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Abstract

Transforming the residual-limb-socket interface from an intermittently evaluated ``black box'' into a monitored clinical setting that permits objective fit assessment, early danger detection, and better long-term prosthesis use is the aim of smart prosthetic health monitoring. This narrative exploration compiles peer-reviewed literature on sensing technology and, importantly, integration strategies that affect practical usability. Iterative searches by keywords and citation linking across major engineering and biomedical journal platforms were used to find literature, giving priority to current contributions while preserving important foundational works. The chosen studies were examined and classified based on (i) sensing modality (pressure/shear, temperature-humidity microclimate, chemical and perfusion-related substitutions, and motion/fit monitoring) and (ii) system-level integration approach (skin/liner-embedded nodes, socket-wall mounting, and externally mounted electronics). The evidence suggests that the most clinically beneficial systems integrate pressure sensing, microclimate, and movement context. Low-profile, compliant sensors (such as force-sensing resistors and textile or capacitive arrays) and sturdy packaging that can tolerate cyclic loading, shear, and perspiration have been used to achieve this. Modular sensorized liners, separating of interface sensors from rigid processing hardware, low-power wireless links such as Bluetooth Low Energy (BLE), and emerging battery-free nodes that reduce charging stress are essential enablers for long-term use. Enduring constraints include calibration drift and hysteresis due to humidity and recurrent loading, motion artifacts resulting from misalignment during donning, as well as the durability and complexity of multi-axis shear and perfusion sensing. The review offers design recommendations for clinically feasible, user-centered smart prosthesis monitoring systems.

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