Perspectives on Upper Extremity Prosthetic Technologies

Michael Boninger, MD, Jennifer Collinger, PhD, Lee Fisher, PhD, and Robert Gaunt, PhD, of the University of Pittsburgh Department of Physical Medicine and Rehabilitation – along with Julie Rekant, PT, DPT, of the University of Pittsburgh Department of Bioengineering – published Amputee, Clinician, and Regulator Perspectives on Current and Prospective Upper Extremity Prosthetic Technologies in early 2022.

The primary aim of their study was to solicit feedback about prosthetic technology and important device design criteria from amputees, clinicians, and device regulators. The study was prompted by the discovery that existing prosthetic technologies for people with upper limb amputation are being adopted at moderate rates, and once fitted for these devices, many upper limb amputees report not using them regularly or at all.

The research team compares these amputee, clinician, and device regulator 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.

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