by Barbara Boughton
Whether it’s rock climbing, triathalons, cycling, running or the high jump, advances in prosthetic design have made high-caliber athletic competition a reality for some amputees. One such athlete testified in the September issue of Prosthetics and Orthotics International, “Snowboarding with the new prosthesis is like it was before the amputation!”
But have these advances in prosthetics trickled down to the average amputee?
In fact, the same technological advances that make it possible for an amputee athlete to win the high jump or a triathalon are also improving the health and function of even the frailest amputees. And for those who are strong enough to participate in sports—whether that’s as a weekend warrior or as a more dedicated athlete—the payoffs of the new technologies are even greater.
“When I got into this field 20 years ago, there were only about 20 different feet to choose from and five different knees,” says Scott Sabolich, CP, LP, owner and clinical director of Scott Sabolich Prosthetics in Oklahoma City. “Now we’ve got over 200 feet to choose from, over 10 electronic computer microprocessor knees and over 180 other knees. We have more technology available to us than ever before as well as better materials. Together, these have caused a paradigm shift in the way that prostheses are designed.”
Amputees who are avid athletes can benefit from the incredible strides that prosthetic technology has made. Golfers, for instance, can now get specialty prostheses with torsion adaptors that enable them to twist on their feet, and technology that helps them hold a flexed position during the golf swing, according to Jason T. Kahle, CPO, director of lower extremity prosthetics at Westcoast Brace & Limb in Tampa, FL.
Research done by M. Jason Highsmith, PT, DPT, CP, and colleagues showed that transtibial amputees can even function quite well in rock climbing with a regular walking prosthesis. However, the research also showed that transfemoral amputees who are rock climbers expend less energy and function better with a specialty prosthesis, said Highsmith, an assistant professor of physical therapy and rehabilitation sciences at the University of South Florida College of Medicine, also in Tampa. The study was e-published in November by the International Journal of Sports Medicine.
Some of the same advances that make a win possible on the playing field—and enhance an athlete’s safety while pursuing a sport—also protect and improve function in the average amputee, Kahle said.
“Not all innovations at the high end will trickle down to the average amputee—because the prostheses for athletes test the limits of prosthetic design. For instance, a blade foot made for sprinting is not going to be useful for an 80-year-old,” Kahle said. “But a knee made for stability will benefit both the athlete and the amputee primarily interested in day-to-day ambulation.”
Sports such as jogging, endurance running and triathalons that require fast forward motion benefit significantly from energy storing feet, but the same type of device can also be used with an “everyday” prosthesis to improve function in activities of daily living.
Lightweight materials such as carbon graphite that are strong as well as thin make it possible for athletes to run faster but also improve any amputee’s ability to function. Silicone gel liners, which increase comfort during physically demanding sports, have also decreased skin ulcerations and friction for all amputees.
A poorly fit prosthesis can create the perception of added mass—a problem bound to affect performance in an athlete. A more intimate fit with a total contact contoured socket design not only addresses this issue but also means that amputees—whether or not they’re athletes–can wear their prostheses longer without sores or redness.
“With the technology we have now, an amputee should be able to wear their prosthesis all day long,” Sabolich said. “If they can’t, there’s a problem.”
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