Background: The implementation of digital technology (DT) in orthotics and prosthetics (O&P) has been slow despite recent research suggesting that the use of DT will continue to grow and become more prevalent within the industry. There is a need to further investigate DT in O&P practice and the current state of its use in the field. Objective: This study aimed to explore the views and experiences of practitioners using DT workflows in their O&P practice. Methods: In this qualitative descriptive study, 10 in-depth, semistructured interviews with O&P practitioners were conducted. A content analysis was performed to analyze the transcripts and identify key themes from the data. Results: The study examined the experiences of practitioners using or trying to use DT in their practices, and three key themes were identified on the implementation of digital practice: 1) technological advancement and scientific evidence; 2) marketplace, economic, and operational factors; and 3) industry mindset shift in embracing DT practice. Conclusion: A collaborative effort involving academia, healthcare institutions, vendors, and individual practitioners will be required to facilitate the widespread adoption of DT in O&P. More work is required to overcome challenges from the technical, logistical, and cultural aspects.

Achieving proper socket fit is crucial for the effective use of a prosthesis. However, digital socket design lacks standardization and presents a steep learning curve for prosthetists. While research has focused on digital socket design for the lower-limb population, there is a research gap in upper-limb socket design. This study aimed to characterize the design (rectification) process for the transradial socket, specifically the three-quarter Northwestern-style design, towards the development of a more systematic, data-driven socket design approach. Fourteen (n = 14) pairs of unrectified and rectified plaster models were compared. Six common rectification zones were identified through shape analysis, with zones of plaster addition being the most prominent in terms of volume and surface area. A novel 3D vector mapping technique was employed, which revealed that most of the shape changes occurred in the anterior–posterior and proximal–distal directions. Overall, the interquartile range of each rectification zone demonstrated reasonable consistency in terms of volume, surface deviation, and 3D vector representation. The initial findings from this study support the potential for quantitively modelling the transradial socket design process. This opens the door for developing tools for categorizing and predicting socket designs across diverse populations through the application of techniques such as machine learning.

Advancements in digital imaging technologies hold the potential to transform prosthetic and orthotic practices. Non-contact optical scanners can capture the shape of the residual limb quickly, accurately, and reliably. However, their suitability in clinical practice, particularly for the transradial (below-elbow) residual limb, is unknown. This project aimed to evaluate the reliability of an optical scanner-based shape capture process for transradial residual limbs related to volumetric measurements and shape assessment in a clinical setting. A dedicated setup for digitally shape capturing transradial residual limbs was developed, addressing challenges with scanning of small residual limb size and aspects such as positioning and patient movement. Two observers performed three measurements each on 15 participants with transradial-level limb absence. Overall, the developed shape capture process was found to be highly repeatable, with excellent intra- and inter-rater reliability that was comparable to the scanning of residual limb cast models. Future work in this area should compare the differences between residual limb shapes captured through digital and manual methods.

Well-fitting sockets are crucial for successful upper-limb prosthesis use, yet current digital socket design workflows are not standardized and demand considerable clinician effort. In this study, we introduce the Predictive Algorithm for Customized Transradial Socket Design (PACT), which generates socket models from a 3D limb scan. It works by retrieving the most similar limb–socket pair from a reference library of prosthetist-designed prosthetic sockets and applying isotropic and anisotropic scaling adjustments to match the input limb. To validate the algorithm, the PACT-predicted sockets for 19 participants were compared to their prosthetist-designed ones (the clinical “gold standard”) using the surface Euclidean (L2) distances, volume differences, and a 100-slice cross-sectional-area analysis. Localized discrepancies were mapped via signed-distance colorization and clustered with DBSCAN. PACT’s outputs differed from prosthetist designs by 2.11 ± 0.51 mm on the surface and 2.74 ± 2.56% in volume on average; slice-wise area differences were within ±10% for most of the socket length, with larger errors near the proximal trimline and distal tip. Recurrent localized discrepancies were found to be concentrated at the anterior-distal trimline (15/19 cases) and anterior–posterior compression (11/19 cases), indicating clear targets for rule-based or measurement-informed refinements. Subgroup patterns suggested an age-related bias (undersizing in pediatric, oversizing in adults). Overall, PACT quickly delivers (13.2 ± 0.7 s) a first-draft transradial socket within commonly cited clinical fit tolerances. Focus on specific regions, along with metadata such as tissue stiffness, age, and clinician-led measurements, can improve personalization and generalizability in future iterations of the PACT.

The 2-axes Automatic Stance Phase Lock (ASPL) stance control mechanism has been demonstrated to improve adult amputees’ mobility but has yet to be developed for the paediatric population. The overall objective for this work was to characterize the ASPL control mechanism with biomechanical modelling and design a 2-axes ASPL prosthetic knee joint suitable for children between the ages of 6 and 12 years. Paediatric anthropometric data and ASPL control mechanism performance characteristics established from adult ASPL knee users were utilized to develop paediatric-appropriate configurations of the ASPL stance control mechanism. Additional predefined design criteria were also included in the detailed knee design. Developed prototypes of the knee joint, Children-ASPL (CASPL) knee, were clinically validated using a single-subject cross-over study design, to assess control mechanism and overall knee functions. Faster walking speed, longer step and stride length with the CASPL knee suggest potential improvements in overall walking performance. The participant also felt confident walking with the CASPL knee and perceived the locking mechanism to be stable. Stemming from the findings here, future design revisions are aimed to improve the performance of the current prototype, including reliability of knee lock disengagement and performance of the swing phase control mechanism.