Biological or Prosthetic Limb—Which Is More Advantageous for Running Performance? A Narrative Review

As the field of prosthetic engineering advances, questions around whether these new prosthetics hold the ability to outperform biological limbs become more relevant. To further clarify such a debate and discover gaps in our understanding, a narrative review of the present literature on this topic is needed. The purpose of the present review was to explore whether prosthetic legs grant amputee athletes an unfair advantage over traditional athletes by reviewing 11 articles pertaining to the running performance and potential among athletes with transtibial amputations. The findings of the included articles were categorized into three domains of running performance, chosen due to their precedence in the current literature: propulsion forward, limb repositioning, and physiological limitations. Our review indicated that the present literature alludes to transtibial amputee runners having a potential competitive advantage over able-bodied runners, with the caveat that some performance domains appear not to be differentiated. The present findings offer a unique perspective on understanding the impact of prosthetics on the running performance among para-athletes and suggest future research directions. As the depth of this area of literature increases, future systematic reviews and meta-analyses may be able to answer with greater certainty whether transtibial prosthetics allow for supra-biological running performances.