Upper extremity prosthesis user perspectives on unmet needs and innovative technology

The needs of individuals with upper limb amputation and congenital limb difference are not being fully met by current prostheses, as evidenced by prosthesis rejection, non-wear, and user reports of pain and challenging activities. Emerging technologies such as dexterous sensorized robotic limbs, osseointegrated prostheses, implantable EMG electrodes, and electrical stimulation for sensory feedback have the potential to address unmet needs, but pose additional risks. We plan to assess upper limb prosthesis user needs and perspectives on these new benefits and risks using an extensive quantitative survey. In preparation for this survey, we report here on qualitative interviews with seven individuals with upper limb amputation or congenital limb difference. Unstructured text was mined using topic modeling and the results compared with identified themes. A more complete understanding of how novel technologies could address real user concerns will inform implementation of new technologies and regulatory decision-making.

[1]  Elaine Biddiss,et al.  Consumer design priorities for upper limb prosthetics , 2007, Disability and rehabilitation. Assistive technology.

[2]  Linda Resnik,et al.  Self-reported and performance-based outcomes using DEKA Arm. , 2014, Journal of rehabilitation research and development.

[3]  M. Keith,et al.  A neural interface provides long-term stable natural touch perception , 2014, Science Translational Medicine.

[4]  Max Ortiz-Catalan,et al.  An osseointegrated human-machine gateway for long-term sensory feedback and motor control of artificial limbs , 2014, Science Translational Medicine.

[5]  A. Schwartz,et al.  High-performance neuroprosthetic control by an individual with tetraplegia , 2013, The Lancet.

[6]  Luca Citi,et al.  Restoring Natural Sensory Feedback in Real-Time Bidirectional Hand Prostheses , 2014, Science Translational Medicine.

[7]  David J. Warren,et al.  Using multiple high-count electrode arrays in human median and ulnar nerves to restore sensorimotor function after previous transradial amputation of the hand , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[8]  David Hankin,et al.  First-in-man demonstration of a fully implanted myoelectric sensors system to control an advanced electromechanical prosthetic hand , 2015, Journal of Neuroscience Methods.

[9]  Michael I. Jordan,et al.  Latent Dirichlet Allocation , 2001, J. Mach. Learn. Res..

[10]  Linda Resnik,et al.  The DEKA Arm: Its features, functionality, and evolution during the Veterans Affairs Study to optimize the DEKA Arm , 2014, Prosthetics and orthotics international.

[11]  Telba Irony,et al.  Incorporating patient-preference evidence into regulatory decision making , 2014, Surgical Endoscopy.

[12]  Alicia J. Davis,et al.  Surveying the interest of individuals with upper limb loss in novel prosthetic control techniques , 2015, Journal of NeuroEngineering and Rehabilitation.

[13]  Alberto Esquenazi,et al.  Unilateral upper-limb loss: satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts. , 2010, Journal of rehabilitation research and development.

[14]  Rickard Brånemark,et al.  Implant Survival, Adverse Events, and Bone Remodeling of Osseointegrated Percutaneous Implants for Transhumeral Amputees , 2014, Clinical orthopaedics and related research.