Running-Specific Prostheses Permit Energy Cost Similar to Nonamputees

BROWN, M. B., M. L. MILLARD-STAFFORD, and A. R. ALLISON. Running-Specific Prostheses Permit Energy Cost Similar to Nonamputees. Med. Sci. Sports Exerc., Vol. 41, No. 5, pp. 1080-1087, 2009. Improvements in prosthesis design have facilitated participation in competitive running for persons with lower limb loss (AMP). Purpose: The purpose of this study was to examine the physiological responses of AMP using a run-specific prosthesis (RP) versus a traditional prosthesis (P) and cross-referenced with nonamputee controls (C) matched by training status, age, gender, and body composition during level treadmill running (TM). Methods: Twelve trained runners completed a multistage submaximal TM exercise during which FIR and oxygen uptake ((V) over dotO(2)) were obtained. Steady state measures at 134 m.min(-1) were compared between RP and P in AMP. AMP using P-P (AMP-RP) and C also performed a continuous speed-incremented maximal TM test until volitional fatigue. Results: RP elicited lower HR and (V) over dotO(2) compared with P in AMP. Using RP, AMP achieved similar (V) over dotO(2max) and peak TM speed compared with C but with higher HRmax. Relative HR (%HRmax) and oxygen uptake (%(V) over dotO(2max)), the regression intercept, slope, SEE, and Pearson's r correlation were not different between AMP-RP and C. %HRmax calculated with the published equation, %HRmax = 0.73(%(V) over dotO(2max)) + 30, was not significantly different from actual %HRmax for AMP-RP or C in any stage. Conclusions: RP permits AMP to attain peak TM speed and aerobic capacity similar to trained nonamputees and significantly attenuates FIR and energy cost of submaximal running compared with a P. Use of RP confers no physiological advantage compared with nonamputee runners because energy cost at the set speed was not significantly different for AMP-RP. Current equations on the basis of the relative HR-(V) over dotO(2) relationship seem appropriate to prescribe exercise intensity for persons with transtibial amputations using RP.