Biomechanical Analysis of an Elite Para Standing Cross-Country Skier Using Lower Limb Prostheses: A Case Study

Para cross-country (XC) skiing has become a prominent sport since its debut at the Örnsköldsvik Winter Olympic Games in 1976. Nevertheless, the lack of studies focusing on standing para XC skiing highlights the need to provide a comprehensive description of this sport, investigating how different prosthetic devices may influence the athletic outcome. In this exploratory case study, the biomechanics of an elite standing para-athlete, with a right-sided transfemoral amputation, was investigated. Tests were performed during diagonal XC skiing on a treadmill, at different speeds and inclinations. Specifically, two different prosthetic feet were compared: the athlete used an Ottobock Genium X3 prosthetic knee with either the Ottobock Taleo or the Ottobock Evanto prosthetic foot. Inertial Measurement Units (IMUs) were employed to estimate joint angles and detect pole hits and lifts. Additionally, data were collected using embedded sensors in the knee prosthesis. Diagonal stride spatiotemporal parameters were further calculated. Results revealed that the Evanto foot significantly increased swing phase duration and hip range of motion, while generating higher knee torque, ankle torque, and axial loading compared to the Taleo foot. This research represents the first application of the employed testing methodology to para standing XC skiing, and it therefore provides a framework for future studies on this discipline.