Page 181 - Handbook of Biomechatronics

Upper-Limb Prosthetic Devices 179

7. Natural appearance. If possible, the control system should be operated in
ways that are esthetically attractive, statically, and dynamically.
In addition, there are several attributes that are desirable to persons respon-
sible for the fitting, maintenance, and modification of a prosthetic controller.
Some are:
1. easy to learn; easy and quickly to setup the controller;
2. highly reliable, reproducible;
3. if possible not needed to be fitted in a lab but anywhere; and
4. does not require highly technical skills or high-tech equipment to set-up.

1.2.1 Voice of Customer (Patient)
Peerdeman et al. (2011) after studying acceptance of myoelectric upper-limb
prostheses suggest that the integration of sensory information from the pros-
thesis to the amputee is a gap and should be improved in order to increase
user acceptance.
Dudkiewicz et al. (2004) reported that 71% (too high) of upper-limb
prosthetic users that participated in a satisfaction study, reported problems
with their prosthesis.
Lock et al. (2005) pointed out that for many-degree of freedom (many-
DoF) prosthetic arms increased classification accuracy is not correlated to
increased usability, meaning that what researchers believe to be a better con-
troller does not lead to better usability results. Therefore, a revisit on the sub-
ject has to happen.
Biddiss and Chau (2007) have performed a metasearch study for the last
25years and reported for pediatric populations rejection rates of 45% for pas-
sive and 35% for electric prostheses. For adult populations the rejection rates
were 26% for body powered and 23% for electric prostheses. The authors
conclude that these high rejection rates make it imperative to investigate
further the reasons for abandonment of the prostheses in order to optimize
prescription practices and guide the proper design choices (Biddiss and
Chau, 2007). Furthermore, not only the rejection causes but also the indi-
vidual needs of a broad population of amputees should be studied in order to
justify personalization or not for the prosthetic process.
Therefore, a more personalized process for prescribing and tailoring the
prosthesis to the amputee is needed, which could be facilitated in the future
years by technologies like targeted muscle reinnervation (TMR), three-
dimensional (3D) printing, and other surgical innovative procedures (see
Section 2).