Technology for monitoring everyday prosthesis use : a systematic review

Chadwell, AEA; Diment, L; Micó-Amigo, M; Morgado Ramírez, DZ; Dickinson, A; Granat, MH; Kenney, LPJ; Kheng, S; Sobuh, M; Ssekitoleko, R; Worsley, P

Abstract

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 lower-limb 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.

Citation

Chadwell, A., Diment, L., Micó-Amigo, M., Morgado Ramírez, D., Dickinson, A., Granat, M., …Worsley, P. (in press). Technology for monitoring everyday prosthesis use : a systematic review. Journal of NeuroEngineering and Rehabilitation, 17(1), 93. https://doi.org/10.1186/s12984-020-00711-4

• Journal Article Type: Article
• Acceptance Date: Jun 23, 2020
• Online Publication Date: Jul 14, 2020
• Deposit Date: Jul 15, 2020
• Publicly Available Date: Jul 15, 2020
• Journal: Journal of NeuroEngineering and Rehabilitation
• Print ISSN: 1743-0003
• Publisher: Springer Verlag
• Volume: 17
• Issue: 1
• Pages: 93
• DOI: https://doi.org/10.1186/s12984-020-00711-4
• Keywords: Review
• Publisher URL: https://doi.org/10.1186/s12984-020-00711-4
• Related Public URLs: http://www.jneuroengrehab.com/
• Additional Information: Additional Information : ** From Springer Nature via Jisc Publications Router ** Licence for this article: https://creativecommons.org/licenses/by/4.0/ **Journal IDs: eissn 1743-0003 **Article IDs: publisher-id: s12984-020-00711-4; manuscript: 711 **History: collection 12-2020; published_online 14-07-2020; online 14-07-2020; registration 24-06-2020; accepted 23-06-2020; submitted 11-03-2020; Funders : Engineering and Physical Sciences Research Council (EPSRC);National Institute for Health Research (NIHR);Royal Academy of Engineering (UK); Grant Number: EP/R014213/1; Grant Number: EP/R013985/1; Grant Number: EP/N02723X/1; Grant Number: RF/130