A review of user needs to drive the development of lower limb prostheses.
Sabina Manz, Romain Valette, Federica Damonte and 5 others
PMID 36335345WHAT IT FOUND
Users prioritize safety, comfort, and social integration over pure function.
They need to walk without constant visual attention, manage pain and heat, and feel the leg is part of their body. Current prostheses often fail these needs, driving dissatisfaction and rejection.
Key findings
01The most frequently expressed needs were less pain, mobility, social integration, independence, and walking.
0257% of users are dissatisfied with prosthetic comfort, and over 50% report pain during use.
03Users need to walk without concentrating on each step to enable multitasking, a need often unmet by current devices.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review excluded needs related to prosthetic service providers, such as education about alignment or satisfaction with clinical care, focusing only on device-related needs. Prosthesis type was reported in only 1.49% of cases, limiting the ability to link specific needs to specific device technologies. The frequency of needs in the literature may be biased toward topics already popular in research, potentially underrepresenting important but less-studied needs. Many included studies used small or biased samples, such as mostly male participants, which limits generalizability.
Declared interests
The paper acknowledges support from non-U.S. government sources but does not detail specific commercial funding or author conflicts of interest in the provided text.
The easy way to misread this
Do not assume that functional improvements like faster walking or better gait symmetry will automatically resolve user dissatisfaction. The review shows that psychological needs like safety, confidence, and social integration, along with ergonomic issues like pain and heat, are equally or more frequently cited as primary drivers of rejection.