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Open research questions in Prosthetics and Rehabilitation Robotics

35 unresolved questions extracted from the limitations and future-work sections of 462 Prosthetics and Rehabilitation Robotics papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • However, this validation is limited to a single subject, and vertebral- level ground truth was not available for the multi-subject dataset; therefore, these findings should be interpreted as supporting the mechanical plausibility of the approach rather than demonstrating definitive physiological superiority.

    A stiffness-dependent method to estimate spine kinematics and loading reveals the impact of nonlinear mechanics during lifting tasks · 2026 · DOI

  • Although ICC was used to quantify absolute agreement between systems, a second limitation of this study was the lack of reliability and repeatability analysis; each par- International Journal of Sports Physical Therapy Investigation of a Low-cost Portable Inline Dynamometer for Measuring Isometric Knee Extensor Strength ticipant only visited the laboratory once, and all experi- ments were conducted in the same trial order by a single re- searcher.

    Investigation of a Low-cost Portable Inline Dynamometer for Measuring Isometric Knee Extensor Strength · 2026 · DOI

  • Future work will focus on advanc‑ ing to practical experiments with actual robots to assess the effectiveness of this approach in improv‑ ing patient outcomes. Additionally, incorporating a dynamic model could be explored to evaluate the in(cid:976)luence of dynamic parameters in scenarios where dynamic responses play a more prominent role.

    Adaptive Upper Limb Robot-Assisted Rehabilitation: Learn-from-Therapist Demonstrations · 2026 · DOI

  • The small sample size substantially limited the statistical power of this study, increasing the likelihood of type II errors and reducing the ability to detect true differences between prosthesis types. Additionally, due to the exploratory nature of this pilot study, no formal power analysis was conducted 6 Mohammad Zadeh M, Jalali M, Khaghani A. Innovative 3D-printed internal structure in silicone partial-hand prostheses: Enhancing function and mechanical performance. Can Prosthet Orthot J. 2026;9(1):10. https://doi.org/10.33137/cpoj.v9i1.47092 CANADIAN PROSTHETICS & ORTHOTICS JOURNAL ISSN: 2561-987X Mohammad Zadeh et al., 2026 3D-PRINTED INTERNAL STRUCTURES IN SILICONE PARTIAL-HAND PROSTHESES to determine the sample size, which may limit the statistical conclusions that can be drawn. The participant group also lacked sufficient demographic diversity in terms of age, gender, and background, restricting the generalizability of the findings to broader populations of prosthesis users. Participants were not blinded to the intervention, and the potential influence of novelty bias on subjective outcomes such as satisfaction and wear time cannot be excluded. Wear time data were self-reported and may be subject to recall bias. Furthermore, because data were collected at a single time point using a cross-sectional approach, causal relationships between prosthesis characteristics and user outcomes cannot be established, nor can long-term effects be evaluated. In addition, fatigue testing was performed on the from a single participant, prostheses generalizability of mechanical durability findings. limiting In addition, unlike conventional prostheses incorporating metal armatures that allow manual positioning of the digits, the TPU-based internal structure used in this study does not provide this capability, which may limit grasp adaptability in certain functional tasks. this study. Minor language editing and phrasing refinements in the manuscript were assisted by ChatGPT-5; all scientific content and interpretations were independently produced by the authors. DECLARATION OF CONFLICTING INTERESTS The authors report no conflict of interest.

    INNOVATIVE 3D-PRINTED INTERNAL STRUCTURE IN SILICONE PARTIAL-HAND PROSTHESES: ENHANCING FUNCTION AND MECHANICAL PERFORMANCE · 2026 · DOI

  • Using school students with no formal P&O training/knowledge increased variability in results. This was demonstrated clearly in one group, which stopped adhering to grid alignment instructions. Intraobserver analysis was also limited by time constraints, and data were checked on Day 8, which reduced interobserver error variability. The intraobserver analysis sample is small and results should be taken as preliminary. The inclusion of variably sized feet with the same keel also introduced errors, as the area of high wear under the distal end of the keel was closer to the toes of smaller feet but the heel of larger feet. While the distance between the bolt hole and keel will remain constant [11], the position of the bolt hole relative to the toes will vary with foot size, being relatively closer to the toes in smaller feet. The published method is ordinal and was constructed for a specific design of SACH foot. Higher scores indicate higher wear, but the intervals between scores are not uniform; this is somewhat exacerbated in the modified method. Designs of prosthetic feet that do not employ layers of nylon (e.g., foot shells) cannot directly apply this method. Finally, this method is time consuming, but time for data collection can be reduced by creating larger and fewer cells.

    A reliable and inclusive method for assessing failure-causing mechanical wear in prosthetic feet · 2026 · DOI

  • This exploratory study has several limitations. First, poor coverage and representativeness: the small, non-probability sample limits generalizability. Also, the absence of official endorsement likely contributed to low participation. Second, the heterogeneity among “qualified professionals,” from var- ious respondents’ backgrounds, hindered subgroup compari- sons. Third, the questionnaire limitations: its length likely influenced completion rates; the non-applicability of some questions to certain participants (i.e., sample diversity); some ambiguous terminology may have caused confusion.

    Additive Manufacturing in Upper-Limb Prosthetics: A Survey of Stakeholders’ Profiles and Expertise · 2026 · DOI

  • To address these limitations, larger, endorsed studies are needed, targeting compartmentalized groups (e.g., prosthe- tists, NGO, researchers) with tailored research instruments. Mixed-methods approaches (quantitative and qualitative) should be combined with experimental studies to optimize each AM workflow stage [22, 46]. Additionally, empirical investigations are required: clinical studies assessing recipi- ents’ response (e.g., satisfaction, rejection) and efficacy of AMULP to successfully perform activities of daily living, should be fostered. Hence, collaboration among stakehold- ers should contribute to establishing accepted standards and guidelines, particularly for material selection in appropri- ate prosthetic applications and for training requirements to improve fitting skills and follow-up strategies for effective care management. Moreover, incorporating additive manu- facturing into the prosthetist trainees’ curriculum will facili- tate its clinical implementation [74]. Likewise, to comple- ment the volunteers’ vital efforts to ensure equitable access to prosthetics, collaborative training programs with upper- limb specialists should be explored where necessary.

    Additive Manufacturing in Upper-Limb Prosthetics: A Survey of Stakeholders’ Profiles and Expertise · 2026 · DOI

  • The paper emphasizes the interdependence between biomechanics, biology, and innovation but does not identify quantitative integration models or metrics that simultaneously measure and predict outcomes when all three domains are optimized together versus when individual domains are targeted separately.

    Integrative Orthopedic Care: Bridging Biomechanics, Regenerative Biology, and Technological Innovation in Modern Musculoskeletal Medicine · 2026 · DOI

  • While tissue engineering is described as bridging biology and innovation through cellular components and engineered scaffolds, specific research quantifying how scaffold biomechanical properties (porosity, stiffness, degradation kinetics) affect both stem cell differentiation and load-bearing capacity in nonunion and soft tissue injury repair is not detailed.

    Integrative Orthopedic Care: Bridging Biomechanics, Regenerative Biology, and Technological Innovation in Modern Musculoskeletal Medicine · 2026 · DOI

  • The integration of robotic-assisted systems for enhanced alignment in arthroplasty is mentioned as improving long-term outcomes, but the paper does not cite studies that directly compare robotic-assisted alignment precision against computer-guided surgery systems across different joint types and implant designs.

    Integrative Orthopedic Care: Bridging Biomechanics, Regenerative Biology, and Technological Innovation in Modern Musculoskeletal Medicine · 2026 · DOI

  • The paper reports that functional recovery is the most emphasized outcome (n=5) across studies, yet provides no meta-analysis or systematic comparison of which specific biomechanical parameters (load distribution, joint stability, muscle dynamics) correlate most strongly with functional recovery metrics in different orthopedic conditions.

    Integrative Orthopedic Care: Bridging Biomechanics, Regenerative Biology, and Technological Innovation in Modern Musculoskeletal Medicine · 2026 · DOI

  • The paper describes that personalized care through patient-specific implants via 3D printing and predictive analytics is an emerging trend, but lacks specific evidence on how anatomical variability, biological response heterogeneity, and functional demands should be weighted and integrated into predictive algorithms for orthopedic treatment selection.

    Integrative Orthopedic Care: Bridging Biomechanics, Regenerative Biology, and Technological Innovation in Modern Musculoskeletal Medicine · 2026 · DOI

  • While the paper emphasizes that implant mechanics must be compatible with tissue regeneration processes and mechanical demands, no studies are cited that systematically evaluate the interaction between specific biomaterial properties (osseointegration rates, wear resistance) and concurrent stem cell or growth factor delivery within the same implant system.

    Integrative Orthopedic Care: Bridging Biomechanics, Regenerative Biology, and Technological Innovation in Modern Musculoskeletal Medicine · 2026 · DOI

  • The paper identifies that technological innovation in orthopedics (3D printing, AI, computer-assisted surgical planning) is rapidly evolving but notes its lower frequency in literature likely reflects recent adoption rather than relevance. Specific comparative studies quantifying clinical outcome differences between AI-assisted surgical planning versus conventional planning in fracture fixation and joint reconstruction procedures are lacking.

    Integrative Orthopedic Care: Bridging Biomechanics, Regenerative Biology, and Technological Innovation in Modern Musculoskeletal Medicine · 2026 · DOI

  • Although the single-case design and controlled environment of this study warrant further investigation in actual construction settings and with larger sample sizes, the findings suggest that exoskeleton adoption could improve worker productivity and reduce WMSD risk.

    Evaluating industrial exoskeletons for performance and fatigue in lifting tasks · 2025 · DOI

  • Some gaps were noted in the evidence and other handling tasks such as sit-to-stand, turning patient in bed, limb lifting, and repositioning and some more high hazard activities like supporting people with limited balance and those that fall need to be investigated with respect to biomechanical outcomes.

    Effectiveness of Safe Patient Handling Equipment and Techniques: A Review of Biomechanical Studies · 2023 · DOI

  • The observed advantage of FES on gait velocity is small and supported by limited evidence.

    Functional electrical stimulation versus ankle-foot orthoses in adults with foot drop: A systematic review and meta-analysis · 2026 · DOI

  • At the same time, randomized and cohort evidence remains mixed, with several trials showing equivalence to conventional care or only subgroup-dependent benefit, and occupational studies often pairing reduced muscle activity with workflow hindrance or shifted loading.

    Exoskeletons for Rehabilitation, Mobility Assistance, Occupational Support, and Human Augmentation: Scoping Review with ☸️SAIMSARA · 2026 · DOI

  • Furthermore, the analysis pursued to quantify the effect of either control algorithm does not account for the specific input parameters tested in each iteration, but instead captures only general trends with respect to iteration number.

    Validation of Dynamic Bayesian Optimization for Human-in-the-Loop Optimization of Exoskeleton Control at User-Driven Walking Speed · 2026 · DOI

  • Moreover, limited by the small sample, we only used equal-weight multi-muscle voting without exploring weighted voting based on muscle activation intensity.

    Feasibility of mechanomyography-based fatigue classification for passive lower-limb exoskeleton evaluation: A pilot study · 2026 · DOI

  • Future research will focus on enhancing the wearability and energy efficiency of the exoskele- ton, broadening the controller’s adaptability for varying walking speeds and terrains, and conducting rigorous clinical trials to assess rehabilitation outcomes.

    Adaptive sliding mode control of a pneumatic ankle exoskeleton for gait assistance · 2026 · DOI

  • The paper lacks empirical validation data on the exoskeleton's performance with actual paralyzed individuals; only prototype demonstration results are provided.

    Robotic Suit for Paralyzed Person · 2026 · DOI

  • Furthermore, the effect of the exoskeleton's assistance versus movement adaptation when wearing the exoskeleton on musculoskeletal loading remains unexplored.

    The Exo4Work shoulder exoskeleton effectively reduces muscle and joint loading during simulated occupational tasks above shoulder height · 2022 · DOI

  • BACKGROUND: BSEs have the potential to be an effective intervention for reducing low-back physical demands, yet little is known about the impacts of different designs in work scenarios requiring varying degrees of symmetric and asymmetric trunk bending during manual assembly tasks.

    Biomechanical Evaluation of Passive Back-Support Exoskeletons in a Precision Manual Assembly Task: “Expected” Effects on Trunk Muscle Activity, Perceived Exertion, and Task Performance · 2020 · DOI

  • These mixed results demonstrate some kinetic changes due to side load carriage and suggest that the side TTAs should carry a load depends on the desired effects, primarily on their intact limb.

    Hathitrust: A research library at web Scale · 2011 · DOI

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35 open questions have been extracted from the limitations and future-work passages of 462 Prosthetics and Rehabilitation Robotics papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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