Transcutaneous Electrical Nerve Stimulation (TENS) is a promising technique for eliciting referred tactile sensations in patients with limb amputation. Although several studies show the validity of this technique, its application in daily life and away from laboratories is limited by the need for more portable instrumentation that guarantees the necessary voltage and current requirements for proper sensory stimulation. This study proposes a low-cost, wearable high-voltage compliant current stimulator with four independent channels based on Components-Off-The-Shelf (COTS). This microcontroller-based system implements a voltage-current converter controllable through a digital-to-analog converter that delivers up to 25 mA to load up to 3.6 kΩ. The high-voltage compliance enables the system to adapt to variations in electrode-skin impedance, allowing it to stimulate loads over 10 kΩ with currents of 5 mA. The system was realized on a four-layer PCB (115.9 mm × 61 mm, 52 g). The functionality of the device was tested on resistive loads and on an equivalent skin-like RC circuit. Moreover, the possibility of implementing an amplitude modulation was demonstrated.

In the last decades, there have been great efforts in the development of advanced polyarticulated prosthetic hands; in contrast, prosthetic wrists have drawn less interest. Nevertheless, increasing the dexterity of the wrist improves handling skills because the wrist allows the prepositioning of the hand before carrying out a task, avoiding the onset of unwanted trunk or shoulders compensatory movements and potential onset or exacerbation of articular injuries. This study presents a novel 2‐degree‐of‐freedom prosthetic wrist module with active pronation/supination and passive elastic flexion/extension. This system is suitable to be included in hand prostheses to improve anthropomorphism and produce a more physiological motion. The first submodule within the socket is able to rotate a prosthetic hand and an external load of 3 kg at 2.6 rad/s. The second one can guarantee a range of motion of ±75° with a centering elastic torque (compliant mode) or it can keep firms grasps (fixed mode). Compliant mode is based on a Scotch‐Yoke mechanism converting wrist flexion/extension into the linear motion of a crossbeam acting on compression springs, while fixed mode is achieved by means of a piston that can be engaged/disengaged. The whole module fits with anthropometry and the modular design ensures the proposed system can be used in a stand‐alone way and adapted to different hand prostheses. This device is expected to favor a more physiological dexterity with respect to simpler fixed prostheses that can potentially induce harmful motion of body districts not naturally involved in the reaching and grasping tasks.

Upper limb amputation severely affects the quality of life of individuals. Therefore, developing closed-loop upper-limb prostheses would enhance the sensory-motor capabilities of the prosthetic user. Considering design priorities based on user needs, the restoration of sensory feedback is one of the most desired features. This study focuses on employing Transcutaneous Electrical Nerve Stimulation (TENS) as a non-invasive somatotopic stimulation technique for restoring somatic sensations in upper-limb amputees. The aim of this study is to propose two encoding strategies to elicit force and slippage sensations in transradial amputees. The former aims at restoring three different levels of force through a Linear Pulse Amplitude Modulation (LPAM); the latter is devoted to elicit slippage sensations through Apparent Moving Sensation (AMS) by means of three different algorithms, i.e. the Pulse Amplitude Variation (PAV), the Pulse Width Variation (PWV) and Inter-Stimulus Delay Modulation (ISDM). Amputees had to characterize perceived sensations and to perform force and slippage recognition tasks. Results demonstrates that amputees were able to correctly identify low, medium and high levels of force, with an accuracy above the 80% and similarly, to also discriminate the slippage moving direction with a high accuracy above 90%, also highlighting that ISDM would be the most suitable method, among the three AMS strategies to deliver slippage sensations. It was demonstrated for the first time that the developed encoding strategies are effective methods to somatotopically reintroduce in the amputees, by means of TENS, force and slippage sensations.

Patients with lower limb amputation experience ambulation disorders since they rely exclusively on visual information in addition to the tactile information they receive from stump–socket interface. The lack of sensory feedback in commercial lower limb prostheses is essential in their abandonment by patients with transtibial amputation (TTA) or transfemoral amputation (TFA). Recent studies have obtained promising results using invasive interfaces with peripheral nervous system presenting drawbacks related to surgery. This paper aims to (a) investigate the potential of transcutaneous electrical nerve stimulation (TENS) as noninvasive means for restoring somatotopic sensory feedback in lower limb amputees and (b) evaluate the effect of the system over a 4-week experimental protocol. The first phase of the study involved 13 participants (6 with TTA and 7 with TFA), and the second one evaluated the long-term effect of TENS on ambulation performance of 2 participants (S1 with TTA and S7 with TFA). The proposed system enhanced participant’s ambulation significantly increasing the body weight distribution between legs (S1: from 134% to 143%, P < 0.0055; S7: from 66% to 72%, P < 0.0055) and gait symmetry (S1: step length symmetry index from 11% to 5%, P < 0.0055; S7: stance phase symmetry index from −4% to −2%, P < 0.0055). It led to a postamputation neuropathic pain reduction in S1 (neuropathic pain symptom inventory score diminished from 6 to 0). This demonstrates how TENS enhanced prosthesis embodiment, enabling greater load bearing and more physiological gait patterns. This study highlights TENS as noninvasive solution for restoring somatotopic sensory feedback, addressing the current limitations and paving the way for further research.

The restoration of sensory feedback is one of the current challenges in the field of prosthetics. This work, following the analysis of the various types of sensory feedback, aims to present a prototype device that could be used both for implantable applications to perform PNS and for wearable applications, performing TENS, to restore sensory feedback. The two systems are composed of three electronic boards that are presented in detail, as well as the bench tests carried out. To the authors’ best knowledge, this work presents the first device that can be used in a dual scenario for restoring sensory feedback. Both the implantable and wearable versions respected the expected values regarding the stimulation parameters. In its implantable version, the proposed system allows simultaneous and independent stimulation of 30 channels. Furthermore, the capacity of the wearable version to elicit somatic sensations was evaluated on healthy participants demonstrating performance comparable with commercial solutions.

Neuroprostheses capable of providing Somatotopic Sensory Feedback (SSF) enables the restoration of tactile sensations in amputees, thereby enhancing prosthesis embodiment, object manipulation, balance and walking stability. Transcutaneous Electrical Nerve Stimulation (TENS) represents a primary non-invasive technique for eliciting somatotopic sensations. Devices commonly used to evaluate the effectiveness of TENS stimulation are often bulky and main powered. However, current portable TENS devices frequently fall short of key functional requirements, particularly in terms of stimulation parameter ranges that are insufficient to reliably evoke somatotopic sensations in either upper and lower limb applications. Moreover, they typically do not support real-time independent channels programming and wireless communication. This work introduces a compact, wearable stimulator, including its external casing, with a total weight of 64 g and dimensions of 70 ${\boldsymbol{\times}}$ 40 ${\boldsymbol{\times}}$ 35 mm, designed to deliver SSF in both upper and lower limb applications. The device was validated through bench testing and human trials involving 20 healthy participants, by comparing the intensity, qualitative characteristics, and referred area of the elicited sensations with those produced by a benchmark. The stimulator reliably delivered the required parameters on a skin-like capacitive-resistive load and elicited somatotopic sensations consistent with the benchmark device and prior somatotopic feedback studies. The proposed stimulator provides non-invasive somatotopic sensory feedback for both upper and lower limbs. Its portability and modular design address key limitations of current commercial and research-grade TENS systems, enabling future studies on the functional benefits of sensory feedback in prosthetic control.