Lower-Limb Prosthetic Technologies in the Developing World

Abstract

In the mid-1990s, a number of key publications and meetings of experts identified major technical issues associated with prosthetic technologies intended for developing countries. These included inadequate durability of prosthetic feet, poor socket quality and prosthetic fit, improper alignment of prostheses, and inferior function of components. To examine the progress that has been made since then in addressing these issues, a comprehensive review of literature was performed. In total, 106 articles were selected and included in the review. The review examined prosthetic technologies categorized into feet and ankles, knees, sockets and suspension, and materials, structures, and alignment methods. Moreover, publications were categorized as technical development, clinical (lab-based) testing, or clinical field testing studies. The results reveal important work that has been carried out to develop and implement standardized outcome measures during field testing, allowing various existing prosthetic technologies to be evaluated in terms of their use, function, durability, and other factors. Progress has also been made toward addressing the aforementioned limitations of prosthetic technologies, however, more research and development is required. This includes improving the durability of the external cosmetic features of prosthetic feet, developing more functional prosthetic knee joints, and simplifying fabrication techniques to further improve outcomes associated with socket fit and prosthetic alignment. Research and development collaborations between developed and developing countries, and the dissemination of ongoing research, development, and evaluation activities are essential to the advancement of prosthetic technologies in these regions.

Interventions to improve the labour market for adults living with physical and/or sensory disabilities in low- and middle-income countries: a systematic review

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“…The literature on assistive technology in LMICs is examined in two non-systematic reviews (Andrysek, 2010;Borg, Lindstrom, & Larsson, 2011). Some evaluative activities were identified, none of which measured employment outcomes.…”

A Robotic Model of Transfemoral Amputee Locomotion for Design Optimization of Knee Controllers

“…In particular, advanced microprocessor-based knee controllers have gained much attention [5][6][7][23][24][25]. However, such systems are too expensive to be affordable for many amputees, particularly in developing countries [26]. Thus, it is still necessary and valuable to improve the design and performance of passive knee controller prostheses using experimental and modelling studies.…”

Provision of prosthetic and orthotic services in low-income countries

“…There is often a great deal of media attention surrounding technological advances in the field, which are media friendly. 17 Very little coverage occurs, however, of the planning and research that creates sustainable services to meet the needs of the majority of patients. 18 This can lead to services becoming focused on new technology rather than on creating an effective service.…”