Joint moment and muscle power output characteristics of below knee amputees during running: the influence of energy storing prosthetic feet.

Stance phase joint moments, muscle power outputs and mechanical energy characteristics were determined in five normal and five below knee amputee subjects running at 2.8 m s-1. The amputees were studied sequentially on three different prosthetic feet: the SACH foot (solid ankle cushion heel), and two energy storing feet, Seattle and Flex. While wearing the SACH foot, the amputees exhibited major alterations in the distribution and magnitude of muscle power output and muscle work: (1) the total work done by the lower extremity was reduced; (2) the hip extensors became the main source of energy absorption and generation, while in normal subjects the ankle plantarflexors were the major energy generators and the knee extensors the major energy absorbers; (3) the eccentric and concentric knee extensor power outputs were reduced and an abnormal concentric knee flexor power output was noted immediately after heel contact. In four of the amputees, energy storing feet resulted in improvements in the power output and mechanical work characteristics of the lower extremity: (1) the energy storing prosthetic feet generated 2-3 times greater energy than the SACH foot; (2) with the Flex foot the amputees exhibited a more normal pattern and magnitude of hip and knee extensor muscle work. One of the subjects, however, exhibited increased abnormalities with the energy storing prosthetic feet. The amount of energy restored relative to the amount of energy absorbed by each of the prosthetic feet was greater with the energy storing feet than the SACH foot (Flex 84%, Seattle 52%, SACH 31%).