Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies

Existing prosthetic technologies for people with upper limb amputation are being adopted at moderate rates and unfortunately these devices are often abandoned. The aims of this study were to: 1) understand the current state of satisfaction with upper extremity prostheses, 2) solicit feedback about prosthetic technology and important device design criteria from amputees, clinicians, and device regulators, and 3) compare and contrast these perspectives to identify common or divergent priorities. Twenty-one adults with upper limb loss, 35 clinicians, and 3 regulators completed a survey on existing prosthetic technologies and a conceptual sensorimotor prosthesis driven by implanted myoelectric electrodes with sensory feedback provided via stimulation of dorsal root ganglion. User and clinician ratings of satisfaction with existing prosthetic devices were similar. While amputees, clinicians, and regulators were similarly accepting of technology in general, amputees were most accepting of the proposed implantable sensorimotor prosthesis. Overall, stakeholders valued user-centred outcomes such as individualized task goals, improved quality of life, device reliability, and user safety; a large emphasis was put on these last two outcomes by regulators. The results of this study provide insight into the priorities of amputees, clinicians, and regulators that will inform future upper-limb prosthetic design and clinical trial protocol development.