A Perspective on Rehabilitation Through Open-Source Low-Cost 3D-Printed Distal to the Wrist Joint Transitional Prosthetics: Towards Autonomous Hybrid Devices

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The document presents a structured study on the development of upper-limb prosthetic systems, focusing on total, partial, and finger amputations. The organization of the study enables a well-directed search for information and highlights relevant findings for the development of low-cost prosthetic systems that are accessible to the general public.

However, I suggest revising a few key points to improve the clarity and depth of the work. In Section 3, the document describes several methodologies for signal processing based on artificial intelligence. It would be useful to review the accuracy rates reported, especially in relation to the number of electrodes used and the movements detected. Research shows that four electrodes can yield good results, recognizing up to five gestures effectively. Incorporating relevant studies could enrich the discussion, such as:

• Toro-Ossaba, A.; Jaramillo-Tigreros, J.; Tejada, J.C.; Peña, A.; López-González, A.; Castanho, R.A. (2022). LSTM Recurrent Neural Network for Hand Gesture Recognition Using EMG Signals. Applied Sciences, 12(9700). https://doi.org/10.3390/app12199700
• Toro-Ossaba, A.; Tejada, J.C.; Rúa, S.; Núñez, J.D.; Peña, A. (2024). Myoelectric model reference adaptive control with adaptive Kalman filter for a soft elbow exoskeleton. Control Engineering Practice, 142, 105774. https://doi.org/10.1016/j.conengprac.2023.105774

Additionally, for Sections 3 through 13, I recommend including diagrams or tables to summarize the most relevant findings. This would enhance the clarity of the document and make it easier to identify the study's key contributions to the state of the art.

In Section 15, the selected alternatives are discussed based on Table 3. However, it is unclear what evaluation criteria were applied to each case. I suggest providing qualitative or quantitative assessments of the selected alternatives and comparing them with those not selected. This would demonstrate a more objective evaluation process and increase the transparency of the study's methodology.

Author Response

Dear reviewer,

thank you very much for your suggestions. They have been used to improve the paper.

You will find the responses in the attached file.

Thank you again!

The authors

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Dear authors,

thank you for the submission of this manuscript. Please find some comments below.

Introduction

- more references to be added

- the introduction to be restructured, as advantages/ disadvantages are in not in order

- the aim and objectives of the study are not clearly shown

Methods

- could idea to add flowcharts and schematics for both literature search and for this study

-it is not clear what is the SANRA methodology and how it was used. Please elaborate 

Control and Signal Processing Algorithms:

- is this section showing the outcomes of the literature search?

- a table or schematic would help to navigate through this section

- an introductory paragraph must be added, otherwise it is not clear what this section is about

Same comments for the rest of the sections. it is not clear for the readers which parts are from the literature review and which parts are novel and original, hence part of this study.

Discussion

- looks more like results section rather than discussion

- comparison with current literature is not evident

Conclusions:

- too long 

Author Response

Dear reviewer,

thank you very much for your suggestions. They have been used to improve the paper.

You will find the responses in the attached file.

Thank you again!

The authors

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This research provides a review of the field and available low-cost 3D printed upper-limb prosthetic devices. The aim of the review is to provide a basic frame of reference on the field of transitional partial hand prosthetics and additive manufacturing techniques on which further research can utilize to develop a new additional variants of upper limb prosthetic devices for patients suffering from partial hand loss.

The topic of the paper is of interest in the field of 3D printed upper-limb prosthetic devices. The reviewer thinks this manuscript is suitable for publication at Machines for the following reasons:

·       Its content is within the scope of the journal.

·       The review presented in the paper contributes to the body of knowledge in the prosthetic devices.

 

The paper can be published after major revision of the following:

 

1)      To make the Methodology section (between lines 61 and 81) clearer I suggest presenting a workflow of the literature (similar to the PRISMA statement method). This can help to better visualise the number of articles identified, screened, and included in the study.

 

2)      The Results sections is missing

 

3)      Section 14 “Transitional 3D Printed Prosthetics” (between lines 559 and 578) feels a combination of the methodology used to select and exclude the articles and the results obtained. I believe the text between lines 550 and 578 is better suited for the Methodology section of the article and leave the tables as part of a Results section which is missing.

 

4)      In section 15 “Discussion” (between lines 582 and 584) is mentioned that the authors added new criteria for the main features of prosthetic for partial hand reduction. Nonetheless, the reasoning for selecting or adding the new that criteria is not described, as well as the criteria itself.

5)      Section 3 “Control and Signal Processing Algorithms” needs an introductory paragraph. This is the same for Sections 4, 5, 6, and 7.

 

6)      The Discussion Section (between lines 579 and 634) feels more like is part of the results sections. This section is not presenting a discussion of the implication of the results and future directions of the manuscript topic.  

 

7)      The text in The Conclusions Section (between lines 648 and 675) is more suitable for the Discussion section.

Comments for author File: Comments.pdf

Author Response

Dear reviewer,

thank you very much for your suggestions. They have been used to improve the paper.

You will find the responses in the attached file.

Thank you again!

The authors

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

Dear authors,

 

thank you for considering the comments from the reviewers and addressing them in your revised manuscript.

Overall, most of the comments were addressed, however the results section could be further improved, by being separated from the discussions, to distinguish between the study's results and any extrapolations coming of the results.

Author Response

Thank you for your review.

Please find the reply in the attached file.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This research provides a review of the field and available low-cost 3D printed upper-limb prosthetic devices. The aim of the review is to provide a basic frame of reference on the field of transitional partial hand prosthetics and additive manufacturing techniques on which further research can utilize to develop a new additional variants of upper limb prosthetic devices for patients suffering from partial hand loss.

The topic of the paper is of interest in the field of 3D printed upper-limb prosthetic devices. The reviewer thinks this manuscript is suitable for publication at Machines for the following reasons:

• Its content is within the scope of the journal.

• The review presented in the paper contributes to the body of knowledge in the prosthetic devices.

 

I confirm that the authors addressed all the comments provided in the previous review. Therefore, I believe that the paper can be published in its current form.

 

Comments for author File: Comments.pdf

Author Response

Thank you very much for the effort in reviewing the paper.

Best regards