Evaluating the Performance of Running-Specific Prostheses for Children and Youth with Lower Limb Amputations

Firdous Hadj-Moussa (1,2), Jan Andrysek (1,2)

1. Institute of Biomaterials and Biomedical Engineering, University of Toronto

2. Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital

Introduction: Children and youth with lower limb amputations are generally prescribed a conventional prosthesis for daily use. However, these prostheses have limited functionality in sports, thereby necessitating secondary sport-specific prostheses for better athletic engagement. Despite the availability of pediatric RSPs, there is little research regarding the clinical impact on performance and sport participation of RSP interventions for pediatric users. While studies in the literature have focused on the use of RSPs in adult populations, mainly for elite athlete use, this is not directly applicable to children and youth due to their ongoing development and their functional needs. In addition, much remains unknown regarding the application, optimization, and function of commercially-available pediatric RSPs.
Objectives: We aim to evaluate and compare the biomechanical performance of pediatric RSPs and conventional prostheses for children and youth with lower-limb absence, as well as, the impact of RSPs on sport participation and quality of life. Our biomechanical study will focus on analyzing different spatiotemporal, kinetic and kinematic parameters that are clinically-relevant to the performance and function of RSPs, which include: cadence, speed, ground reaction forces and loading asymmetries.
Methodology: We will develop and validate biomechanical models to analyze pediatric gait for different RSP and conventional prostheses. We will recruit children and youth with lower-limb absence to perform a series of walking, running and sprinting tasks. We will assess their biomechanical performance via gait analysis using a force-measuring treadmill and a motion capture system with integrated force plates for over-ground running. Finally, we will use standard outcome measures to evaluate prosthetic usefulness, quality of life, and physical activity participation.
Significance: Our work will help establish the evidence base for the benefits of RSP prescription for children and youth. This can serve as a justification for funding agencies to further their support of RSPs making these technologies more accessible. Our findings will help improve clinical outcomes of children and youth by providing clinicians with recommendations that can directly be applied to the prescription, usage and optimization of pediatric RSPs. In turn, this can lead to children and youth making better use of their prostheses and adopting healthier and more active lifestyles.