Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses

Abstract Background Transfemoral amputees experience a complex host of physical, psychological, and social challenges, compounded by the functional limitations of current transfemoral prostheses. However, the specific relationships between human factors and prosthesis design and performance characte...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Chiara Fanciullacci, Zach McKinney, Vito Monaco, Giovanni Milandri, Angelo Davalli, Rinaldo Sacchetti, Matteo Laffranchi, Lorenzo De Michieli, Andrea Baldoni, Alberto Mazzoni, Linda Paternò, Elisa Rosini, Luigi Reale, Fabio Trecate, Simona Crea, Nicola Vitiello, Emanuele Gruppioni
Formato: article
Lenguaje:EN
Publicado: BMC 2021
Materias:
Acceso en línea:https://doaj.org/article/3c32514904c84782b0f183f350c8a9cd
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:3c32514904c84782b0f183f350c8a9cd
record_format dspace
institution DOAJ
collection DOAJ
language EN
topic Transfemoral amputation
Lower-limb prostheses
Powered prosthesis
User-centered design
Human factors
Rehabilitation
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
spellingShingle Transfemoral amputation
Lower-limb prostheses
Powered prosthesis
User-centered design
Human factors
Rehabilitation
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Chiara Fanciullacci
Zach McKinney
Vito Monaco
Giovanni Milandri
Angelo Davalli
Rinaldo Sacchetti
Matteo Laffranchi
Lorenzo De Michieli
Andrea Baldoni
Alberto Mazzoni
Linda Paternò
Elisa Rosini
Luigi Reale
Fabio Trecate
Simona Crea
Nicola Vitiello
Emanuele Gruppioni
Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses
description Abstract Background Transfemoral amputees experience a complex host of physical, psychological, and social challenges, compounded by the functional limitations of current transfemoral prostheses. However, the specific relationships between human factors and prosthesis design and performance characteristics have not yet been adequately investigated. The present study aims to address this knowledge gap. Methods A comprehensive single-cohort survey of 114 unilateral transfemoral amputees addressed a broad range of demographic and clinical characteristics, functional autonomy, satisfaction and attitudes towards their current prostheses, and design priorities for an ideal transfemoral prosthesis, including the possibility of active assistance from a robotic knee unit. The survey was custom-developed based on several standard questionnaires used to assess motor abilities and autonomy in activities of daily living, prosthesis satisfaction, and quality of life in lower-limb amputees. Survey data were analyzed to compare the experience (including autonomy and satisfaction) and design priorities of users of transfemoral prostheses with versus without microprocessor-controlled knee units (MPKs and NMPKs, respectively), with a subsequent analyses of cross-category correlation, principal component analysis (PCA), cost-sensitivity segmentation, and unsupervised K-means clustering applied within the most cost-sensitive participants, to identify functional groupings of users with respect to their design priorities. Results The cohort featured predominantly younger (< 50 years) traumatic male amputees with respect to the general transfemoral amputee population, with pronounced differences in age distribution and amputation etiology (traumatic vs. non-traumatic) between MPK and NMPK groups. These differences were further reflected in user experience, with MPK users reporting significantly greater overall functional autonomy, satisfaction, and sense of prosthesis ownership than those with NMPKs, in conjunction with a decreased incidence of instability and falls. Across all participants, the leading functional priorities for an ideal transfemoral prosthesis were overall stability, adaptability to variable walking velocity, and lifestyle-related functionality, while the highest-prioritized general characteristics were reliability, comfort, and weight, with highly variable prioritization of cost according to reimbursement status. PCA and user clustering analyses revealed the possibility for functionally relevant groupings of prosthesis features and users, based on their differential prioritization of these features—with implications towards prosthesis design tradeoffs. Conclusions This study’s findings support the understanding that when appropriately prescribed according to patient characteristics and needs in the context of a proactive rehabilitation program, advanced transfemoral prostheses promote patient mobility, autonomy, and overall health. Survey data indicate overall stability, modularity, and versatility as key design priorities for the continued development of transfemoral prosthesis technology. Finally, observed associations between prosthesis type, user experience, and attitudes concerning prosthesis ownership suggest both that prosthesis characteristics influence device acceptance and functional outcomes, and that psychosocial factors should be specifically and proactively addressed during the rehabilitation process.
format article
author Chiara Fanciullacci
Zach McKinney
Vito Monaco
Giovanni Milandri
Angelo Davalli
Rinaldo Sacchetti
Matteo Laffranchi
Lorenzo De Michieli
Andrea Baldoni
Alberto Mazzoni
Linda Paternò
Elisa Rosini
Luigi Reale
Fabio Trecate
Simona Crea
Nicola Vitiello
Emanuele Gruppioni
author_facet Chiara Fanciullacci
Zach McKinney
Vito Monaco
Giovanni Milandri
Angelo Davalli
Rinaldo Sacchetti
Matteo Laffranchi
Lorenzo De Michieli
Andrea Baldoni
Alberto Mazzoni
Linda Paternò
Elisa Rosini
Luigi Reale
Fabio Trecate
Simona Crea
Nicola Vitiello
Emanuele Gruppioni
author_sort Chiara Fanciullacci
title Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses
title_short Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses
title_full Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses
title_fullStr Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses
title_full_unstemmed Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses
title_sort survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses
publisher BMC
publishDate 2021
url https://doaj.org/article/3c32514904c84782b0f183f350c8a9cd
work_keys_str_mv AT chiarafanciullacci surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT zachmckinney surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT vitomonaco surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT giovannimilandri surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT angelodavalli surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT rinaldosacchetti surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT matteolaffranchi surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT lorenzodemichieli surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT andreabaldoni surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT albertomazzoni surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT lindapaterno surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT elisarosini surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT luigireale surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT fabiotrecate surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT simonacrea surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT nicolavitiello surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
AT emanuelegruppioni surveyoftransfemoralamputeeexperienceandprioritiesfortheusercentereddesignofpoweredrobotictransfemoralprostheses
_version_ 1718371952309043200
spelling oai:doaj.org-article:3c32514904c84782b0f183f350c8a9cd2021-12-05T12:24:43ZSurvey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses10.1186/s12984-021-00944-x1743-0003https://doaj.org/article/3c32514904c84782b0f183f350c8a9cd2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12984-021-00944-xhttps://doaj.org/toc/1743-0003Abstract Background Transfemoral amputees experience a complex host of physical, psychological, and social challenges, compounded by the functional limitations of current transfemoral prostheses. However, the specific relationships between human factors and prosthesis design and performance characteristics have not yet been adequately investigated. The present study aims to address this knowledge gap. Methods A comprehensive single-cohort survey of 114 unilateral transfemoral amputees addressed a broad range of demographic and clinical characteristics, functional autonomy, satisfaction and attitudes towards their current prostheses, and design priorities for an ideal transfemoral prosthesis, including the possibility of active assistance from a robotic knee unit. The survey was custom-developed based on several standard questionnaires used to assess motor abilities and autonomy in activities of daily living, prosthesis satisfaction, and quality of life in lower-limb amputees. Survey data were analyzed to compare the experience (including autonomy and satisfaction) and design priorities of users of transfemoral prostheses with versus without microprocessor-controlled knee units (MPKs and NMPKs, respectively), with a subsequent analyses of cross-category correlation, principal component analysis (PCA), cost-sensitivity segmentation, and unsupervised K-means clustering applied within the most cost-sensitive participants, to identify functional groupings of users with respect to their design priorities. Results The cohort featured predominantly younger (< 50 years) traumatic male amputees with respect to the general transfemoral amputee population, with pronounced differences in age distribution and amputation etiology (traumatic vs. non-traumatic) between MPK and NMPK groups. These differences were further reflected in user experience, with MPK users reporting significantly greater overall functional autonomy, satisfaction, and sense of prosthesis ownership than those with NMPKs, in conjunction with a decreased incidence of instability and falls. Across all participants, the leading functional priorities for an ideal transfemoral prosthesis were overall stability, adaptability to variable walking velocity, and lifestyle-related functionality, while the highest-prioritized general characteristics were reliability, comfort, and weight, with highly variable prioritization of cost according to reimbursement status. PCA and user clustering analyses revealed the possibility for functionally relevant groupings of prosthesis features and users, based on their differential prioritization of these features—with implications towards prosthesis design tradeoffs. Conclusions This study’s findings support the understanding that when appropriately prescribed according to patient characteristics and needs in the context of a proactive rehabilitation program, advanced transfemoral prostheses promote patient mobility, autonomy, and overall health. Survey data indicate overall stability, modularity, and versatility as key design priorities for the continued development of transfemoral prosthesis technology. Finally, observed associations between prosthesis type, user experience, and attitudes concerning prosthesis ownership suggest both that prosthesis characteristics influence device acceptance and functional outcomes, and that psychosocial factors should be specifically and proactively addressed during the rehabilitation process.Chiara FanciullacciZach McKinneyVito MonacoGiovanni MilandriAngelo DavalliRinaldo SacchettiMatteo LaffranchiLorenzo De MichieliAndrea BaldoniAlberto MazzoniLinda PaternòElisa RosiniLuigi RealeFabio TrecateSimona CreaNicola VitielloEmanuele GruppioniBMCarticleTransfemoral amputationLower-limb prosthesesPowered prosthesisUser-centered designHuman factorsRehabilitationNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENJournal of NeuroEngineering and Rehabilitation, Vol 18, Iss 1, Pp 1-25 (2021)