Multistakeholder Perceptions on Lower-Limb Prosthetic User Requirements and the Development of Neuroprostheses: A Contextual Inquiry

Abstract

IntroductionNeuroprosthetic systems that can work with prosthetic legs are currently being developed to provide individuals with lower-limb amputation with intent control over their device and sensory feedback. No such system is commercially available, and the effects of providing functions that have previously not been available to lower-limb prosthetic users are unclear.MethodsHere we present investigations of the perceptions of multiple stakeholders (prosthetic users, physician, psychologist, physiotherapist, prosthetist, and groups of prosthetic designers and engineers) on prosthetic user problems and the development of neuroprosthetics. The investigation entailed semistructured interviews, focus group discussions, and a contextual inquiry.ResultsOur findings indicate that prosthetic users may face several challenges that can potentially be addressed via neurological interfacing. We further identified criteria perceived as integral for the development of lower-limb neuroprostheses as well as considerations for the actualization of a usable system that reaches end users.ConclusionsOn the whole, the field of neuroprosthetics has great potential to increase the wellbeing, mobility, and quality of life of persons with lower-limb amputation.

What a Knee Should Be: A Pilot Study on the Perspectives of Highly Active Prosthetic Users

“…According to one such study, consistency, control over the prosthesis, and trust may be unfulfilled requirements, both for people with TFA and transtibial amputations. Its authors further identified unintuitive triggering methods as preventative for device utilization in scenarios such as stairs 34 . Other investigations have also discerned stairs as cumbersome, 2,3 some including less active individuals 1 who may experience even greater challenges in their navigation because of a lack of physical strength to compensate.…”

“…Its authors further identified unintuitive triggering methods as preventative for device utilization in scenarios such as stairs. 34 Other investigations have also discerned stairs as cumbersome, 2,3 some including less active individuals 1 who may experience even greater challenges in their navigation because of a lack of physical strength to compensate. Lastly, some studies have found volume and weight to be an issue in addressing not only knees 33 but also ankles 3 to improve the user experience.…”

“…The duration of each interview was approximately an hour. Interview content, described in Table 1, was defined based on previous literature findings 34 …”

“…However, recent evidence suggests that the economic benefits of MPKs are at least equivalent to, if not greater than, those of N-MPKs 24 and may encourage prosthetic use, 25 which can promote quality of life 14,15,25–32 . Nevertheless, some individuals may discontinue use because of the weight and high maintenance requirements associated with MPKs, 33 whereas others do not fully utilize the functions owing to unintuitive triggering methods, cognitive demands, and the physical exertion they require 34 . Harmonious matching of user needs and the properties of the prosthesis requires greater understanding of how device functionality influences satisfaction, acceptance, and use.…”

“…14,15,[25][26][27][28][29][30][31][32] Nevertheless, some individuals may discontinue use because of the weight and high maintenance requirements associated with MPKs, 33 whereas others do not fully utilize the functions owing to unintuitive triggering methods, cognitive demands, and the physical exertion they require. 34 Harmonious matching of user needs and the properties of the prosthesis requires greater understanding of how device functionality influences satisfaction, acceptance, and use. Individual needs and preferences vary depending on peoples' experience, lifestyles, and clinical and psychosocial factors, and as such, qualitative research can provide valuable insights into considerations for future design.…”