A scoping review of digital fabrication techniques applied to prosthetics and orthotics: Part 1 of 2—Prosthetics

Author:

Oldfrey Ben M.123ORCID,Morgado Ramirez Dafne Z.13,Miodownik Mark2,Wassall Matthew4,Ramstrand Nerrolyn5,Wong Man S.6,Danemayer Jamie1,Dickinson Alex7,Kenney Laurence4,Nester Christopher8,Lemaire Edward9,Gholizadeth Hossein9,Diment Laura E.10,Donovan-Hall Margaret K.11,Holloway Catherine13

Affiliation:

1. Global Disability Innovation Hub (GDI Hub), London, UK

2. Institute of Making, University College London, London, UK

3. University College London Interaction Centre (UCLIC), London, UK

4. Centre for Human Movement and Rehabilitation Research, University of Salford, Salford, UK

5. Department of Rehabilitation, CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden

6. Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong

7. Faculty of Engineering & Physical Science, University of Southampton, Southampton, UK

8. School of Allied Health Professions, Keele University, Keele, UK

9. Faculty of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada

10. College of Science and Engineering, Flinders University, Adelaide, SA, Australia

11. Faculty of Health Sciences, University of Southampton, Southampton, UK

Abstract

Background: Traditionally, the manufacture of prostheses is time-consuming and labor-intensive. One possible route to improving access and quality of these devices is the digitalizing of the fabrication process, which may reduce the burden of manual labor and bring the potential for automation that could help unblock access to assistive technologies globally. Objectives: To identify where there are gaps in the literature that are creating barriers to decision-making on either appropriate uptake by clinical teams or on the needed next steps in research that mean these technologies can continue on a pathway to maturity. Study design: Scoping literature review. Methods: A comprehensive search was completed in the following databases: Allied and Complementary Medicine Database, MEDLINE, Embase, Global Health Archive, CINAHL Plus, Cochrane Library, Web of Science, Association for Computing Machinery, Institute of Electrical and Electronics Engineers, and Engineering Village, resulting in 3487 articles to be screened. Results: After screening, 130 lower limb prosthetic articles and 117 upper limb prosthetic articles were included in this review. Multiple limitations in the literature were identified, particularly a lack of long-term, larger-scale studies; research into the training requirements for these technologies and the necessary rectification processes; and a high range of variance of production workflows and materials which makes drawing conclusions difficult. Conclusions: These limitations create a barrier to adequate evidence-based decision-making for clinicians, technology developers, and wider policymakers. Increased collaboration between academia, industry, and clinical teams across more of the pathway to market for new technologies could be a route to addressing these gaps.

Funder

Foreign, Commonwealth and Development Office

Publisher

Ovid Technologies (Wolters Kluwer Health)

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