Prosthetics for Lower Limb Amputees: A Comprehensive Review of Technologies, Applications, and Future Directions
DOI:
https://doi.org/10.70112/ajeat-2024.13.1.4233Keywords:
Active Prosthetics, Electromyography (EMG) Sensors, Adaptive Control Systems, Real-Time Feedback Mechanisms, AI-Enabled ImprovementsAbstract
With improvements in active prosthetics, new possibilities have emerged for managing lower limb amputations, significantly enhancing both functional performance and quality of life for users. Recent technological developments, including electromyography (EMG) sensors, adaptive control systems, real-time feedback mechanisms, and remote-control functionality, have introduced advanced capabilities that mimic natural limb movements, greatly benefiting users of artificial limbs. This review paper provides a comprehensive overview of these advancements and assesses their potential clinical impact. EMG sensors have increased prosthetic control by up to 30% by detecting muscle signals with high precision. Adaptive control systems have enhanced the naturalness of gait by approximately 25%, closely approximating normal human locomotion. Real-time feedback systems, such as haptics and vibration alerts, have improved user confidence and mobility by 40% by providing immediate tactile sensory information about the prosthetic’s position. The addition of remote-control systems has improved efficiency by 20% through easier adjustments and real-time tuning of the prosthesis. Researchers have observed a 35% reduction in recovery time for patients using active prosthetics, which enable quicker walking and reduce the effort required from other limbs. In recreational and sporting contexts, these prosthetics have nearly matched non-amputees in peak speed, achieving up to 50% of human performance in power and non-power metrics. AI-enabled improvements are anticipated to further enhance adaptivity and responsiveness in the future. Overall, these high-tech developments represent a significant advancement in aiding lower limb amputees in their daily lives, with considerable potential for future growth and improvement.
References
J. L. C. Zamora, “Trend of Global Mortality Due to Major Amputations in Chronic Threatening Ischemia of Lower Limbs,” Open Access Journal of Cardiology, 2023.
A. M. Al-Shenqiti, “Traumatic Upper and Lower Limb Amputations of Saudi Arabian Locals: A Ten-year Epidemiological Overview,” International Journal of Physiotherapy, 2021.
E. J. Hawkins and W. Riddick, “Reliability, Validity, and Responsiveness of Clinical Performance-Based Outcome Measures of Walking for Individuals with Lower Limb Amputations: A Systematic Review,” Phys. Ther., vol. 98, no. 12, pp. 1037-1045, Dec. 2018.
S. M. Agius, D. Balzan, K. Cassar, and J. Buttigieg, “#4893 The Incidence, Risk Factors and Outcomes of Acute Kidney Injury After Minor Lower Limb Amputations,” Nephrology Dialysis Transplantation, 2023.
R. LeMoyne, Amputations and Prostheses, a Topic of Global Concern, 2016.
A. Abdellatif, Hydraulic Integration Technology for Lower Limb Active Prosthetics, 2020.
A. M. Boudali, P. J. Sinclair, and I. R. Manchester, “Prediction of Smooth Gait Transitioning for Active Lower Limb Prosthetics,” in Proc. Annu. Int. Conf. IEEE Eng. Med. Biol. Soc., vol. 2019, pp. 2424-2429, Jul. 2019.
N. Ramstrand, A. Sterner, and L. Palmér, “Lower Limb Prosthesis Users’ Perceptions of Everyday Life: A Phenomenographic Study,” Prosthet. Orthot. Int., vol. 48, no. 2, pp. 115-121, Jun. 2023.
V. V. Valgeirsdóttir, Á. Alexandersson, K. Lechler, Ó. I. Jóhannesson, and Á. Kristjánsson, “What a Knee Should Be: A Pilot Study on the Perspectives of Highly Active Prosthetic Users,” J. Prosthet. Orthot., vol. 36, pp. 33-41, 2022.
E. J. Hawkins and W. Riddick, “Reliability, Validity, and Responsiveness of Clinical Performance-Based Outcome Measures of Walking for Individuals with Lower Limb Amputations: A Systematic Review,” Phys. Ther., vol. 98, no. 12, pp. 1037-1045, Dec. 2018.
C. M. Lara-Barrios, A. Blanco-Ortega, C. H. G. Valdivia, and K. D. B. Valles, “Literature Review and Current Trends on Transfemoral Powered Prosthetics,” Adv. Robot., vol. 32, pp. 51-62, 2018.
H. Sun, C. He, and I. Vujaklija, “Design Trends in Actuated Lower-Limb Prosthetic Systems: A Narrative Review,” Expert Rev. Med. Devices, vol. 20, no. 12, pp. 1157-1172, Nov. 2023.
A. Abdellatif, Hydraulic Integration Technology for Lower Limb Active Prosthetics, 2020.
M. Nalini, V. P. Ragavesh, B. V. Akash, V. K. S. S. Raja, and B. Abishek, “Advanced Integrated Prosthetic Ankle,” in Proc. 2024 Int. Conf. Communication, Computing and Internet of Things (IC3IoT), 2024, pp. 1-6.
R. El-Qadi and M. A. Al-Shammari, “EMG-Based Control of Active Ankle-Foot Prosthesis,” J. Eng., 2023.
H. Wang et al., “High-Performance Hydrogel Sensors Enabled Multimodal and Accurate Human-Machine Interaction System for Active Rehabilitation,” Adv. Mater., vol. 36, no. 11, p. e2309868, Dec. 2023.
M. Nalini, V. P. Ragavesh, B. V. Akash, V. K. S. S. Raja, and B. Abishek, “Advanced Integrated Prosthetic Ankle,” in Proc. 2024 Int. Conf. Communication, Computing and Internet of Things (IC3IoT), 2024, pp. 1-6.
B. Kundu and D. S. Naidu, “Classification and Feature Extraction of Different Hand Movements from EMG Signal Using Machine Learning Based Algorithms,” in Proc. 2021 Int. Conf. Electrical, Communication, and Computer Engineering (ICECCE), 2021, pp. 1-5.
C. Garg, Y. Narayan, and L. Mathew, “Development of a Software Module for Feature Extraction and Classification of EMG Signals,” in Proc. 2015 Communication, Control and Intelligent Systems (CCIS), 2015, pp. 250-254.
M. Z. A. Chowdhury and D. P. Roy, “Circuit Design and Analysis of an Electromyography (EMG) Signal Acquisition System,” in Proc. 2020 2nd Int. Conf. Electr. Control Instrum. Eng. (ICECIE), 2020, pp. 1-5.
M. D. Sharma et al., “Enhanced Framework for Active Prosthetic Arm,” in Proc. 2022 Int. Conf. Adv. Comput. Commun. Appl. Informatics (ACCAI), 2022, pp. 1-5.
T. Triwiyanto, I. P. A. Pawana, T. Hamzah, and S. Luthfiyah, “Low-Cost and Open-Source Anthropomorphic Prosthetic Hand Using Linear Actuators,” TELKOMNIKA Telecommun. Comput. Electron. Control, vol. 18, pp. 953-960, 2020.
M. Hakan et al., Turkish J. Electr. Eng. Comput. Sci., 2022.
C. Garg, Y. Narayan, and L. Mathew, “Development of a Software Module for Feature Extraction and Classification of EMG Signals,” in Proc. 2015 Commun. Control Intell. Syst. (CCIS), 2015, pp. 250-254.
K. Yoshida, D. Farina, M. Akay, and W. Jensen, “Multichannel Intraneural and Intramuscular Techniques for Multiunit Recording and Use in Active Prostheses,” Proc. IEEE, vol. 98, pp. 432-449, 2010.
J. M. Canton Leal, J. V. Gyllinsky, A. A. Arredondo Zamudio, and K. Mankodiya, “HapticLink: A Force-Based Haptic Feedback System for Single and Double Lower-Limb Amputees,” in Proc. 2022 Annu. Int. Conf. IEEE Eng. Med. Biol. Soc., Jul. 2022, pp. 4226-4229.
G. Kaplan, T. L. McDaniel, J. J. Abbas, R. Tadayon, and S. Panchanathan, “A Time-Discrete Haptic Feedback System for Use by Persons with Lower-Limb Prostheses During Gait,” in Interacción, 2019.
A. Dey, H. Basumatary, and S. M. Hazarika, “A Decade of Haptic Feedback for Upper Limb Prostheses,” IEEE Trans. Med. Robot. Bionics, vol. 5, pp. 793-810, 2023.
F. Barontini et al., “Tactile Feedback in Upper Limb Prosthetics: A Pilot Study on Trans-Radial Amputees Comparing Different Haptic Modalities,” IEEE Trans. Haptics, vol. 16, no. 4, pp. 760-769, Dec. 2023.
K. Yoshida, D. Farina, M. Akay, and W. Jensen, “Multichannel Intraneural and Intramuscular Techniques for Multiunit Recording and Use in Active Prostheses,” Proc. IEEE, vol. 98, pp. 432-449, 2010.
M. Windrich, M. Grimmer, O. Christ, S. Rinderknecht, and P. Beckerle, “Active Lower Limb Prosthetics: A Systematic Review of Design Issues and Solutions,” Biomed. Eng. Online, vol. 15, no. Suppl 3, p. 140, Dec. 2016.
J. Burke and G. Fiedler, “Clinicians’ Access to Peer-Reviewed Prosthetics Research Articles,” Can. Prosthet. Orthot. J., 2018.
C. M. Lara-Barrios, A. Blanco-Ortega, C. H. G. Valdivia, and K. D. B. Valles, “Literature Review and Current Trends on Transfemoral Powered Prosthetics,” Adv. Robot., vol. 32, pp. 51-62, 2018.
A. Abdellatif, Hydraulic Integration Technology for Lower Limb Active Prosthetics, 2020.
R. Gailey, A. Kristal, J. Lucarevic, S. Harris, B. Applegate, and I. Gaunaurd, “The Development and Internal Consistency of the Comprehensive Lower Limb Amputee Socket Survey in Active Lower Limb Amputees,” Prosthet. Orthot. Int., vol. 43, no. 1, pp. 80-87, Aug. 2018.
H. Ipaye and N. Eckerson, Resilience: Activewear for Lower Limb Amputees Who Utilize Prosthetic Limbs, 2018.
R. Dordunu, C. A. Adjei, J. M. Kyei, and M. Ani-Amponsah, “Experiences of Persons with Lower Limb Amputation After Prosthetic Rehabilitation in Ghana: A Qualitative Inquiry,” Prosthet. Orthot. Int., vol. 48, no. 3, pp. 329-336, Aug. 2023.
K. P. Priyadharshan, N. Kumar, D. Shanmugam, D. Kadambari, and S. S. Kar, “Quality of Life in Lower Limb Amputees: A Cross-Sectional Study from a Tertiary Care Center of South India,” Prosthet. Orthot. Int., vol. 46, no. 3, pp. 246-251, Mar. 2022.
N. Rachmat and B. Kuncoro, “Effect of Use of Flexible Transfemoral Prosthesis on Level of Independence in Performing Daily Activities of Transfemoral Amputee,” J. Keterapian Fisik, 2022.
M. Nalini, V. P. Ragavesh, B. V. Akash, V. K. S. S. Raja, and B. Abishek, “Advanced Integrated Prosthetic Ankle,” in Proc. 2024 Int. Conf. Commun. Comput. Internet Things (IC3IoT), 2024, pp. 1-6.
M. P. Mileusnic, L. Rettinger, M. J. Highsmith, and A. Hahn, “Benefits of the Genium Microprocessor Controlled Prosthetic Knee on Ambulation, Mobility, Activities of Daily Living and Quality of Life: A Systematic Literature Review,” Disabil. Rehabil. Assist. Technol., vol. 16, no. 5, pp. 453-464, Aug. 2019.
H. Ipaye and N. Eckerson, Resilience: Activewear for Lower Limb Amputees Who Utilize Prosthetic Limbs, 2018.
S. H. Rapp Jr, N. Pathak, A. Yellapragada, S. Gayakwad, M. Gupta, and K. Musunuru, “Current Trends & Challenges in Prosthetic Product Development: Literature Review,” Int. J. Sci. Res. (IJSR), 2019.
F. Sanfilippo, M. Økter, J. Dale, T. M. Hua, and M. Ottestad, “Revolutionising Prosthetics and Orthotics with Affordable Customisable Open-Source Elastic Actuators,” in Proc. 2024 10th Int. Conf. Autom. Robot. Appl. (ICARA), 2024, pp. 57-63.
R. Kumar and S. Kumar, “Trending Applications of 3D Printing: A Study,” Asian J. Eng. Appl. Technol., vol. 9, no. 1, pp. 1-12, 2020.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Centre for Research and Innovation
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.