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Innovative prostheses positively change the Paralympics

September 2021

By Maja Hoock, IP & R&D Corporate Communications, Ottobock, Germany

The Tokyo 2020 Paralympic Games took place in Tokyo from August 24 to September 5, 2021. Some 4,400 athletes with disabilities competed for gold in 22 disciplines. IP protected sports prostheses were one of the key devices they used to achieve their goals. Research and development have helped athletes get the most out of their athletic ability.

Johannes Floors (26) improved his world record in the 200 meters on June 25 using sports prosthetics – and won gold at the Paralympic Games in Tokyo in August 2021. (Photo: Courtesy of Ottobock)

Johannes Floors sprints on his track in Leverkusen for up to six hours every day. In August, he flew to Japan to compete against athletes from every corner of the world. “I’ve actually been preparing for the Paralympic Games since 2016,” says the 26-year-old. The German track and field athlete won gold at the Paralympic Games in Tokyo. Mr. Floors is currently the world’s fastest person on prostheses. He improved his world record in the 200 meter at the end of June and is also the fastest in his class(T62) in the 100 and 400 meters. But these achievements are anything but a given. Mr. Floors was born with a genetic defect affecting the fibula. He was missing both fibulas and had deformed feet. Sprinting was out of the question. “There was too much pain,” he says. For this reason, he made the decision to have both lower legs amputated ten years ago. “I was still in bed at the hospital when I decided to register for the sports program at school,” he recalls. His everyday prostheses allow him to walk normally now – and he can sprint with special carbon springs designed for sports. “Feeling that speed is a huge emotional experience,” he says.

Not long ago, Paralympic athletes wore their everyday prostheses during competitive sports. Only in the 1980s did they begin wearing specially-designed prostheses for sprinting. Unlike the natural leg or sports prostheses today, conventional prostheses don’t flex as easily and make it difficult to carry out movements required for specific sports. “All of a sudden, there were sports prostheses – and that changed everything,” says Mr. Floors.

Ottobock now holds 1,886 patents issued in over 540 patent families – including numerous technical innovations for Paralympic sports.

Sports prostheses help people participate

Ottobock is a manufacturer of widely used sports prostheses and wheelchairs and has been providing devices for Paralympic athletes for over 30 years. The German company, known for wearable human bionics, has been fabricating prostheses for over 100 years. Initially, the company produced replacement limbs made of wood for those who had been injured in the First World War. Today, its products include AI-supported prostheses, such as the bebionic hand, that have set new technological standards.

Ottobock now holds 1,886 patents issued in over 540 patent families – including numerous technical innovations for Paralympic sports.

The agile 1E95 prosthetic foot, for example, is used in sports such as basketball and volleyball. The foot has a simple structure and makes walking, jogging and sudden changes of direction easier. Ottobock developed the patented 1E91 Runner especially for sprinters and long jumpers. Many Paralympic legends wear this prosthetic foot, which can be easily adapted to suit the needs of different individuals. And its force line is closer to the body’s center of gravity, making the carbon spring more efficient to use.

Video: How a carbon fibre running blade is made

Orthotics and prosthetics (O&P) professional Julian Napp was part of the development team. He has been overseeing the Ottobock Technical Repair Service Center at the Paralympic Games since 2012. Athletes bring their prostheses and wheelchairs to the workshop when they need to be repaired. The technician incorporated his practical experiences into the development process: “You have to work very precisely to ensure the foot is correctly aligned with the body,” he says.

The concept behind Ottobock's popular 1E90 Sprinter running blade that 26-year-old Johannes Floors wears is nearly as old as he is. The Sprinter was developed in the United States in the 1990s, before Ottobock acquired the product and enhanced its design.

The carbon foot is worn with a carbon fibre vacuum socket including an outlet valve and sealing sleeve. The residual limb is enclosed and protected by a type of stocking, the polymer liner. A 1E90 adapter between the socket and prosthetic foot with a protected design ensures that the position of the prosthesis can be easily readjusted. “I can adjust the static alignment perfectly with the adapter, and this is what actually makes it possible to run without any limitations,” Mr. Napp explains.

He custom makes prostheses for various sports and athletes, including well-known sprinters and long jumpers, Heinrich Popow and Léon Schäfer: “It makes me really proud to see them chalking up one world record after the other,” Mr. Napp says. He also works closely with current world record holder, Johannes Floors. “I try to adjust the technology so it suits athletes better and better all the time – it develops along with the athlete,” Mr. Napp notes. “I couldn’t put a prosthesis that was made for Johannes Floors on a different athlete like Léon Schäfer. He probably wouldn’t be able to run very quickly with it. The static alignment is different for everyone.”

Orthotics and prosthetics professional Julian Napp (center) adjusts Paralympic athlete Léon Schäfer’s (left) everyday prosthesis with former world record holder Heinrich Popow (right) in the Ottobock Technical Repair Service Center. (Photo: Courtesy of Ottobock)

Patent for first mechanical sports knee joint

Despite the invention of the prosthetic sports foot, athletes with a transfemoral above-knee amputation still had a problem. Some of them wore the carbon foot directly on their residual limb and basically pieced together their prostheses themselves. The result can be seen in sports videos showing the characteristic swivelling movement the leg makes when extended. It helps runners who don’t wear a sports knee joint avoid an excessively long swing phase. Other athletes ran with everyday prostheses and polycentric joints, which are actually unsuitable for this purpose. The first monocentric sports prosthesis in the world offered a solution. Ottobock developed it on the basis of the 3R80 joint, for which the patent for rotational hydraulics was initially granted in Germany in 1995*.

The 3S80 has a manual lock and individually adjustable damping characteristics and is particularly compact and robust: “When jogging, the body weight acting on the prosthesis is doubled. There is as much as a fivefold increase when sprinting, with an increase of six to seven times for long jumpers,” says Julian Napp. Artificial sports knees have to be able to withstand this strain but remain flexible enough to permit acceleration. In other words, this type of sports joint is tailored to the athletes rather than the other way round, as was the case previously.

Martina Caironi, former world record holder, and silver medallist at the 2020 Paralympic Games in Tokyo, uses an above-knee prosthesis with a sports knee joint and carbon foot. (Photo: Courtesy of Ottobock)

Paralympic athlete Martina Caironi wears this type of sports knee prosthesis. Ms. Caironi, a native of Italy, won a silver medal in the long jump and the 100 meters at the Tokyo 2020 Paralympic Games.

In 2007, she lost her left leg in a motorcycle accident. It was during rehabilitation that she realized she had a gift for sports. She started achieving her first records three years later. “I never actually wanted to be a professional athlete,” Ms. Caironi says. “But after my accident, I realized how well I was able to run with prostheses. It would have been a waste if I hadn’t pursued my talent.”

Ms. Caironi initially participated in sports with her everyday prosthesis before being fitted with the 3S80 and the 1E91 carbon spring. “I was able to experience the technological transformation right on my own body,” says the 31 year old. “I am living the transformation.”

The International Paralympic Committee (IPC) has defined clear rules taking into account the degree to which the athletes’ disabilities impact their performance. For this reason, only passive prostheses without electronics are allowed.

She says she found it difficult to control the sports prosthesis at first because the joint is more flexible and provides less stability to allow for faster acceleration. Ms. Caironi won gold with this joint at the Paralympic Games in London in 2012, finishing the 100 meter in 14.65 seconds – she was the only female athlete to complete the race in under 15 seconds.

In 2013, Ms. Caironi became a double world champion in the long jump and the 100 meter. In 2015, she ran a world record time in the 200 meter and won gold at the World Para Athletics Championships in Doha.

The new prostheses have enhanced her quality of life as well. Ms. Caironi wears the Genium X3 as her everyday prosthesis; the intelligent knee joint automatically adapts to various situations. “I’ve become much more mobile,” she says. “I can take the stairs or work out at the gym without thinking twice, which has a positive impact on my career as an athlete as well.”

Video: Passion for Paralympics Tokyo 2020

Sports with prostheses isn’t technology doping

It’s worth noting that Ms. Caironi was not allowed to use her everyday mechatronic prosthesis at the Paralympic Games. The International Paralympic Committee (IPC) has defined clear rules taking into account the degree to which the athletes’ disabilities impact their performance. For this reason, only passive prostheses without electronics are allowed. The approved length of the prostheses is determined on the basis of a complex formula that takes into account the user’s height and the length of the femur. Yet still, the media’s perception of “enhanced humans” is difficult to shift.

Johannes Floors says he would be rich if he had five euros for every time someone asked him whether he can run faster with his prostheses than professional athletes do with healthy legs. He finds the narrative about superhumans with bionic limbs difficult to swallow. “It degrades my performance and suggests I’m nothing more than my prosthesis,” he says. “It’s as if the six hours I spend training every day aren’t worth anything! And my sports prostheses aren’t even high-tech compared to my everyday prostheses – they’re the same as they have been since the 90s."

WIPO’s Technology Trends Report 2021

In March 2021, WIPO released its latest Technology Trends report, which covers assistive technologies - innovations that help people living with functional limitations in relation to mobility or vision, for example, to participate in all aspects of life and fulfil their potential.

The report is part of a series that tracks technology trends through the analysis of patent and other data to provide solid, factual evidence on innovation in specific fields.

At a time when over 1 billion people need assistive technology – this figure is set to double over the next decade as populations age – the 2021 report concludes that intellectual property (IP) is enabling the growth in innovation in assistive technologies. Experts contributing to the report, however, underline the need for this innovation to become more widely available to those who rely on it. Globally, only 1 in 10 people currently has access to the assistive products they need.

The report is designed to provide the knowledge-base to support global discussions to promote greater access to assistive technology.

Key findings:

  • Innovations, ranging from small improvements in existing products to cutting-edge developments in frontier technologies, can greatly enhance the lives of those with functional limitations, enabling them to live, communicate and work independently.
  • Assistive technologies have enjoyed double-digit growth in recent years and are increasingly integrated in consumer goods.
  • China, USA, Germany, Japan and the Republic of Korea are the five main origins of innovation in assistive technology.
  • Patent filings in emerging assistive technology, including assistive robots, smart home applications, wearables for the visually impaired and smart glasses, have grown three times faster than conventional assistive technology, which include improvement and accessories for wheelchairs, environmental alarms and Braille-enabled devices.
  • Two fast-growing areas of emerging assistive tech are environment (e.g. navigation aids in public spaces and assistive robots) and mobility (e.g. autonomous wheelchairs and advanced prosthetics.
  • The assistive technology field is converging with consumer electronics and general medical technologies, with growth in less invasive assistive products (thanks to increasingly sophisticated sensors) and more invasive solutions like brain stem implants to recover hearing, vision, mobility. Technologies developed for those with functional limitations are increasingly applied to mainstream products. For example, bone conduction technology that can assist with hearing impairment can also be used in runners’ headsets.
  • Advanced and new assistive products are available thanks to developments in and use of enabling technologies like Artificial Intelligence, Internet of Things, new materials and advanced robotics.
  • Corporate players are leading the development of assistive technology, including specialized assistive tech companies, such as WS Audiology, Cochlear, Sonova, Second Sight, Ottobock and Össur. Electronic consumer goods companies (e.g. Panasonic, Samsung, IBM, Google and Hitachi) and auto industry companies (e.g. Toyota and Honda) are also major players given the growing trend to integrate assistive technologies into mainstream electronic consumer goods.
  • Universities and public research organizations are more prominent in the emerging assistive technology dataset and are particularly active in the field of mobility.

Despite advances in prosthetics, most Paralympic runners are also slower than Olympic athletes. While para athlete Johannes Floors can cover 200 meters in 21.04 seconds, it takes Usain Bolt, currently the fastest non-disabled athlete, just 19.19 seconds. Throughout the history of para track and field, only a handful of athletes have equalled the world-class levels of non-amputees; they include sprinter Johannes Floors and Markus Rehm in the long jump. “Blade Runner” Oscar Pistorius is controversial for various reasons.

Throughout the history of para track and field, only a handful of athletes have equalled the world-class levels of non-amputees.

“Athletes who wear prostheses still face disadvantages in every phase that requires acceleration,” says Dr. Thomas Schmalz, an expert in biomechanical analyses of top athletes with amputations. Para athletes have been through traumatic accidents, cancer, amputations and other difficult life events. “They are still athletes with a disability. Unilateral amputees have to compensate for asymmetries in the musculoskeletal system. There is a lack of proprioceptive feedback effects in the nervous and muscular system. Key reflex mechanisms triggered by sensors in the musculature and tendons are missing,” Dr. Schmalz explains.

Prosthetic feet don’t have any intrinsic energy during the first few steps, and what’s more, the user doesn’t perceive them as part of their body. Research in the field of prosthetics is seeking to address this drawback. “Ideally, the user should feel that the prosthesis is part of their own body – a natural extension of the body,” says Dr. Andreas Goppelt, Chief Technology Officer at Ottobock. His research and development team is conducting projects aiming to make this a reality, for example with feedback prostheses.

Johannes Floors says that feeling the prosthesis as a part of his body would be the next big step towards a normal life. “I feel a sense of identity with my prosthesis, but I would like to see it as an even more integral part of myself,” he says. “But you can’t let it get you down; you have to pursue your goals. And then the prosthesis isn’t a hindrance anymore!” In Tokyo 2020, all his hard work paid off when he brought home gold.


*The patent expired in 2014.

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