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. Once fitted for these devices, many upper limb amputees report not using them regularly or at all. The primary aim of this study was to solicit feedback about prosthetic technology and important device design criteria from amputees, clinicians, and device regulators. We compare 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 via spinal root stimulation. The survey included questions from the Trinity Amputation and Prosthesis Experience Scale, the Disabilities of the Arm, Shoulder, and Hand, and novel questions about technology acceptance and neuroprosthetic design. User and clinician ratings of satisfaction with existing devices were similar. Amputees were most accepting of the proposed sensorimotor prosthesis (75.5% vs clinicians (68.8%), regulators (67.8%)). Stakeholders valued user-centered outcomes like individualized task goals, improved quality of life, device reliability, and user safety; regulators emphasized these last two. The results of this study provide insight into amputee, clinician, and regulator priorities to inform future upper-limb prosthetic design and clinical trial protocol development.

KEYWORDS:

• amputation
• myoelectric
• prosthesis
• sensory feedback
• upper limb

Acknowledgments

The authors would like thank Santiago Munoz for contributions to the survey design and Debbie Harrington for coordinating study activities and for assistance with data collection.

Disclosure statement

Robert Gaunt is on the scientific advisory board of Neurowired LLC.

Supplemental data

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

Research was sponsored by the U.S. Army Research Office and the Defense Advanced Research Projects Agency (DARPA) was accomplished under Cooperative Agreement Number W911NF-15-2-0016. The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the Army Research Office or the U.S. Government. The U.S. Government is authorized to reproduce and distribute reprints for Government purposes notwithstanding any copyright notation hereon.