Prosthetic Users Research Articles

Pelvic obliquity as a compensatory mechanism leading to lower energy recovery: Characterization among the types of prostheses in subjects with transfemoral amputation

BackgroundSubjects with transfemoral amputation (TFA) show an asymmetric gait pattern associated with a decreased ability to recover mechanical energy and an increased metabolic cost of walking. Research questionThis study aimed to identify the spatio-temporal and kinematic gait variables correlated with mechanical energy values in subjects with TFA and to observe the ability of the identified parameters to discriminate between TFA and controls according to the type of prosthesis. MethodsThe gait of 40 subjects with TFA was evaluated with a motion 3-D optoelectronic system. Nine subjects wore a mechanical prosthesis (TFAm), seventeen a C-Leg prosthesis (TFAc), and fourteen a Genium prosthesis (TFAg). Spatio-temporal and pelvic kinematic parameters were measured. Energy recovery was measured relative to the whole-body center of mass (CoM) kinematics as the fraction of mechanical energy recovered during each walking step (R-step). Correlation tests and multiple linear regression analyses were used to evaluate the correlation and association between kinematic and energy variables, respectively. Receiver operating characteristics curves were plotted to assess the ability of the correlated parameter to distinguish subjects with TFA from controls, and optimal cutoff point values were calculated according to the type of prosthesis. ResultsAmong the spatio-temporal and kinematic parameters correlated to R-step, only pelvic obliquity of the prosthetic side was significantly associated with R-step. It showed an excellent ability to discriminate between TFA and controls. Furthermore, pelvic obliquity showed an excellent discriminative ability in identifying TFAm and TFAc and a good discriminative ability in identifying TFAg from controls. SignificancePelvic obliquity plays an important role in energy recovery during gait for subjects using prosthetics. This information might be exploited to monitor the adaptation of subjects with TFA to prosthetic devices, to lower the energetic cost of walking potentially, and to reduce the long-term risks of secondary physical complications in prosthetic users.

Is an artificial limb embodied as a hand? Brain decoding in prosthetic limb users.

The potential ability of the human brain to represent an artificial limb as a body part (embodiment) has been inspiring engineers, clinicians, and scientists as a means to optimise human-machine interfaces. Using functional MRI (fMRI), we studied whether neural embodiment actually occurs in prosthesis users' occipitotemporal cortex (OTC). Compared with controls, different prostheses types were visually represented more similarly to each other, relative to hands and tools, indicating the emergence of a dissociated prosthesis categorisation. Greater daily life prosthesis usage correlated positively with greater prosthesis categorisation. Moreover, when comparing prosthesis users' representation of their own prosthesis to controls' representation of a similar looking prosthesis, prosthesis users represented their own prosthesis more dissimilarly to hands, challenging current views of visual prosthesis embodiment. Our results reveal a use-dependent neural correlate for wearable technology adoption, demonstrating adaptive use-related plasticity within the OTC. Because these neural correlates were independent of the prostheses' appearance and control, our findings offer new opportunities for prosthesis design by lifting restrictions imposed by the embodiment theory for artificial limbs.

Retrospective analysis of Quality of Life for patients received Prosthetic limbs to overcome their Physical Disability

Background: Quality of life (QoL) is affected by physical and psychosocial parameters after amputation. Aims of Person with amputations are to reintegrate in community and improved mobility, optimum quality of life should be among the top priorities of prosthetic and rehabilitation center. The purpose of the study was to retrospectively assess the QoL of the patient receiving artificial limbs to overcome their physical disability. Methodology: A retrospective cross-sectional study was conducted among 120 lower limb prosthetic users; the study duration was four months. Data were collected using the World Health Organization Quality of Life Instruments (WHOQoL-BREF) questionnaire. SPSS Version 16.0 was used for statistical analysis, Mann-Whitney U test and Kruskal-Wallis test were used to compare domain QoL score. Results: Out of 120 respondents, 66(55%) were early prosthetic users and 54(45%) were late prosthetic users. 61(50.8%) lower limb amputees were availing rehabilitative services and 44(36.7%) were employed. Male participant's mean scores were significantly higher in all domains of QoL as compared to females. There was a significant mean difference among male and female patients concerning physical health (p=0.003), psychological health (p=0.027), social relationship (p=0.005) and environment (p=0.000). There were significant differences in the overall QoL domain and the above-mentioned aspects (p<0.05) among the enrolled patients with different working statuses. There was a significant difference in the environment and overall QoL scored in different age group participants. Conclusion: The findings of the study showed that gender, working status and age have significant influences on the QoL of the patients who received Prosthetic limbs to overcome their Physical Disability.

카메라 영상과 딥러닝을 이용한 의수로봇 제어 시스템과 파지대상 선정

Robotic prosthetic hands are a device that helps to improve the quality of life for patients without hands. Recently, robotic prosthetic hands can perform various grasping patterns because of improvement of bioengineering and robotics. The research that automatically selects the appropriate operation according to the situation is important. Many previous studies have used EMG signals. However, EMG signals are difficult to generalize because EMG signals vary depending on the position of the muscle. In this study, we developed a system for controlling robotic prosthetic hands using images and deep learning to facilitate generalization. We also proposed a method for selecting a grasping target to be held in the image. These results will help to improve the quality of life of the robotic prosthetic hand user.

Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency

Children with lower limb prostheses cannot always keep up with their peers during active play. A pediatric crossover foot may be a promising prosthetic alternative for children engaging in high-intensity movements necessary for active play. To compare children's walking performance, running performance, experienced competence, and cosmesis using their prescribed prosthesis compared with the crossover foot. Pretest-posttest study. Children with lower limb amputation or deficiency were recruited. Measurements were taken at baseline with the prescribed prosthesis and 6 weeks later with the crossover foot. Walking speed, energy cost of walking, anaerobic muscle power, stair climbing speed, ankle power, and cosmesis were evaluated. Four children participated in the study. Two children had increased walking speed with the same energy cost, one child had decreased speed with increased energy cost, and one child had the same speed with decreased energy cost. Muscle power increased for three of the four children and ankle power increased for all children while using the crossover foot compared to the prescribed prosthesis. Two children reported knee pain or feeling excessive knee flexion when running with the crossover foot. One child reported negative feelings toward cosmesis of the crossover foot. This study suggests crossover foot may benefit active children by improving walking and running performance, and decreasing energy cost. However, knee pain reports or negative feelings toward the atypical design suggest the crossover foot may not be ideal for every child. Further research is needed to determine which pediatric users would benefit from this type of prosthetic foot. Children with lower limb deficiencies are active prosthetic users who often switch between low- and high-intensity movements in their daily activities. Therefore, they might benefit from a crossover prosthetic design. The preliminary findings of this study suggest the crossover foot (XF) may be a promising foot for active children.

Access to basic needs and health care for Malawian prosthetic and orthotic users with lower limb physical disabilities: a cross-sectional study

Purpose To investigate access to basic human rights such as health, a standard of living adequate for health, education, work, marrying and establishing a family, and voting for prosthetic and orthotic users with lower limb disabilities in Malawi. Materials and methods A cross-sectional design and a questionnaire were used to collect data from 83 participants. Results Most participants reported their overall physical and mental health as good (60 [72%] and 50 [60%], respectively) and said they could access medical care (69 [83%]). Fifty (60%) participants had access to food, 72 (87%) had access to basic water, and 55 (66%) lived in housing adequate for their health. Most participants had studied in school (74 [89%]) but only 27 (33%) of the participants were working. Forty-three (52%) were married and 53 (64%) had children. Seventy-six (92%) participants could vote if they wished. Conclusions Rurality and high costs of transport and medication increase the barriers to accessing several basic human rights for people with lower limb physical disabilities. Interventions to target these barriers and increase access to secondary school, employment, and income could improve health equity for people with physical disabilities in Malawi and similar contexts. Implications for Rehabilitation In Malawi, the convention on the rights of persons with disabilities is yet to be implemented. Policy makers in Malawi need to take actions to increase access to regular and specialized healthcare services for persons with physical disabilities including financial support to afford medications and transport to reach health services. Policy makers in Malawi need to take actions to increase access to secondary and higher education, and employment for persons with physical disabilities to increase their possibilities to earn an income.

Tactile Feedback in Closed-Loop Control of Myoelectric Hand Grasping: Conveying Information of Multiple Sensors Simultaneously via a Single Feedback Channel.

The appropriate sensory information feedback is important for the success of an object grasping and manipulation task. In many scenarios, the need arises for multiple feedback information to be conveyed to a prosthetic hand user simultaneously. The multiple sets of information may either (1) directly contribute to the performance of the grasping or object manipulation task, such as the feedback of the grasping force, or (2) simply form additional independent set(s) of information. In this paper, the efficacy of simultaneously conveying two independent sets of sensor information (the grasp force and a secondary set of information) through a single channel of feedback stimulation (vibrotactile via bone conduction) to the human user in a prosthetic application is investigated. The performance of the grasping task is not dependent to the second set of information in this study. Subject performance in two tasks: regulating the grasp force and identifying the secondary information, were evaluated when provided with either one corresponding information or both sets of feedback information. Visual feedback is involved in the training stage. The proposed approach is validated on human-subject experiments using a vibrotactile transducer worn on the elbow bony landmark (to realize a non-invasive bone conduction interface) carried out in a virtual reality environment to perform a closed-loop object grasping task. The experimental results show that the performance of the human subjects on either task, whilst perceiving two sets of sensory information, is not inferior to that when receiving only one set of corresponding sensory information, demonstrating the potential of conveying a second set of information through a bone conduction interface in an upper limb prosthetic task.

A National Survey of Prosthesis Use in Veterans with Major Upper Limb Amputation: Comparisons by Gender.

A better understanding of women veterans with upper limb amputation is needed. To compare prosthetic use and outcomes of female and male veterans with upper limb amputation. Cross-sectional survey: Amputation characteristics, prosthesis use, and quality of life outcomes were compared by gender. Separate logistic regression models examined association of gender with prosthesis use and receipt of training to use a prosthesis. Separate linear regression models examined the relationship between gender and health-related quality of life (HRQoL) outcomes. Participants were veterans with major upper limb amputation who received care at the Department of Veterans Affairs (VA) in 2010-2015, identified from VA data sources. A total of 808 individuals (755 men, 21 women) were surveyed by telephone. Disabilities of the Arm, Shoulder and Hand (QuickDASH), VR-12 Physical Component Summary (PCS) and VR-12 Mental Component Summary (MCS), Trinity Amputation and Prosthetic Experience Scale satisfaction scale, Orthotics and Prosthetic User's Survey client satisfaction with devices scale. Telephone survey of community dwelling participants. Not applicable. Survey response rate was 47.3% for men and 62.8% for women. Women were less likely to have ever used a prosthesis (adjusted odds ratio [aOR] = 0.26; confidence interval [CI] 0.08-0.88), have received training for an initial prosthesis (aOR: 0.24; CI 0.08-0.70), be current users (aOR = 0.34; CI 0.12-1.01), and have received training for a current prosthesis (aOR: 0.15; 0.03-0.87). A greater proportion of women used cosmetic and a smaller proportion used body-powered devices compared to men (P < .05). Device heaviness or fatigue was the most common reason for abandonment. There were no significant differences in outcome measures by gender. Women were less likely than men to have ever used and currently use prostheses or to have received prosthetic training, more likely to use cosmetic devices, and less likely to use body-powered devices. Efforts to develop prostheses that are cosmetically acceptable, yet lightweight and functional, are needed.

Development of Two-Sensation Feedback Device for Myoelectric Prosthetic Hand Users – Compensation of Effect of Temperature Change on Haptic Feedback –

In this study, a feedback device of force and temperature sensations for myoelectric prosthetic hand users was developed. When a prosthetic hand user grasps an object using the myoelectric prosthetic hand, the stiffness and temperature of the object are measured using sensors attached to the prosthetic hand, and force and temperature sensations are fed back to the upper arm of the user. From the experimental evaluation of the feedback device, the influence of temperature change on force sensations was confirmed. Therefore, to feed back the same force sensation to the user even if a temperature change has occurred, compensation functions were derived using the maximum likelihood method. On the basis of paired comparison, verification experiments were conducted, which demonstrated the effectiveness of the derived compensation functions.

Comparative Effectiveness of Microprocessor-Controlled and Carbon-Fiber Energy-Storing-and-Returning Prosthetic Feet in Persons with Unilateral Transtibial Amputation: Patient-Reported Outcome Measures

ABSTRACT Introduction Microprocessor ankles (MPAs) have recently been developed for persons with lower-limb amputation to overcome known limitations of fixed-ankle energy-storing-and-returning (ESAR) feet. This study aimed to examine differences in patient-reported balance, mobility, socket comfort, and preference between an ESAR foot and an MPA in persons with unilateral transtibial amputation (UTA). Materials and Methods Twenty-three participants with UTA enrolled in an institutional review board–approved, randomized crossover protocol with ESAR (Pacifica LP) and microprocessor-ankle configurations (Kinnex, Freedom Innovations) and a 4-week accommodation period. The outcome measures collected included Activities Specific Balance Confidence Scale (ABC), Prosthesis Evaluation Questionnaire–Mobility Subscale (PEQ-MS), and Prosthetic Limb User Survey of Mobility (PLUS-M). Participants were asked to rate Socket Comfort Score (SCS) while ascending and descending a 15° sloped ramp. Finally, ankle-foot preference and aspects liked and disliked about each configuration were recorded. Results Significant improvements were seen with the MPA in patient-reported mobility in the community (PEQ-MS, ρ = 0.0465) and socket comfort walking and standing on slopes (SCS, ρ &lt; 0.001). Differences in balance confidence (ABC) did not reach a level of significance, whereas improvement in perceived mobility with a prosthesis approached a level of significance (PLUS-M, ρ = 0.102). When asked, 81% of participants preferred the MPA over the ESAR foot. Participants reported positively about the reduced weight of the ESAR foot, whereas they frequently reported that the MPA was better on slopes and uneven terrain. Conclusions The 30° range of motion in the MPA can allow greater mobility when ambulating on typical environmental barriers (e.g., uneven terrain, ramps, and stairs) and allow patients to stand and walk on slopes with less socket discomfort. Most participants preferred the MPA. Frequently reported positive and negative aspects of both systems may be useful for patient consultation regarding ankle-foot technology. This study represents the largest known investigation of MPAs, and the results provide evidence of benefits from MPAs over ESAR feet in persons with UTA.

Exploring the role of transtibial prosthetic use in deep tissue injury development: a scoping review

BackgroundThe soft tissue of the residual limb in transtibial prosthetic users encounters unique biomechanical challenges. Although not intended to tolerate high loads and deformation, it becomes a weight-bearing structure within the residuum-prosthesis-complex. Consequently, deep soft tissue layers may be damaged, resulting in Deep Tissue Injury (DTI). Whilst considerable effort has gone into DTI research on immobilised individuals, only little is known about the aetiology and population-specific risk factors in amputees. This scoping review maps out and critically appraises existing research on DTI in lower-limb prosthetic users according to (1) the population-specific aetiology, (2) risk factors, and (3) methodologies to investigate both.ResultsA systematic search within the databases Pubmed, Ovid Excerpta Medica, and Scopus identified 16 English-language studies. The results indicate that prosthetic users may be at risk for DTI during various loading scenarios. This is influenced by individual surgical, morphological, and physiological determinants, as well as the choice of prosthetic componentry. However, methodological limitations, high inter-patient variability, and small sample sizes complicate the interpretation of outcome measures. Additionally, fundamental research on cell and tissue reactions to dynamic loading and on prosthesis-induced alterations of the vascular and lymphatic supply is missing.ConclusionWe therefore recommend increased interdisciplinary research endeavours with a focus on prosthesis-related experimental design to widen our understanding of DTI. The results have the potential to initiate much-needed clinical advances in surgical and prosthetic practice and inform future pressure ulcer classifications and guidelines.

Semantic and structural image segmentation for prosthetic vision.

Prosthetic vision is being applied to partially recover the retinal stimulation of visually impaired people. However, the phosphenic images produced by the implants have very limited information bandwidth due to the poor resolution and lack of color or contrast. The ability of object recognition and scene understanding in real environments is severely restricted for prosthetic users. Computer vision can play a key role to overcome the limitations and to optimize the visual information in the prosthetic vision, improving the amount of information that is presented. We present a new approach to build a schematic representation of indoor environments for simulated phosphene images. The proposed method combines a variety of convolutional neural networks for extracting and conveying relevant information about the scene such as structural informative edges of the environment and silhouettes of segmented objects. Experiments were conducted with normal sighted subjects with a Simulated Prosthetic Vision system. The results show good accuracy for object recognition and room identification tasks for indoor scenes using the proposed approach, compared to other image processing methods.

Efficacy of a topical formulation of henna (Lawsonia inermis L.) in contact dermatitis in patients using prosthesis: A double-blind randomized placebo-controlled clinical trial

BackgroundContact dermatitis is a common complication in prosthetic limb users. There are no effective, available and cheap treatments for skin problems of these patients. In traditional Iranian medicine, henna (Lawsonia inermis L.) is a plant that has anti-inflammatory, antimicrobial and skin-enhancing properties, all of which are beneficial for people with artificial limbs. The aim of this study was to assess the efficacy of a topical henna preparation in management of contact dermatitis in patients using lower limb prosthetics. MethodsThe current randomized, double-blind, placebo-controlled clinical trial was conducted on ninety-five participants with lower extremity amputation using limb prosthetics, aged 12–70 years who complained of contact dermatitis. They were randomly assigned to receive either two weeks of topical henna preparation every night as the intervention group, or topical placebo as the control group. Participants were instructed to spread henna preparation on the surfaces of the amputated limb that were in contact with the prosthesis. Severity of contact dermatitis symptoms was set as the primary outcome measure. Edema, papules and erythema were evaluated by a physician using standard color atlas. Secondary outcomes included symptoms such as burning, itching, pain, thickness and skin sweating evaluated by a self-administered questionnaire. ResultsA significant improvement was observed in the symptoms of contact dermatitis including skin edema, itching, sweating, skin thinning and pain (p-value<0.05) in the henna group compared to the placebo group. Skin burning decreased more in the henna group compared to the placebo group, but this was not statistically significant (p-value = 0.052). Moreover, skin redness significantly increased in the henna group (p-value = 0.001). ConclusionTopical formulation of henna might be a complementary choice for improving contact dermatitis in patients using lower limb prosthetics.

The Effect of Postamputation Pain and Phantom Sensations on Prosthesis Use, Body Image, and Quality of Life in Patients with Lower-extremity Amputation.

The aim of this study was to investigate phantom limb pain (PLP), phantom limb sensation (PLS), and residual limb pain (RLP) after lower-extremity amputation and their effect on patients' effective prosthesis use, body image, and quality of life in prosthetic users. Fifty-seven patients with lower-extremity amputation who used prosthesis for at least three months were included in our study. PLP, PLS, and RLP were evaluated via the prosthesis evaluation questionnaire (PEQ). Prosthetic use, locomotor skills, body image, quality of life were measured by administering Houghton scale, locomotor capabilities index (LCI), amputee body image scale (ABIS), and short-form health survey (SF-36), respectively. On the PEQ, 43.9% of the patients reported PLP, while 63.2% reported PLS, and 40.4% reported RLP. Correlation analyses revealed that as the frequency and duration of PLP increased, the patients' basic and advanced locomotor skills and quality of life decreased. When the intensity of PLP and the degree of distress caused by it increased, the patients' quality of life decreased, and when the frequency of PLS increased, the patients' emotional state worsened. When the intensity of PLS and the degree of bother caused by it increased, the patients' body image, emotional state, and social status worsened. There was no correlation between the rate, frequency, severity, or duration of RLP and scores on Houghton scale, LCI, ABIS, or SF-36. The presence of PLP and PLS decreases the use of prostheses and impairs body image and quality of life in prosthetic users.

Designing and evaluation of new dynamic prosthetic foot on transtibial amputees in a low resource setup

BACKGROUND: Foot as an essential part in lower extremity, serves for variety of purposes in daily life. Complex anatomy and biomechanics of normal foot makes its prosthetic replacement quite challenging. Technological boom in prosthetic industries has somehow improved the performance of prosthetic foot but also hike the cost, resulting in limited accessibility to majority of prosthetic user. In this study, we have designed a new dynamic prosthetic foot at low cost and compare its efficacy from the traditional solid-ankle, cushion-heel (SACH) foot.MATERIALS AND METHODS: The current prototype presented is a dynamic foot design consisting of commercially available thermoplastic materials that resembles a hybrid model with true ankle articulation and a flexible keel in order to mimic motion in all cardinal planes. A posttest experimental study has been conducted with fifteen individuals selected purposively. The gait parameters with current prototype and SACH foot were analyzed in conventional way by using 10 meter walk test and energy cost was estimated by calculating physiological cost index (PCI). The correlation between gait variables and PCI were analyzed through a paired t-test.RESULTS: Data analysis shows significant differences in the gait characteristics as stride length (P = 0.000), cadence (P = 0.001), velocity (P = 0.000), and PCI (P value 0.001), comparing the SACH foot and current foot prototype.CONCLUSION: The study outcome reveals the advantage of current prototype over conventional SACH foot in terms of gait characteristic and energy cost at self-selected walking speed.

A Comparison of Recognition and Sensitivity in the Upper Arm and Lower Arm to Mechanotactile Stimulation

Sensory feedback is a highly researched area for upper limb prosthetics, for which the stimulation is applied to either the upper arm or lower arm with minimal justification for the chosen site. In this study, we compare the recognition of three stimulation sites and their sensitivities to the stimulation applied to the upper and lower arm sites from a mechanotactile stimulation device. Our stimulation device is a crank-based mechanotactile feedback system, which applies a combination of a pressure applied in the normal direction and tangential direction to the skin at the stimulation sites on the lower arm and upper arm. The recognition rate for six grip patterns was found to be not statistically different between the upper and lower sites. Further, through Just Noticeable Difference (JND) measurements, there was no statistical difference between the sensitivities of the upper arm and lower arm at four stimulation sites. This study contributes to the literature from the point of view of identifying the upper arm as the alternative site of mechanotactile feedback for transradial prosthetic hand users in comparison to the lower arm, which is primarily used for EMG electrodes to identify the user’s intention to control their robotic prosthetic hand.

Prosthetic push-off power in trans-tibial amputee level ground walking: A systematic review.

ObjectiveUnilateral trans-tibial amputation signifies a challenge to locomotion. Prosthetic ankle-foot units are developed to mimic the missing biological system which adapts push-off power to walking speed in some new prosthetic ankle-foot designs. The first systematic review including the two factors aims to investigate push-off power differences among Solid Ankle Cushion Heel (SACH), Energy Storage And Return (ESAR) and Powered ankle-foot units (PWR) and their relation to walking speed.Data sourcesA literature search was undertaken in the Web of Science, PubMed, IEEE xplore, and Google Scholar databases. The search term included: ampu* AND prosth* AND ankle-power AND push-off AND walking.Study appraisal and synthesis methodsStudies were included if they met the following criteria: unilateral trans-tibial amputees, lower limb prosthesis, reported analysis of ankle power during walking. Data extracted from the included studies were clinical population, type of the prosthetic ankle-foot units (SACH, ESAR, PWR), walking speed, and peak ankle power. Linear regression was used to determine whether the push-off power of different prosthetic ankle-foot units varied regarding walking speed. Push-off power of the different prosthetic ankle-foot units were compared using one-way between subjects’ ANOVAs with post hoc analysis, separately for slower and faster walking speeds.Results474 publications were retrieved, 28 of which were eligible for inclusion. Correlations between walking speed and peak push-off power were found for ESAR (r = 0.568, p = 0.006) and PWR (r = 0.820, p = 0.000) but not for SACH (r = 0.267, p = 0.522). ESAR and PWR demonstrated significant differences in push-off power for slower and faster walking speeds (ESAR (p = 0.01) and PWR (p = 0.02)).ConclusionPush-off power can be used as a selection criterion to differentiate ankle-foot units for prosthetic users and their bandwidth of walking speeds.

Prostheses Use and Satisfaction among People with Lower-limb Amputation in 10 districts of Bhutan

Introduction: The use of lower-limb prostheses restores functional mobility and improves quality of life for people with lower limb amputation. However, the use of prostheses is significantly impacted by users’ satisfaction with their prostheses and service delivery. Therefore, the excellence of prosthetic rehabilitation is not only assessed by the number of prostheses users but is also determined by the level of satisfaction with the prostheses and services received. The study was conducted to determine prostheses use and satisfaction among people with lower-limb amputation. Methods: A cross-sectional study was conducted among lower-limb prosthetic users in 10 districts of Bhutan. Data was collected by face-to-face interview using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. Participants were recruited by purposive sampling. Results: The study found that 96.4% of persons with lower-limb amputation currently used prostheses and 79% of them have used it for more than 7 hours/day. However, 44% of prostheses needed repair. The total QUEST score of satisfaction was 4.0 (SD 0.5). Conclusion: Majority of lower-limb prostheses are in use and the users reported being quite satisfied with their prostheses and service delivery. The study recommends initiating follow-up services to improve prosthetic use and overall satisfaction scores for both prostheses and service delivery.

Articulating Alternatives: Moving Past a Plug-and-Play Prosthetic Media Model

Articulating Alternatives: Moving Past a Plug-and-Play Prosthetic Media Model

A Modular Transradial Bypass Socket for Surface Myoelectric Prosthetic Control in Non-Amputees.

Bypass sockets allow researchers to perform tests of prosthetic systems from the prosthetic user's perspective. We designed a modular upper-limb bypass socket with 3D-printed components that can be easily modified for use with a variety of terminal devices. Our bypass socket preserves access to forearm musculature and the hand, which are necessary for surface electromyography and to provide substituted sensory feedback. Our bypass socket allows a sufficient range of motion to complete tasks in the frontal working area, as measured on non-amputee participants. We examined the performance of non-amputee participants using the bypass socket on the original and modified Box and Block Tests. Participants moved 11.3 ± 2.7 and 11.7 ± 2.4 blocks in the original and modified Box and Block Tests (mean ± SD), respectively, within the range of reported scores using amputee participants. Range of motion for users wearing the bypass socket meets or exceeds most reported range of motion requirements for activities of daily living. The bypass socket was originally designed with a freely rotating wrist; we found that adding elastic resistance to user wrist rotation while wearing the bypass socket had no significant effect on motor decode performance. We have open-sourced the design files and an assembly manual for the bypass socket. We anticipate that the bypass socket will be a useful tool to evaluate and develop sensorized myoelectric prosthesis technology.