Impact of Long-Term Home and Community Use of a Lower Limb Sensory Neuroprosthesis.

Background: Individuals with lower limb loss experience sensorimotor deficits that often lead to adoption of compensatory gait strategies, which increase their risk of developing secondary comorbidities, reduce balance confidence, and negatively impact functional abilities. Despite advancements in prosthetic technology, current devices lack direct sensory feedback that replicates the somatosensation once provided by the missing foot. This study examines how long-term home and community use of a sensory neuroprosthesis (SNP) designed to provide real-time plantar sensory feedback through implanted nerve cuff technology affects functional performance, balance confidence, and quality of life. Methods: A 68-year-old individual with unilateral transtibial limb loss utilized the system in home and community environments for 9.5-months to perform normal daily activities, while returning to the laboratory periodically to complete various functional and qualitative assessments. Results: Results included measurable improvement in prosthetic propulsion, adoption of more typical gait behaviors, reduced errors in stair negotiation, and a decline in self-reported stumble frequency. Conclusions: These findings offer compelling evidence that home use of the SNP may reduce reliance on compensatory gait mechanics, potentially lower fall risk, and improve user confidence in diverse and uncontrolled real-world environments. Trial registration: ClinicalTrials.gov Identifier: NCT03409133 - Trial Registration Date: 01/24/2018.