BACKGROUND: In 2013 alone, ∼5000 new cases of Upper limb (UL) loss in India were reported. This segment has been poorly understood, with limited or no access to quality prosthetic rehabilitative care. Furthermore, very few studies have been carried out to capture their needs and concerns. OBJECTIVE: To understand demographics and needs of UL prosthesis users belonging to low-and middle-income settings in India. Additionally, this study focuses at gaining insights on patient satisfaction levels, patterns of wear, challenges faced, patient priorities, and affordability. METHODS: The questionnaire-based survey data (n = 60) were acquired through telephone for 53 patients and direct interview for 7 patients and the replies were subjected to statistical analysis. RESULTS: The study reveals that currently available prosthetic arms are not enabling the users to achieve desired functional and satisfaction levels. For a prosthetic UL to be affordable in this context, a price less than Indian Rupee (INR) 20,000 with an instalment mode of payment is preferred. CONCLUSIONS: Major design priorities of the patients are functionality, comfort, and durability. Further, providing a subsidy, minimising delays in limb provision and fitting could maximise long-term prosthetic use and enable a much greater rate of acceptance.

Intent sensing—the ability to sense what a user wants to happen—has many potential technological applications. Assistive medical devices, such as prosthetic limbs, could benefit from intent-based control systems, allowing for faster and more intuitive control. The accuracy of intent sensing could be improved by using multiple sensors sensing multiple environments. As users will typically pass through different sensing environments throughout the day, the system should be dynamic, with sensors dropping in and out as required. An intent-sensing algorithm that allows for this cannot rely on training from only a particular combination of sensors. It should allow any (dynamic) combination of sensors to be used. Therefore, the objective of this study is to develop and test a dynamic intent-sensing system under changing conditions. A method has been proposed that treats each sensor individually and combines them using Bayesian sensor fusion. This approach was tested on laboratory data obtained from subjects wearing Inertial Measurement Units and surface electromyography electrodes. The proposed algorithm was then used to classify functional reach activities and compare the performance to an established classifier (k-nearest-neighbours) in cases of simulated sensor dropouts. Results showed that the Bayesian sensor fusion algorithm was less affected as more sensors dropped out, supporting this intent-sensing approach as viable in dynamic real-world scenarios.

Globally, the most popular upper-limb prostheses are powered by the human body. For body-powered (BP) upper-limb prostheses, control is provided by changing the tension of (Bowden) cables to open or close the terminal device. This technology has been around for centuries, and very few BP alternatives have been presented since. This paper introduces a new BP paradigm that can overcome certain limitations of the current cabled systems, such as a restricted operation space and user discomfort caused by the harness to which the cables are attached. A new breathing-powered system is introduced to give the user full control of the hand motion anywhere in space. Users can regulate their breathing, and this controllable airflow is then used to power a small Tesla turbine that can accurately control the prosthetic finger movements. The breathing-powered device provides a novel prosthetic option that can be used without limiting any of the user’s body movements. Here we prove that it is feasible to produce a functional breathing-powered prosthetic hand and show the models behind it along with a preliminary demonstration. This work creates a step-change in the potential BP options available to patients in the future.

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Objectives: India has committed to formulating a roadmap for realising a resilient health system, with digital health being an important element of this. Following the successful implementation of a free telemedicine service, eSanjeevani, India published the Telemedicine Practice Guidelines in 2020 to further scale telemedicine use in India. The main objective of the current study was to understand the perspective and use of telemedicine by medical doctors in India after the release of its telemedicine policy. Methods: Data were acquired through an anonymous, cross-sectional, internet-based survey of medical doctors (n = 444) at a pan-India level. Replies were subjected to statistical analysis. Results: Telemedicine was used for various non-mutually exclusive reasons, with the top two reasons being live audio or video consultations (60.4%) and online payments (19.1%) and smartphones were the most frequently used device type (60.6%). The telemedicine benefit that the greatest proportion of respondents (93%) recognised was its potential to reduce COVID-19 infection risk for healthcare professionals. Interestingly, nearly 45% of respondents felt that limited and fragmented insurance coverage was an important limitation to the practice of telemedicine in India and 49% believed reduced patient fees for teleconsultations could help incentivise telemedicine use. Conclusions: This study helps to appraise the use of telemedicine in India after the publication of telemedicine guidelines in 2020. Furthermore, the findings can inform the development of telemedicine platforms, policies and incentives to improve the design and implementation of effective telemedicine in India. Public Interest Summary: India has committed to formulating a roadmap for realising a resilient health system, with digital health being an important element of this. In 2020, India published its Telemedicine Practice Guidelines to scale telemedicine use in India. The main objective of the current study was to survey medical doctors in India to understand their perspectives on and use of telemedicine after the release of Indias telemedicine policy. Our findings revealed that the top two reasons doctors used telemedicine were for live audio or video consultations and online payments. Interestingly, a large proportion of respondents felt that limited and fragmented insurance coverage was an important limitation to the practice of telemedicine in India. This study helps to appraise the use of telemedicine in India after the publication of its telemedicine guidelines and can inform the development of telemedicine platforms, policies and incentives to improve the design and implementation of telemedicine in India.