Technology for monitoring everyday prosthesis use: a systematic review

Abstract

Background: Understanding how prostheses are used in everyday life is central to the design, provision and evaluation of prosthetic devices and associated services. This paper reviews the scientific literature on methodologies and technologies that have been used to assess the daily use of both upper-and lower-limb prostheses. It discusses the types of studies that have been undertaken, the technologies used to monitor physical activity, the benefits of monitoring daily living and the barriers to long-term monitoring, with particular focus on low-resource settings. Methods: A systematic literature search was conducted in PubMed, Web of Science, Scopus, CINAHL and EMBASE of studies that monitored the activity of prosthesis users during daily-living. Results: Sixty lower-limb studies and 9 upper-limb studies were identified for inclusion in the review. The first studies in the lower-limb field date from the 1990s and the number has increased steadily since the early 2000s. In contrast, the studies in the upper-limb field have only begun to emerge over the past few years. The early lowerlimb studies focused on the development or validation of actimeters, algorithms and/or scores for activity classification. However, most of the recent lower-limb studies used activity monitoring to compare prosthetic components. The lower-limb studies mainly used step-counts as their only measure of activity, focusing on the amount of activity, not the type and quality of movements. In comparison, the small number of upper-limb studies were fairly evenly spread between development of algorithms, comparison of everyday activity to clinical scores, and comparison of different prosthesis user populations. Most upper-limb papers reported the degree of symmetry in activity levels between the arm with the prosthesis and the intact arm. Conclusions: Activity monitoring technology used in conjunction with clinical scores and user feedback, offers significant insights into how prostheses are used and whether they meet the user's requirements. However, the cost, limited battery-life and lack of availability in many countries mean that using sensors to understand the daily use of prostheses and the types of activity being performed has not yet become a feasible standard clinical practice. This review provides recommendations for the research and clinical communities to advance this area for the benefit of prosthesis users.

The influence of powered prostheses on user perspectives, metabolics, and activity: a randomized crossover trial

“…Because the patient’s surroundings can play a large role in the accessibility to physical activity, it is imperative that evaluations of physical activity are made in the patient’s everyday environment. As such, a growing number of studies have employed community-based activity monitoring to evaluate prosthetic interventions, to provide clinicians with more comprehensive characterizations of the patient’s functional mobility [ 17 ]. The ICF also recommends that to properly measure improvements in health, psychological and social aspects of health should also be collected, which may heavily impact everyday performance.…”

Lower limb prosthetic interfaces

“…Monitoring and sensing technologies have the potential to complement current clinical practice approaches by improving therapeutic, diagnostic and prognostic outcomes. 149,150 Instrumented socket inserts incorporating sensors (e.g. proximity, force and inductive), wires, and circuitry have been employed to collect field data on socketresidual limb variables.…”

A Prosthetic Socket with Active Volume Compensation for Amputated Lower Limb

“…The amputated patient removed parts of the body for a variety of reasons, including trauma, tumor, peripheral arterial disease, infection, and diabetic foot ulcer [1][2][3]. Unfortunately, the number of patients with amputated limb is increasing every year [2,4].…”

“…As the number of amputated patients increases, so does the need for patient-specific prosthesis. Prosthesis plays an important role in helping the patient perform a variety of daily activities naturally [3,5]. In particular, successful rehabilitation for patients with amputated lower limb is associated with the comfort and fit of the prosthesis while walking.…”