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ABSTRACT
Despite progress in research and media attention on active upper limb prostheses, presently the most common commercial upper limb prosthetic devices are not fundamentally different from solutions offered almost one century ago. Limited information transfer for both control and sensory-motor integration and challenges in socket technology have been major obstacles. By analysing the present state-of-the-art and academic achievements, we provide our opinion on the future of upper limb prostheses. We believe that surgical procedures for muscle reinnervation and osseointegration will become increasingly clinically relevant; muscle electrical signals will remain the main clinical means for prosthetic control; and chronic electrode implants, first in muscles (control), then in nerves (sensory feedback), will become viable clinical solutions. After decades of suspended clinically relevant progress, it is foreseeable that a new generation of upper limb prostheses will enter the market in the near future based on such advances, thereby offering substantial clinical benefit for patients.
Financial and competing interests disclosure
The authors were supported by the German Ministry for Education and Research (BMBF) via the Bernstein Focus Neurotechnology (BFNT) Göttingen under Grant No. 01GQ0810; European Commission via the Industrial Academia Partnerships and Pathways (IAPP) under Grant No. 251555 (AMYO) and Grant No. 286208 (MYOSENS); and European Research Council (ERC) via the ERC Advanced Grant DEMOVE (No. 267888). S. Amsuess is employed as Technologist at Otto Bock Healthcare Products GmbH, Vienna, Austria, manufacturer of prosthetic devices. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.