Evaluation of methods for calculating maximum allowable standing height in amputees competing in Paralympic athletics

Race and geography impact validity of maximum allowable standing height equations for para-athletes

World Athletics use maximum allowable standing height (MASH) equations for para-athletes with bilateral lower extremity amputations to estimate stature and limit prosthesis length since longer prostheses can provide running performance advantages. The equations were developed using a white Spanish population; however, validation for other races and geographical groups is limited. This study aimed to determine the validity of the MASH equations for Black and white Americans and whether bias errors between calculated and measured stature were similar between these populations. Sitting height, thigh length, upper arm length, forearm length, and arm span of 1899 male and 1127 female Black and white Americans from the Anthropometric Survey of US Army Personnel database were input into the 6 sex-specific MASH equations to enable comparisons of calculated and measured statures within and between Black and white groups. Two of 12 MASH equations validly calculated stature for Black Americans and 3 of 12 equations were valid for white Americans. Bias errors indicated greater underestimation or lesser overestimation of calculated statures in 10 equations for Black compared to white Americans and in 2 equations for white compared to Black Americans. This study illustrates that race and geography impact the validity of MASH equations.

Equivalent running leg lengths require prosthetic legs to be longer than biological legs during standing

We aimed to determine a method for prescribing a standing prosthetic leg length (ProsL) that results in an equivalent running biological leg length (BioL) for athletes with unilateral (UTTA) and bilateral transtibial amputations (BTTA). We measured standing leg length of ten non-amputee (NA) athletes, ten athletes with UTTA, and five athletes with BTTA. All athletes performed treadmill running trials from 3 m/s to their maximum speed. We calculated standing and running BioL and ProsL lengths and assessed the running-to-standing leg length ratio (L_ratio) at three instances during ground contact: touchdown, mid-stance, and take-off. Athletes with UTTA had 2.4 cm longer standing ProsL than BioL length (p = 0.030), but their ProsL length were up to 3.3 cm shorter at touchdown and 4.1 cm shorter at mid-stance than BioL, at speed 3-11.5 m/s. At touchdown, mid-stance, and take-off, athletes with BTTA had 0.01-0.05 lower L_ratio at 3 m/s (p < 0.001) and 0.03-0.07 lower L_ratio at 10 m/s (p < 0.001) in their ProsL compared to the BioL of NA athletes. During running, ProsL were consistently shorter than BioL. To achieve equivalent running leg lengths at touchdown and take-off, athletes with UTTA should set their running-specific prosthesis height so that their standing ProsL length is 2.8-4.5% longer than their BioL length, and athletes with BTTA should set their running-specific prosthesis height so that their standing ProsL lengths are at least 2.1-3.9% longer than their presumed BioL length. Setting ProsL length to match presumed biological dimensions during standing results in shorter legs during running.

Artificially long legs directly enhance long sprint running performance

This comment addresses the incomplete presentation and incorrect conclusion offered in the recent manuscript of Beck et al. (R. Soc. Open Sci. 9, 211799 (doi:10.1098/rsos.211799)). The manuscript introduces biomechanical and performance data on the fastest-ever, bilateral amputee 400 m runner. Using an advantage standard of not faster than the fastest non-amputee runner ever (i.e. performance superior to that of the intact-limb world record-holder), the Beck et al. manuscript concludes that sprint running performance on bilateral, lower-limb prostheses is not unequivocally advantageous compared to the biological limb condition. The manuscript acknowledges the long-standing support of the authors for the numerous eligibility applications of the bilateral-amputee athlete. However, it does not acknowledge that the athlete's anatomically disproportionate prosthetic limb lengths (+15 cm versus the World Para Athletics maximum) are ineligible in both Olympic and Paralympic track competition due to their performance-enhancing properties. Also not acknowledged are the slower sprint performances of the bilateral-amputee athlete on limbs of shorter length that directly refute their manuscript's primary conclusion. Our contribution here provides essential background information and data not included in the Beck et al. manuscript that make the correct empirical conclusion clear: artificially long legs artificially enhance long sprint running performance.

"Fairness, Technology and the Ethics of Paralympic Sport Classification"

Fairness in sport is a widely shared meritocratic norm. Its application is usually restricted to equality of opportunity to compete for victory. Paralympic sports lay down a further challenge in that equality of opportunity must be shaped by considerations of fairness, evidenced by the development of discrete competition categories to construct fair and meaningful contests. In this article we extend these philosophical ideas to consider how Fair Equality of Opportunity might operate in the context of Paralympic sports classification. We articulate three conceptions of fairness relevant to these sports: (i) background fairness; (ii) procedural fairness; and (iii) stakes fairness. We critically review the International Paralympic Committee's Policy on Sport Equipment in relation to the first two conceptions and argue that greater clarification, theorization and rule modification is required if physical prowess, as opposed to equipment technology, is to be assured as the dominant determinant of Paralympic athletic success.Bullet points: Fair equality of opportunity in sport is applied to disability or Paralympic sportConceptual and ethical review of IPC sport equipment policyGreater theorization and rule modification required to preserve the principle that physical prowess as opposed to equipment technology is the dominant determinat of athletic success.

Anthropometry, Body Composition, and Performance in Sport-Specific Field Test in Female Wheelchair Basketball Players

Data on the physical and performance characteristics of female wheelchair basketball (WB) players are scarce. In several countries female WB players train and compete with male players on mixed teams due to the limited total population of players, which would otherwise lead to large territorial spread for each team. Any differences in terms of physical characteristics and/or WB skill proficiency between male and female WB players would be relevant to team performance in mixed teams. This work examined anthropometry, body composition, and performance in a set of sport-specific field tests in a sample of 13 female WB players representing about 40% of the eligible population in Italy across a range of functional point scores (Point). Point is assigned on an ordinal scale from 1.0 (i.e., players with minimal functional potential) through to 4.5 (players with maximum functional potential). Our female sample was then compared against twice as many (n = 26) Point-matched (±0.5 points) male players. The two groups were similar for age (P = 0.191; effect size [d] = 0.2), self-reported duration of injury (P = 0.144, d = 0.6), WB experience (P = 0.178, d = 0.5), and volume of training (P = 0.293, d = 0.4). The large majority of measured linear anthropometric variables (10/13) were lower in female players than males (0.001 < P ≤ 0.041). Skinfold-estimated percent body fat was higher (+7.6%) in females (30.7 ± 6.0%; P < 0.001, d = 1.3). Mean performance was worse in female than in males in six out of seven sport-specific field tests, scores being significantly lower in females for the maximal pass (7.5 ± 2.0 m for females vs. 10.4 ± 2.8 m for males; P = 0.002, d = 1.2) and suicide tests (55.8 ± 6.4 s for females vs. 45.4 ± 6.7 s for males; P < 0.001, d = 1.6). When performance in subgroups of females (n = 9) chosen across a range of Point was compared with that of males assigned 1.0 or 1.5 Point less (each n = 9), performance differences between male and female WB players were partially and completely eliminated, respectively. This work contributed new data for characterizing the physique and performance of female WB players. Further, the results suggested that when male and female athletes compete together in mixed teams, a 1.5 points subtraction from female players is needed to match the real gender difference in performance.

Relationship between body height and spatiotemporal parameters during a 100-m sprint in able-bodied and unilateral transtibial sprinters

BACKGROUND

Although anthropometric factors could influence sprint performance in able-bodied sprinters, little is known about the relationships between these anthropometric factors and sprint performance in amputee sprinters.

OBJECTIVES

To investigate the relationships between body height and spatiotemporal parameters of 100-m sprints in unilateral transtibial amputee and able-bodied sprinters.

STUDY DESIGN

This is a cross-sectional study.

METHODS

We analyzed elite-level 100-m races of 14 male unilateral transtibial amputee sprinters and 22 male able-bodied sprinters from publicly available Internet broadcasts. For each sprinter's run, the mean step length and frequency were determined using the number of steps in conjunction with the official race time. Furthermore, body height data for sprinters in both groups were obtained from publicly available resources.

RESULTS

Linear relationships were found between body height and mean step length and frequency in able-bodied sprinters, respectively. However, there were no significant relationships between body height and spatiotemporal parameters in transtibial amputee sprinters.

CONCLUSION

The results of this study suggest that the relationship between body height and spatiotemporal parameters during a 100-m sprint is not the same between unilateral transtibial amputees and able-bodied sprinters. Clinical relevance Understanding of the relationship between body height and spatiotemporal parameters during a 100-m sprint would provide important information that could be utilized for evaluating prosthetic sprint performance and coaching.

Performance-Focussed Sport – An Avenue to Gold-Medal Clinical Outcomes for People with Neurological Impairments?

This paper investigates the premise that long-term engagement in performance-focussed sports training may lead to significantly enhanced clinical outcomes for people with neurological impairments (NI). The minimum volume of moderate-intensity activity recommended for good health is 450 MET.minutes/week, although evidence from the general population indicates that outcomes may be enhanced by completing up to five times this volume (2250 MET.minutes/week) at vigorous (rather than moderate) intensity. Most studies evaluating physical activity interventions for people with NI deliver low volumes (<450 MET.minutes/week), which may explain why evidence for some clinical outcomes is weak. Athletes (with or without NI) who aim to achieve high-level sports performance undertake an increasingly large volume of vigorous intensity physical activity over several seasons. Evidence that people with NI may enhance clinical outcomes through performance-focussed sports training includes: evidence from studies investigating the benefits of high-intensity and/or high volume clinical exercise; scientific evidence from elite/high-level athletes; and anecdotal evidence from Paralympic athlete testimonials. Additionally, sports participants with NI may also accrue an important array of psychosocial benefits, including higher rates of employment, and higher satisfaction with life and social integration. Rigorous, prospective, longitudinal clinical monitoring of people with NI undertaking performance-focussed sports training are required to evaluate its clinical utility.