Cognitive Workload Assessment of Prosthetic Devices: A Review of Literature and Meta-Analysis

Limb amputation can cause severe functional disability for the performance of activities of daily living. Previous studies have found differences in cognitive demands imposed by prosthetic devices due to variations in their design. The objectives of this article were to 1) identify the range of cognitive workload (CW) assessment techniques used in prior studies comparing different prosthetic devices, 2) identify the device configurations or features that reduced CW of users, and 3) provide guidelines for designing future prosthetic devices to reduce CW. A literature search was conducted using Compendex, Inspec, Web of Science, Proquest, IEEE, Engineering Research Database, PubMed, Cochrane, and Google Scholar. Forty-three studies met the inclusion criteria. Findings suggested that CW of prosthetic devices was assessed using physiological, task performance, and subjective measures. However, due to the limitations of these methods, there is a need for more theoretical and model-based approaches to quantify CW. Device configurations such as hybrid input signals and use of multimodal feedback can reduce CW of prosthetic devices. Furthermore, to evaluate the effectiveness of a training strategy for reducing CW and improving device usability, both task performance and subjective measures should be considered. Based on the literature review, a set of guidelines was provided to improve the usability of future prosthetic devices and reduce CW.