Over time, leg prostheses have improved in design, but have been incapable of actively adapting to different walking velocities in a manner comparable to a biological limb. People with a leg amputation using such commercially available passive-elastic prostheses require significantly more metabolic energy to walk at the same velocities, prefer to walk slower and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed that emulates the function of a biological ankle during level-ground walking, specifically providing the net positive work required for a range of walking velocities. We compared metabolic energy costs, preferred velocities and biomechanical patterns of seven people with a unilateral transtibial amputation using the bionic prosthesis and using their own passiveelastic prosthesis to those of seven non-amputees during level-ground walking. Compared with using a passive-elastic prosthesis, using the bionic prosthesis decreased metabolic cost by 8 per cent, increased trailing prosthetic leg mechanical work by 57 per cent and decreased the leading biological leg mechanical work by 10 per cent, on average, across walking velocities of 0.75-1.75 m s 21 and increased preferred walking velocity by 23 per cent. Using the bionic prosthesis resulted in metabolic energy costs, preferred walking velocities and biomechanical patterns that were not significantly different from people without an amputation.

The metabolic cost of walking is determined by many mechanical tasks, but the individual contribution of each task remains unclear. We hypothesized that the force generated to support body weight and the work performed to redirect and accelerate body mass each individually incur a significant metabolic cost during normal walking. To test our hypothesis, we measured changes in metabolic rate in response to combinations of simulated reduced gravity and added loading. We found that reducing body weight by simulating reduced gravity modestly decreased net metabolic rate. By calculating the metabolic cost per Newton of reduced body weight, we deduced that generating force to support body weight comprises approximately 28% of the metabolic cost of normal walking. Similar to previous loading studies, we found that adding both weight and mass increased net metabolic rate in more than direct proportion to load. However, when we added mass alone by using a combination of simulated reduced gravity and added load, net metabolic rate increased about one-half as much as when we added both weight and mass. By calculating the cost per kilogram of added mass, we deduced that the work performed on the center of mass comprises approximately 45% of the metabolic cost of normal walking. Our findings support the hypothesis that force and work each incur a significant metabolic cost. Specifically, the cost of performing work to redirect and accelerate the center of mass is almost twice as great as the cost of generating force to support body weight.

The recent competitive successes of a bilateral, transtibial amputee sprint runner who races with modern running prostheses has triggered an international controversy regarding the relative function provided by his artificial limbs. Here, we conducted three tests of functional similarity between this amputee sprinter and competitive male runners with intact limbs: the metabolic cost of running, sprinting endurance, and running mechanics. Metabolic and mechanical data, respectively, were acquired via indirect calorimetry and ground reaction force measurements during constant-speed, level treadmill running. First, we found that the mean gross metabolic cost of transport of our amputee sprint subject (174.9 ml O(2)*kg(-1)*km(-1); speeds: 2.5-4.1 m/s) was only 3.8% lower than mean values for intact-limb elite distance runners and 6.7% lower than for subelite distance runners but 17% lower than for intact-limb 400-m specialists [210.6 (SD 13.2) ml O(2)*kg(-1)*km(-1)]. Second, the speeds that our amputee sprinter maintained for six all-out, constant-speed trials to failure (speeds: 6.6-10.8 m/s; durations: 2-90 s) were within 2.2 (SD 0.6)% of those predicted for intact-limb sprinters. Third, at sprinting speeds of 8.0, 9.0, and 10.0 m/s, our amputee subject had longer foot-ground contact times [+14.7 (SD 4.2)%], shorter aerial [-26.4 (SD 9.9)%] and swing times [-15.2 (SD 6.9)%], and lower stance-averaged vertical forces [-19.3 (SD 3.1)%] than intact-limb sprinters [top speeds = 10.8 vs. 10.8 (SD 0.6) m/s]. We conclude that running on modern, lower-limb sprinting prostheses appears to be physiologically similar but mechanically different from running with intact limbs.

. We reduced weight using a harness system, increased mass and weight using lead worn about the waist, and increased mass alone using a combination of weight support and added load. We found that net metabolic rate decreased in less than direct proportion to reduced body weight, increased in slightly more than direct proportion to added load (added mass and weight), and was not substantially different from normal running with added mass alone. Adding mass alone was not an effective method for determining the metabolic cost attributable to braking/propelling body mass. Runners loaded with mass alone did not generate greater vertical or horizontal impulses and their metabolic costs did not substantially differ from those of normal running. Our results show that generating force to support body weight is the primary determinant of the metabolic cost of running. Extrapolating our reduced weight data to zero weight suggests that supporting body weight comprises at most 74% of the net cost of running. However, 74% is probably an overestimate of the metabolic demand of body weight to support itself because in reduced gravity conditions decrements in horizontal impulse accompanied decrements in vertical impulse.

Running-specific prostheses (RSP) emulate the spring-like behaviour of biological limbs during human running, but little research has examined the mechanical means by which amputees achieve top speeds. To better understand the biomechanical effects of RSP during sprinting, we measured ground reaction forces (GRF) and stride kinematics of elite unilateral trans-tibial amputee sprinters across a range of speeds including top speed. Unilateral amputees are ideal subjects because each amputee's affected leg (AL) can be compared with their unaffected leg (UL). We found that stance average vertical GRF were approximately 9 per cent less for the AL compared with the UL across a range of speeds including top speed (p < 0.0001). In contrast, leg swing times were not significantly different between legs at any speed (p 5 0.32). Additionally, AL and UL leg swing times were similar to those reported for non-amputee sprinters. We infer that RSP impair force generation and thus probably limit top speed. Some elite unilateral trans-tibial amputee sprinters appear to have learned or trained to compensate for AL force impairment by swinging both legs rapidly.

The authors are with the Department of Integrative Physiology, University of Colorado, Boulder, CO.The biomechanical and metabolic demands of human running are distinctly affected by velocity and body weight. As runners increase velocity, ground reaction forces (GRF) increase, which may increase the risk of an overuse injury, and more metabolic power is required to produce greater rates of muscular force generation. Running with weight support attenuates GRFs, but demands less metabolic power than normal weight running. We used a recently developed device (G-trainer) that uses positive air pressure around the lower body to support body weight during treadmill running. Our scientific goal was to quantify the separate and combined effects of running velocity and weight support on GRFs and metabolic power. After obtaining this basic data set, we identified velocity and weight support combinations that resulted in different peak GRFs, yet demanded the same metabolic power. Ideal combinations of velocity and weight could potentially reduce biomechanical risks by attenuating peak GRFs while maintaining aerobic and neuromuscular benefits. Indeed, we found many combinations that decreased peak vertical GRFs yet demanded the same metabolic power as running slower at normal weight. This approach of manipulating velocity and weight during running may prove effective as a training and/or rehabilitation strategy.

The mechanical stiffness of running-specific prostheses likely affects the functional abilities of athletes with leg amputations. However, each prosthetic manufacturer recommends prostheses based on subjective stiffness categories rather than performance based metrics. The actual mechanical stiffness values of running-specific prostheses (i.e. kN/m) are unknown. Consequently, we sought to characterize and disseminate the stiffness values of running-specific prostheses so that researchers, clinicians, and athletes can objectively evaluate prosthetic function. We characterized the stiffness values of 55 running-specific prostheses across various models, stiffness categories, and heights using forces and angles representative of those measured from athletes with transtibial amputations during running. Characterizing prosthetic force-displacement profiles with a 2nd degree polynomial explained 4.4% more of the variance than a linear function (p<0.001). The prosthetic stiffness values of manufacturer recommended stiffness categories varied between prosthetic models (p<0.001). Also, prosthetic stiffness was 10% to 39% less at angles typical of running 3 m/s and 6 m/s (10°-25°) compared to neutral (0°) (p<0.001). Furthermore, prosthetic stiffness was inversely related to height in J-shaped (p<0.001), but not C-shaped, prostheses. Running-specific prostheses should be tested under the demands of the respective activity in order to derive relevant characterizations of stiffness and function. In all, our results indicate that when athletes with leg amputations alter prosthetic model, height, and/or sagittal plane alignment, their prosthetic stiffness profiles also change; therefore variations in comfort, performance, etc. may be indirectly due to altered stiffness.

Running-specific prostheses (RSF) are designed to replicate the spring-like nature of biological legs (bioL) during running. However, it is not clear how these devices affect whole leg stiffness characteristics or running dynamics over a range of speeds. We used a simple spring -mass model to examine running mechanics across a range of speeds, in unilateral and bilateral transtibial amputees and performance-matched controls. We found significant differences between the affected leg (AL) of unilateral amputees and both ALs of bilateral amputees compared with the bioL of non-amputees for nearly every variable measured. Leg stiffness remained constant or increased with speed in bioL, but decreased with speed in legs with RSPs. The decrease in leg stiffness in legs with RSPs was mainly owing to a combination of lower peak ground reaction forces and increased leg compression with increasing speeds. Leg stiffness is an important parameter affecting contact time and the force exerted on the ground. It is likely that the fixed stiffness of the prosthesis coupled with differences in the limb posture required to run with the prosthesis limits the ability to modulate whole leg stiffness and the ability to apply high vertical ground reaction forces during sprinting.