Redefining Prosthetic Needs: Insights from Individuals with Upper Limb Loss-A Systematic Review.

Area of Science:

• Prosthetics and Orthotics
• Rehabilitation Engineering
• Human-Computer Interaction

Background:

• Upper limb loss significantly impacts daily life, self-perception, and social engagement.
• Despite technological progress, high upper-limb prosthesis abandonment rates indicate unmet user needs.

Purpose of the Study:

• To synthesize user-reported needs across ergonomic, functional, and psychosocial dimensions for upper-limb prosthesis users.
• To identify key factors contributing to prosthesis satisfaction and abandonment.

Main Methods:

• A systematic review following PRISMA guidelines was conducted.
• Searched Web of Science (2016-2023) for studies reporting direct user perspectives on upper-limb prostheses.
• Included 31 studies analyzing user-reported evidence on usability, functionality, and lived experiences.

Main Results:

• Functional performance, comfort, weight, control, and reliability are closely linked to psychosocial factors like confidence and social participation.
• Technological advancements have not consistently improved user satisfaction, leading to continued abandonment.
• User needs often remain misaligned with current prosthetic solutions.

Conclusions:

• A user-centered, interdisciplinary approach is crucial for developing more usable and acceptable upper-limb prostheses.
• Translating user-reported needs into design guidelines can bridge the gap between expectations and capabilities.
• Improved prosthetic design can enhance long-term adoption and users' quality of life.