Design trends in actuated lower-limb prosthetic systems: a narrative review

ABSTRACT

Introduction

Actuated lower limb prostheses, including powered (active) and semi-active (quasi-passive) joints, are endowed with controllable power and/or impedance, which can be advantageous to limb impairment individuals by improving locomotion mechanics and reducing the overall metabolic cost of ambulation. However, an increasing number of commercial and research-focused options have made navigating this field a daunting task for users, researchers, clinicians, and professionals.

Areas covered

The present paper provides an overview of the latest trends and developments in the field of actuated lower-limb prostheses and corresponding technologies. Following a gentle summary of essential gait features, we introduce and compare various actuated prosthetic solutions in academia and the market designed to provide assistance at different levels of impairments. Correspondingly, we offer insights into the latest developments of sockets and suspension systems, before finally discussing the established and emerging trends in surgical approaches aimed at improving prosthetic experience through enhanced physical and neural interfaces.

Expert opinion

The ongoing challenges and future research opportunities in the field are summarized for exploring potential avenues for development of next generation of actuated lower limb prostheses. In our opinions, a closer multidisciplinary integration can be found in the field of actuated lower-limb prostheses in the future.

KEYWORDS:

• Amputation
• gait analysis
• powered prosthesis
• prosthetic socket
• semi-active prosthesis

Article highlights

• The article reviews and catalogs the latest developments in the area of actuated lower-limb prostheses and the corresponding technologies in a manner suitable to a broad range of relevant stakeholders.

• Currently, commercially available lower-limb prostheses tend to be more technically conservative, yet most advancements in academia are still awaiting commercial translation.

• Some emerging surgical techniques are increasingly integral to the holistic prosthetic fitting process, as they aim to improve the overall fit and function of prostheses.

• Prosthesis connection interfaces in recent advances not only provide physical connection, but also strive to serve as gateways for establishing robust biosensing channels.

• Future updates with a closer multidisciplinary integration will lead to better stability, adaptability, and comfort for the next generation of actuated lower limb prostheses.

Declaration of interest

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17434440.2023.2279999

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Haoran Sun contributed to the writing and editing. Chaoming He contributed to the writing. Ivan Vujaklija contributed to the study design, writing, and editing.

Additional information

Funding

This work was supported by the Sichuan Science and Technology Program [Grant no. 2021YFS0065].