Enhancing access to prostheses in sports: a call to action for the future of Paralympic athletes

Abstract

The recent call by Paralympic champion Richard Whitehead for improved access to advanced prosthetics within the National Health Service (NHS) underscores a critical issue in sports and rehabilitation: the need for prostheses that not only restore basic function but also empower individuals to excel in athletic pursuits1. This editorial explores the importance of prostheses in sport, the current challenges faced by aspiring athletes and the imperative to enhance access to cutting-edge prosthetic technology to foster the next generation of Paralympic champions. Advances in limb prostheses have revolutionised the possibilities for athletes with limb loss or limb deficiency. These devices, now often equipped with microprocessors, advanced materials and biomechanical features, enable athletes to perform complex movements, maintain balance and optimise their performance in ways that traditional prosthetics cannot.2 In sports, where precision, speed and agility are critical, the functionality of prostheses can be the determining factor between participation and elite performance. Biomechatronic prostheses incorporate active elements like sensors, actuators and microprocessors that support adaptive movement and user-specific responses, mainly intended for everyday life rather than sporting competition.3 In contrast, passive sports prostheses rely on advanced but non-powered materials - such as carbon fibre - to optimise performance by maximising energy storage and return.3 In Paralympic athletics, prostheses are tightly regulated to maintain fair competition. Only passive prosthetic systems are permitted, as powered prostheses could create an unfair advantage and lead to a technological arms race.4 Athletes with lower-limb impairments competing with prosthetics fall into classifications T61–T64 (for track) and F61–F64 (for field events), depending on the type and level of impairment.4 These classifications ensure that athletes compete with others who have similar functional abilities. Early access to biomechatronic devices, alongside passive sports-specific prosthetics, could significantly benefit young athletes. Biomechatronic prostheses provide adaptive functionality that …