Prosthesis Embodiment in Lower Extremity Limb Loss: A Narrative Review

Nguyen, Tuyet Thao; Wang, Bingjie; Alas, Haddy; Jones, Quincy; Clark, Chase; Lazar, Sabrina; Malik, Shaddy; Graham , Joshua; Talaat, Yasmeen; Shin, Chris; Schofield, Jonathon; Macleod, Toran; Smedley, Laduan; Pereira, Clifford; Joiner, Wilsaan; Randall, R. Lor; Farmer, Diana; Wang, Aijun; Hao, Dake; Greene, Spencer; Sood, Ravi; Brown, Danielle; Russo, Rachel; Manoharan, Kingsley; Simpkins, Andrew; Li, Andrew

doi:10.3390/app15094952

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Open AccessArticle

Prosthesis Embodiment in Lower Extremity Limb Loss: A Narrative Review

by

Tuyet Thao Nguyen

^1,†,

Bingjie Wang

^2,†,

Haddy Alas

³,

Quincy Jones

¹,

Chase Clark

¹,

Sabrina Lazar

⁴,

Shaddy Malik

¹,

Joshua Graham

⁵

,

Yasmeen Talaat

¹,

Chris Shin

^6,7,

Jonathon Schofield

^7,8,

Toran Macleod

^7,9

,

Laduan Smedley

^6,7,

Clifford Pereira

^7,10,

Wilsaan Joiner

^7,11

,

R. Lor Randall

^7,12

,

Diana Farmer

^7,13

,

Aijun Wang

^7,14

,

Dake Hao

^7,14,

Spencer Greene

^7,15,

Ravi Sood

^7,10,

Danielle Brown

^7,12,

Rachel Russo

^7,13

,

Kingsley Manoharan

^6,7,

Andrew Simpkins

^7,15 and

Andrew Li

^7,10,*

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¹

School of Medicine, University of California Davis, 4610 X St, Sacramento, CA 95817, USA

²

Department of Biomedical Engineering, Columbia University, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York, NY 10027, USA

³

Department of Surgery, Columbia University, 630 West 168th Street, New York, NY 10032, USA

⁴

Albany Medical College, 43 New Scotland Ave, Albany, NY 12208, USA

⁵

School of Medicine, Royal College of Surgeons in Ireland, 123 St Stephen’s Green, D02 YN77 Dublin, Ireland

⁶

Department of Physical Medicine and Rehabilitation, University of California Davis Health, Sacramento, CA 95817, USA

⁷

Prosthesis Embodiment Through Intuitive Technology (PETIT), University of California Davis Health, Davis, CA 95616, USA

⁸

Department of Aerospace Engineering, University of California Davis Health, Sacramento, CA 95616, USA

⁹

Department of Physical Therapy, California State University, Sacramento, CA 95616, USA

¹⁰

Division of Plastic Surgery, University of California Davis Health, Sacramento, CA 95816, USA

¹¹

Department of Neuroengineering, Neurobiology, Physiology, and Behavior, University of California Davis Health, Sacramento, CA 95616, USA

¹²

Department of Orthopedic Surgery, University of California Davis Health, Sacramento, CA 95817, USA

¹³

Department of Surgery, University of California Davis Health, Sacramento, CA 95817, USA

¹⁴

Department of Bioengineering, University of California Davis Health, Sacramento, CA 95616, USA

¹⁵

Hanger Clinic, 1248 32nd Street, Sacramento, CA 95816, USA

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^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Appl. Sci. 2025, 15(9), 4952; https://doi.org/10.3390/app15094952 (registering DOI)

Submission received: 31 January 2025 / Revised: 7 April 2025 / Accepted: 17 April 2025 / Published: 29 April 2025

(This article belongs to the Special Issue New Insight into the Biomechanics of Lower Limb: Prevention, Injury, Rehabilitation and Replacements)

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Abstract

Lower limb prosthesis abandonment is a significant challenge, leading to reliance on walking aids, such as wheelchairs, which frequently do not match the patient’s needs and lead to increased morbidity. Prosthesis abandonment is driven by a lack of embodiment, the latter defined as the integration of a prosthetic device into one’s body schema. This review evaluates interventions enhancing embodiment through three dimensions: ownership, agency, and co-location. The aim of this narrative review is to ask what interventions are available to improve embodiment, and what dimensions of embodiment should be included in the standard of care for lower-limb amputation surgery and componentry development. This narrative is constructed through a thorough literature search on how the aforementioned dimensions of embodiment can be optimized. In the studies reviewed, standardization of embodiment metrics and longitudinal data are lacking, hindering clinical translation. Future work must prioritize patient-centered design, integrate multidimensional assessments, and address practical issues to expand eligibility for advanced interventions.

Keywords: embodiment; prosthesis; amputation; rehabilitation; ownership; agency

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MDPI and ACS Style

Nguyen, T.T.; Wang, B.; Alas, H.; Jones, Q.; Clark, C.; Lazar, S.; Malik, S.; Graham , J.; Talaat, Y.; Shin, C.; et al. Prosthesis Embodiment in Lower Extremity Limb Loss: A Narrative Review. Appl. Sci. 2025, 15, 4952. https://doi.org/10.3390/app15094952

AMA Style

Nguyen TT, Wang B, Alas H, Jones Q, Clark C, Lazar S, Malik S, Graham J, Talaat Y, Shin C, et al. Prosthesis Embodiment in Lower Extremity Limb Loss: A Narrative Review. Applied Sciences. 2025; 15(9):4952. https://doi.org/10.3390/app15094952

Chicago/Turabian Style

Nguyen, Tuyet Thao, Bingjie Wang, Haddy Alas, Quincy Jones, Chase Clark, Sabrina Lazar, Shaddy Malik, Joshua Graham , Yasmeen Talaat, Chris Shin, and et al. 2025. "Prosthesis Embodiment in Lower Extremity Limb Loss: A Narrative Review" Applied Sciences 15, no. 9: 4952. https://doi.org/10.3390/app15094952

APA Style

Nguyen, T. T., Wang, B., Alas, H., Jones, Q., Clark, C., Lazar, S., Malik, S., Graham , J., Talaat, Y., Shin, C., Schofield, J., Macleod, T., Smedley, L., Pereira, C., Joiner, W., Randall, R. L., Farmer, D., Wang, A., Hao, D., ... Li, A. (2025). Prosthesis Embodiment in Lower Extremity Limb Loss: A Narrative Review. Applied Sciences, 15(9), 4952. https://doi.org/10.3390/app15094952

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Prosthesis Embodiment in Lower Extremity Limb Loss: A Narrative Review

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