Mechanics and Energetics of Cycling with Unilateral Transtibial Amputation: Effects of Prosthetic Effective Leg Length and Prosthesis Type

Cyclists with a TTA can increase prosthetic effective leg length in a daily-use prosthesis or CSP up to 15 mm without affecting performance. However, use of a CSP decreases knee angle asymmetry and improves efficiency compared to a daily-use prosthesis. CSPs may shift knee extensor muscles into a more favorable region of the force-length relationship for producing force more economically. These findings can be used to inform bicycle and prosthesis designs that may encourage individuals with a TTA to increase exercise and sport participation.