Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies

Abstract

Existing prosthetic technologies for people with upper limb amputation are being adopted at moderate rates and unfortunately these devices are often abandoned. The aims of this study were to: 1) understand the current state of satisfaction with upper extremity prostheses, 2) solicit feedback about prosthetic technology and important device design criteria from amputees, clinicians, and device regulators, and 3) compare and contrast these perspectives to identify common or divergent priorities. Twenty-one adults with upper limb loss, 35 clinicians, and 3 regulators completed a survey on existing prosthetic technologies and a conceptual sensorimotor prosthesis driven by implanted myoelectric electrodes with sensory feedback provided via stimulation of dorsal root ganglion. User and clinician ratings of satisfaction with existing prosthetic devices were similar. While amputees, clinicians, and regulators were similarly accepting of technology in general, amputees were most accepting of the proposed implantable sensorimotor prosthesis. Overall, stakeholders valued user-centred outcomes such as individualized task goals, improved quality of life, device reliability, and user safety; a large emphasis was put on these last two outcomes by regulators. The results of this study provide insight into the priorities of amputees, clinicians, and regulators that will inform future upper-limb prosthetic design and clinical trial protocol development.

Factors that influence the adoption of rehabilitation technologies: a multi-disciplinary qualitative exploration

“…Further, similar to other work, our findings indicate that serious consideration must also be given to the risk of psychological and physical harm [ 28 , 29 , 40 , 45 ] and concerns about data privacy and security [ 23 , 26 , 40 ]. When not appropriately addressed, for example through clinical trials, these are significant barriers to the regulatory approval of technology, delivery by health service providers, and use among individuals with disability.…”

“…Desirable benefits to technology users with disability were biopsychosocial in nature, aligning with previous literature that highlights the importance of considering a wide range of physiological, psychological, and social benefits of technology use during its development [ 39 , 45 – 48 ]. This includes, for example, recovering sense of agency, providing opportunities for participation, and positive effects on users’ self-image [ 48 ].…”