# Redefining Prosthetic Needs: Insights from Individuals with Upper Limb Loss—A Systematic Review

## TL;DR

This review explores the needs of people with upper limb loss, finding that prosthetic devices often fail to meet functional and emotional expectations, leading to high abandonment rates.

## Contribution

The study synthesizes user-reported needs across functional, ergonomic, and psychosocial dimensions to guide future prosthetic design.

## Key findings

- Functional performance, comfort, and intuitive control are closely linked to psychosocial factors like confidence and social participation.
- Technological advancements have not consistently improved alignment with user needs, leading to dissatisfaction and device abandonment.
- User-centered design guidelines are proposed to enhance usability and acceptance of upper-limb prosthetics.

## Abstract

Background: Upper limb loss has a profound impact on individuals’ daily activities, self-image, and social interactions. Despite continuous technological advances in upper-limb prosthetics, high rates of device abandonment persist, highlighting the need to better understand users’ functional and psychosocial needs. Methods: To gain a deeper understanding of the perspectives of upper limb amputees and the synthesis of their needs across ergonomic, functional, and psychological dimensions, this study was conducted. A systematic review was conducted following PRISMA guidelines to synthesize user-reported evidence on upper-limb prosthesis use. Articles indexed in the Web of Science database between 2016 and December 2023 were screened using predefined search terms related to upper-limb amputation, prostheses, social impact, and user needs. Studies were included if they reported direct perspectives of upper-limb prosthesis users regarding usability, functionality, and lived experience. Results: Out of 239 papers identified, 31 were included and analyzed. The findings reveal that functional performance, comfort, weight, intuitive control, and reliability are strongly interconnected with psychosocial factors such as confidence, embodiment, social participation, and acceptance. Technological advances have not consistently translated into improved alignment between prosthetic solutions and user needs, which is reflected in continued dissatisfaction and abandonment. Conclusions: This review provides a structured synthesis of user-reported needs across functional, ergonomic, and psychosocial dimensions, translating these insights into design-relevant guidelines. Emphasizing a user-centered and interdisciplinary perspective, the findings aim to support the development of upper-limb prosthetic devices that are more usable, acceptable, and aligned with users’ expectations, ultimately bridging the gap between user expectations and technological capabilities and promoting long-term adoption and quality of life.