Oldfrey Ben M, Morgado Ramirez Dafne Z, Miodownik Mark, Wassall Matthew, Ramstrand Nerrolyn, Wong Man S, Danemayer Jamie, Dickinson Alex, Kenney Laurence, Nester Christopher, Lemaire Edward, Gholizadeth Hossein, Diment Laura E, Donovan-Hall Margaret K, Holloway Catherine
Global Disability Innovation Hub (GDI Hub), London, UK.
Institute of Making, University College London, London, UK.
Prosthet Orthot Int. 2024 Oct 1;48(5):574-589. doi: 10.1097/PXR.0000000000000351. Epub 2024 Apr 16.
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.
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.
Scoping literature review.
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.
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.
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.
传统上，假肢制造既耗时又费力。提高这些设备的可及性和质量的一条可能途径是制造过程的数字化，这可能减轻体力劳动负担，并带来自动化的潜力，有助于在全球范围内消除辅助技术的获取障碍。
确定文献中存在哪些差距，这些差距对临床团队的适当采用或研究所需的后续步骤的决策造成障碍，而这些后续步骤意味着这些技术能够继续走向成熟。
范围综述。
在以下数据库中完成了全面检索：联合与补充医学数据库、医学期刊数据库、荷兰医学文摘数据库、全球卫生档案库、护理学与健康照护数据库、考克兰图书馆、科学引文索引数据库、美国计算机协会数据库、电气与电子工程师协会数据库以及工程索引数据库，共筛选出3487篇文章。
筛选后，本综述纳入了130篇下肢假肢文章和117篇上肢假肢文章。发现文献存在多个局限性，尤其是缺乏长期、大规模研究；对这些技术的培训要求和必要的矫正过程的研究；以及生产工作流程和材料的差异范围很大，难以得出结论。
这些局限性给临床医生、技术开发者和更广泛的政策制定者进行充分的循证决策造成了障碍。学术界、产业界和临床团队在新技术更多的上市途径上加强合作可能是解决这些差距的一条途径。
