KINGSTON, R.I. – April 2, 2026 – Artificial limbs look and function more like real limbs than ever before—but that’s only helpful if they are used as intended. One of the main reasons amputees give for not using their body-powered prosthesis is a lack of motivation or knowledge of how to properly use them.
Part of the reason for this is that compared to the time and resources devoted to improving the comfort and function of prostheses, much less attention is spent on making prosthetic training more effective.
But Susan D’Andrea, an associate professor of kinesiology in the University of Rhode Island College of Health Sciences, recently undertook a study aimed at trying to rectify this. D’Andrea conducted a feasibility study using an augmented reality game to keep people engaged and motivated during training or rehabilitation.
“The quality and quantity of prosthetic training have a significant influence on prosthetic acceptance,” said D’Andrea. “However, there’s no consensus on the most effective delivery for this training.”
D’Andrea recruited 32 healthy, able-bodied participants for the study, ranging in age from 18-65. Wearing a bypass body-powered prosthetic device, participants performed functional task assessments in D’Andrea’s MotionVR Biomechanics Lab.
“We focused on the upper extremities because individuals with upper extremity amputations will often reject their prosthetic,” said D’Andrea. “Many times, it feels easier for them to use their uninjured arm because they don’t get enough training on using the prosthetic.”
Half the participants in the study were randomly assigned to an augmented reality intervention group and the other half to a control group.
Participants in the augmented reality group used the ARm-Strong training game, which was developed at URI by kinesiology and biomedical engineering students. The game challenges participants to stack holographic cups while wearing a Microsoft HoloLens2 headset. They were tested during three visits, with 4-6 days between each visit.
Participants in the control group received no training between pre- and post-measurements of hand function and were instructed not to use a prosthesis between visits to the lab. During their two visits, which were 8-12 days apart, they were instructed to complete a seven-task functional assessment using the prosthesis only. One task was to turn over five index cards on a table, while being timed.
“On average, individuals in the augmented reality group were significantly more efficient at using the bypass prosthesis to complete functional tasks compared to the control group,” said D’Andrea. “Individuals who engaged in the augmented reality training had positive feelings of engagement, engrossment, and immersion towards the application.”
D’Andrea is hopeful that augmented reality will become widely adopted in healthcare as a training or rehabilitation tool.
“The amount of time needed to progress through prosthetic training protocol varies from person to person depending on their needs and function. That’s why the augmented reality game is appealing—it can be tailored to the needs and abilities of the user,” said D’Andrea. “It’s also a great solution because you can play the game anywhere.”
She also noted that there are very few safety issues because users can see their ‘real’ environment through the lenses, as opposed to virtual reality headsets, where users can only see the game.
While widespread implementation of the technology has been cost-prohibitive to this point, D’Andrea expressed optimism that the technology may soon be available more widely.
“I think the price point of the augmented reality headsets are finally starting to come down, which might speed up the adoption of the technology for rehabilitation,” she said.
A peer-reviewed article about the study, which the professor co-authored with former URI students Lauren Deus and Leah Wohlbach, was published in the February issue of the scientific journal PLOS One.