Skip to main content


  • Tara Sims (a1), Andy Cranny (a2), Cheryl Metcalf (a3), Paul Chappell (a2) and Maggie Donovan-Hall (a3)...

Objectives: The study aims to develop an understanding of the views of children and adolescents, parents, and professionals on upper limb prosthetic devices to develop and improve device design. Previous research has found that children are dissatisfied with prostheses but has relied heavily on parent proxy reports and quantitative measures (such as questionnaires) to explore their views.

Methods: Thirty-four participants (eight children aged 8–15 years with upper limb difference, nine parents, eight prosthetists, and nine occupational therapists) contributed to the development of new devices through the BRIDGE methodology of participatory design, using focus groups and interviews.

Results: The study identified areas for improving prostheses from the perspective of children and adolescents, developed prototypes based on these and gained feedback on the prototypes from the children and other stakeholders (parents and professionals) of paediatric upper limb prostheses. Future device development needs to focus on ease of use, versatility, appearance, and safety.

Conclusions: This study has demonstrated that children and adolescents can and should be involved as equal partners in the development of daily living equipment and that rapid prototyping (three-dimensional printing or additive manufacturing), used within a participatory design framework, can be a useful tool for facilitating this.

Hide All
1. Smith, DG. Congenital limb deficiencies and acquired amputations in childhood, part 3. In motion. 2006;16.
2. Shida-Tokeshi, J, Bagley, A, Molitor, F, et al. Predictors of continued prosthetic wear in children with upper extremity prostheses. J Prosthet Orthot. 2005;17:119124.
3. Routhier, F, Vincent, C, Morissette, MJ, Desaulniers, L. Clinical results of an investigation of paediatric upper limb myoelectric prosthesis fitting at the Quebec Rehabilitation Institute. Prosthet Orthot Int. 2001;25:119131.
4. Wagner, LV, Bagley, AM, James, MA. Reasons for prosthetic rejection by children with unilateral congenital transverse forearm total deficiency. J Prosthet Orthot. 2007;19:5154.
5. Biddiss, EA, Chau, TT. Upper-limb prosthetics: Critical factors in device abandonment. Am J Phys Med Rehabil. 2007;86:977987.
6. Pylatiuk, C, Schulz, S, Döderlein, L. Results of an Internet survey of myoelectric prosthetic hand users. Prosthet Orthot Int. 2007;31:362370.
7. Donovan-Hall, M. Supporting the positive development and well-being of children and young people with prostheses: The influence of the appearance of the prosthesis and individual choice. Big Lottery Final Report. 2010;RG1/010120846.
8. Allsop, MJ, Holt, RJ, Levesley, MC, Bhakta, B. The engagement of children with disabilities in health-related technology design processes: Identifying methodology. Disabil Rehabil Assist Technol. 2010;5:113.
9. Sinclair, R, Franklin, A. Young people's participation: Quality Protects Research Briefing, No. 3. London: Department of Health; 2000.
10. Nesset, V, Large, A. Children in the information technology design process: A review of theories and their applications. Libr Inf Sci Res. 2004;26:140-61.
11. Light, L, Page, R, Curran, J, Pitkin, L. Children's ideas for the design of AAC assistive technologies for young children with complex communication needs. Augment Altern Commun. 2007;23:274287.
12. Rigby, P, Ryan, S, From, W, Walczak, E, Jutai, J. A client-centred approach to developing assistive technology with children. Occup Ther Int. 1996;3:67-67.
13. Cooke, GA. Involving children in planning healthcare: The Derby experience. Curr Paediatr. 2004;14:246251.
14. Weightman, APH, Preston, N, Holt, R, et al. Engaging children in healthcare technology design, developing rehabilitation technology for children with cerebral palsy. J Eng Des. 2010;21:579600.
15. Atkins, D, Heard, DCY, Donovan, WH. Epidemiologic overview of individuals with upper-limb loss and their reported research priorities. J Prosthet Orthot. 1996;8:211.
16. Biddiss, EA, Beaton, D Chau TT. Consumer design priorities for upper limb prosthetics. Disabil Rehabil Assist Technol. 2007; 2:346357.
17. Shah, SGS, Robinson, I. Medical device technologies: Who is the user? Int J Healthc Technol Manag. 2008;9:181197.
18. Shah, SG, Robinson, I. User involvement in medical device technology development and assessment: Structured literature review. Int J Health Care Qual Assur Inc Leadersh Health Serv. 2006;19:500515.
19. Nichols, PJ, Rogers, EE, Clark, MS, Stamp, WG. The acceptance and rejection of prostheses by children with multiple congenital limb deformities. Artif Limbs. 1968;12:113.
20. Postema, K, van der Donk, V, van Limbeek, J, Rijken, RA. Prosthesis rejection in children with a unilateral congenital arm defect. Clin Rehabil. 1999;13:243249.
21. Rycroft-Malone, J. Formal consensus, the development of a national clinical guideline. Qual Health Care. 2001;10:238244.
22. Resnik, L. Development and testing of new upper-limb prosthetic devices: Research designs for usability testing. J Rehabil Res Dev. 2011;48:697706.
23. Peerdeman, B, Boere, D, Witteveen, H, et al. Myoelectric forearm prostheses, State of the art from a user-centred perspective. J Rehabil Res Dev. 2011;48:719738.
24. Glushko, A. Participatory design in healthcare: Patients and doctors can bridge critical information gaps. UX Magazine. 2013; 1028.
25. Iversen, OS, Brodersen, C. Bridging the gap between users and children - A socio-cultural approach to designing with children. Cognition, technology and work: Special issue on child-computer interaction methodological research. 2007;9.
26. Snyder, RG, Spencer, ML, Owings, CL, Schneider, LW. Anthropometry of U.S. infants and children. Warrendale, PA: Society of Automotive Engineers, Inc; 1975.
27. Sims, T. A participatory design approach to developing upper limb prostheses for children and young people (unpublished doctoral thesis). University of Southampton, UK; 2014.
28. Crow, I. The power of research. In: Burton, D, editor. Research training for social scientists: A handbook for postgraduate researchers. London: Sage; 2000:6880.
29. Knafl, K, Breitmaye, B.Triangulation in qualitative research: Issues of conceptual clarity and purpose. In: Morse, J, editor. Qualitative nursing research. Rockville, MD: Aspen; 1989:193203.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed