Over the past couple of years I have been quite busy speaking about the role of technology in disability sport at numerous science festivals and conferences. South Africa’s ground breaking decision to select the bi-lateral amputee, Oscar Pistorius, to compete at the IAAF World Championships in South Korea has prompted me to finally write a new blog post on the topic.
I am a huge supporter of disability sport and have been privileged to attend the past two Paralympic Games. I also lead a major Cultural Olympiad project called Extraordinary Moves that aims to challenge perceptions of disability through the creation of a new body of provocative artworks. Furthermore, through academic research I have tried to understand why some performance enhancing technologies are permitted, whilst other are prohibited. Perhaps I am somewhat qualified to comment on this highly emotive issue.
I disagreed with Pistorius’ inclusion at Daegu, and do not welcome his likely appearance at the London 2012 Olympics. Surely this was a great news story for those of us with a passion for disability sport and technology? Surely he acts as a hugely positive beacon for inclusion and may even challenge the very meaning of the word ‘disabled’? Many people will understandably see the inclusion of Pistorius as wonderful manifestation of the very best aspects of sport; after all, he perfectly embodies the notions of achieving one’s personal best and never giving up. However, this issue is unquestionably more complex than a simple ‘feel good’ story.
The fundamental problem comes down to a question of enhancement. Do the specialist running prostheses enhance the performance of Pistorius, or do they merely enable him to overcome his disability? Athletic competitions are supposedly controlled by rules that define the sporting test. When an athlete enters the 400 metres, the sporting test is to run 400 metres as fast as they can. Athletes are not allowed to use a set of rollerblades as this would fundamentally change the nature of the sporting test. Now, whilst I think that a 400 metre sprint on roller blades might be an interesting and entirely valid sporting test, one would not expect rollerblades and running spikes to appear in the same contest. Of course, what I am getting at here is the question of whether Pistorius undertakes the same sporting test as other athletes when he competes in IAAF sanctioned events. To answer this question we have to consider the differences, if any, between the running gait of Pistorius and the running gait of others that are deemed to be ‘conventional’.
Understanding what these differences are has been the focus of two major studies. The first study was conducted at the University of Cologne by Peter Bruggeman in 2007, and made a very strong case that the gait of Pistorius was far from conventional. Bruggeman concluded that the prostheses created a significant performance advantage, and that Pistorius uses up to 25% less energy in the latter stages of a 400 metre sprint. On the basis of this evidence, the IAAF banned Pistorius from competition. Put simply, it was concluded that Pistorius would be undertaking a different sporting test to other competitors.
The IAAF ban was immediately challenged by Pistorius and the issue was taken to the Court of Arbitration for Sport (CAS) in Lausanne. A new team of respected researchers from America were recruited to further probe his running gait, and their new findings were successfully used by Pistorius’ lawers to overturn the IAAF ban. The new study was led by Peter Weyand from Rice University with Hugh Herr from MIT, and their headline conclusion was that Pistorius actually uses a comparable amount of energy to non-disabled runners. This new and entirely opposing conclusion was central to Pistorius’s winning appeal and, providing that qualifying times could be reached, opened the door to IAAF sanctioned competition.
Despite their formidable reputation, I have a number of problems with Weyand and Herr’s conclusion. Their argument was formed on a comparison of Pistorius’ ‘low speed’ running economy to that of endurance runners. Whilst it may not seem sensible to compare the running economy of a sprinter to a marathon runner, this approach does allow for a fair comparison of the aerobic energy system. Bruggeman‘s first study on Pistorius was criticised for not properly considering the uncertain effects of the anaerobic energy system on the sprinter, and Weyand and Herr promptly overcame this problem by only testing at low speeds where only the aerobic system would be in use.
The trouble with this approach is that Pistorius’ prosthesis are designed for sprinting and are therefore very unlikely to perform with good energy economy at low speeds. Furthermore, as a sprinter, Pistorius himself is far from optimised for low speeds and is surely less economical than elite endurance runners. Nonetheless, Weyand and Herr still found that Pistorius uses less energy than elite endurance runners; however, the difference was not statistically significant, hence their conclusion of ‘no advantage’.
Whilst the data may be correct, their conclusion was surely erroneous; for a sprinter to have a comparable running economy to an elite endurance athlete they must surely be assisted in some way? If I were writing the conclusion I would argue for a clear verdict of ‘advantage’.
The somewhat agreeable epilogue to this story is that along with some of his co-authors, Peter Weyand has done the scientific equivalent of a U-turn and now publicly states that through his prostheses, Pistorius has a clear and considerable advantage. So, what we actually have is two independent studies that both conclude that the gait of Pistorius is significantly different to a conventional gait, and that he experiences a considerable performance advantage as a result. In other words, he undertakes a different sporting test to non-disabled 400 metre runners; equally valid perhaps, but certainly different.
The trouble with all this scientific debate, IAAF rulings and lawyers at the Court of Arbitration is that it is a very messy process, and a process that evidently does not always lead to a logical resolution. In agreeing to revoke their ban, the IAAF has unwittingly opened a Pandora’s box of future problems and controversies. Do we have to go through this same process again each time the prosthetic is subtlety developed for an enhanced performance as it surely already is? What happens when a new contender comes along (as they surely will) with a different amputation level and different prosthesis requirements? What do we do when we are able to directly connect prostheses to the remaining skeletal system and thus overcome the training intensity problem of tissue damage?
I think that there has been a general absence of clear thought on this whole issue, and it is my suspicion that the incredible public support behind Pistorius has significantly influenced the decision makers. It is actually this public support that concerns me the most, because whilst public sentiment may be behind Pistorius to compete, I cannot imagine a scenario where that public support would remain if he were to actually win. Questions about fairness would be raised and a presumption of enhancement would prevail. Call me old-fashioned but I don’t think that it is compatible to want an athlete to compete, but only as long as they don’t win.
Dr David James