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Updated: Jul 31, 2025

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A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
Published on: November 6, 2015
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A tool for measuring mental workload during prosthesis use: The Prosthesis Task Load Index (PROS-TLX).
Johnny V V Parr1, Adam Galpin2, Liis Uiga1
1Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom.
Plos One
|May 4, 2023
Summary
This study introduces the Prosthesis Task Load Index (PROS-TLX), a new tool to measure the mental, physical, and emotional effort of using upper-limb prosthetics. The PROS-TLX aims to improve device satisfaction and user experience.
Area of Science:
- Rehabilitation Engineering
- Human-Computer Interaction
- Prosthetics and Orthotics
Background:
- Upper-limb prosthesis use involves significant mental, emotional, and physical effort, often leading to dissatisfaction and rejection.
- Quantifying this workload is crucial for improving prosthetic device design and user support.
- Existing workload measures may not fully capture the unique demands of prosthetic limb use.
Purpose of the Study:
- To design and validate a self-report measure, the Prosthesis Task Load Index (PROS-TLX), for quantifying mental workload in upper-limb prosthesis users.
- To identify and confirm key workload constructs relevant to the prosthetic limb experience.
- To assess the validity of the PROS-TLX during the initial learning phase of prosthesis use.
Main Methods:
- Surveyed upper-limb prosthesis users to identify and confirm eight critical workload constructs.
- Validated the PROS-TLX by comparing able-bodied participants' performance using a prosthesis simulator versus their anatomical hand on a coin-placement task.
- Utilized eye-tracking equipment to measure visual fixation during the task.
Main Results:
- The PROS-TLX successfully encapsulated mental, physical, and emotional demands reported by users.
- Prosthesis simulator use led to slower movements, increased errors, and heightened visual attention to the hand compared to anatomical hand use.
- Performance decrements correlated with significant increases in PROS-TLX subscale scores, demonstrating good convergent and divergent validity.
Conclusions:
- The developed PROS-TLX is a promising tool for assessing the multifaceted workload associated with upper-limb prosthesis use.
- The findings highlight the significant performance and cognitive demands during initial prosthesis learning.
- Further validation is needed to confirm the PROS-TLX's clinical utility for real-world prosthetic users.

