Evaluating Real-World Ambulation and Activity in Prosthetic Users with Wearable Sensors

Purpose of Review: The purpose of this review is to gather information that would motivate researchers, prosthetic development engineers, and health care providers to expand the emphasis on functional mobility, activity, and exercise that prosthetic users perform in real-world settings. Intuitive measures of daily activity performed in-tandem with laboratory assessments could provide a more complete perspective of functional performance. Recent Findings: The use of wearable sensors to assess prosthetic use has gained traction in the recent decade and can provide ecologically valid real-world mobility and activity data. This knowledge can be used to promote exercise and develop interventions that may mitigate the comorbidities related to limb loss. Not all wearable sensors perform well on prosthetic users, and sample periods (usually 7 days) are probably too short. High tech watches from major manufacturers still have substantial errors in estimating heart rate and energy expenditure across a range of intensities, but upgrades are occurring frequently. Summary: Objective metrics that quantify real-world mobility and activity provide a unique perspective that compliments laboratory and survey outcomes to better inform on the effectiveness of prosthetic interventions. However, choosing an appropriate sensor that is valid and sensitive is critical to capture meaningful outcomes and requires careful consideration of the activity of interest and the effects of different prosthetic prescriptions.