot Int. 2004;28:121–31.

    Article  Google Scholar 

  44. Waters RL, et al. Energy cost of walking of amputees: the influence of level of amputation. J Bone Joint Surg Am. 1976;58(1):42–6.

    Article  PubMed  Google Scholar 

  45. Waters RL, Perry J, Chambers R. Energy expenditure of amputee gait. In: Moore WS, et al., editors. Lower limb amputation. Philadelphia: Saunders; 1989. p. 250–60.

    Google Scholar 

  46. Kuiken TA, Miller L, Lipschutz R, Huang ME. Rehabilitation of people with lower limb amputation. In: Braddom RL, editor. Physical medicine and rehabilitation. Philadelphia, PA: Elsevier; 2007. p. 283–323.

    Google Scholar 

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De Luigi, A.J. (2023). Technology and Biomechanics of Adaptive Sports Prostheses. In: De Luigi, A.J. (eds) Adaptive Sports Medicine. Springer, Cham. https://doi.org/10.1007/978-3-031-44285-8_3

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  • DOI: https://doi.org/10.1007/978-3-031-44285-8_3

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