an extended systematic literature review on the...

International Journal of Mechanical & Mechatronics Engineering IJMME-IJENS Vol:19 No:05 75

190105-4848-IJMME-IJENS © October 2019 IJENS I J E N S

Abstract— Amputees wish to live a normal life similar to the other

healthy human beings. An ideal prosthesis should help amputees

making progress and try something new in their daily life. In order

to do so, the amputees need a sense of touch from their prostheses

in carrying out their daily activities. Thus, a haptic feedback

stimulation system providing a sense of touch is an essential

functionality for upper extremity prostheses. In this context, the

haptic feedback stimulation system conveys the touch sensation to

the patients’ brain and enable them to interact with their

surroundings. To provide valuable technological insights into

prosthetic research, the options and gaps in this field of study must

be understood. Therefore, in this investigation, a review is

performed to outline the research landscape into a coherent

taxonomy. The investigated study covered every article related to

the haptic upper limb prostheses with nonsurgical intervention

feedback stimulation system in three main databases, namely,

ScienceDirect, IEEE Explore, and Scopus. After scanning and

filtering, 159 articles have been classified into five classes. These

five classes are: (i) reviews and survey articles, (ii) the demands of

modifying the haptic prosthetic hand, (iii) the development of the

tactile sensory technologies, (iv) the haptic feedback displays with

the upper extremity prostheses, and (v) studies which analyze the

performance of the sensory system and the feedback stimulation

system at the same operating time. The fundamental

characteristics of this emerging field are studied against the

following criteria: benefits, challenges, limitation, and future

trend to improve the acceptance of the amputees towards haptic

upper limb prostheses. The hybrid haptic feedback stimulation

systems are effective in recovering the sense of touch to the upper

limb amputees. The review points out the need for more study in

this field to improve the performance and the functionality of the

haptic system.

Index Term— Prosthetic hand, Upper limb prostheses, Arm

amputation, Haptic feedback stimulation system, Hybrid

stimulation system, and Recover feeling for amputees

I. INTRODUCTION

The visual information is the principal sensory input by

human for observing the objects.

However, the sensing capability significantly increases when

using the haptic information parallel to the virtual information

during the human’s real-life activities, especially, the

information about the shape size, surface texture, and object’s

temperature [1].

The human performance would be better if he is able to see,

to touch, to grasp, and to get full information about the objects

and surfaces depending on multi-information sources [2]. The

number of amputees, who lost the gift of touch and grasp

objects, increased rapidly. For instance, 3 million people with

upper limb amputation were recorded recently over the world

[3], of which 1.6 million amputees were estimated just in the

United States, 68.6 % of trauma-related amputations and 58.5

% of congenital birth defects [4].

The upper limb prostheses were remarkably and effectively

developed during the last few years from cosmetic prostheses

to smart interactive prostheses. At the same time, providing

feeling to the prostheses’ users became an urgent requirement

to increase the objects’ manipulation ability and to enhance the

body ownership feeling [5]. Therefore, the haptic prosthetic

hand has two different control loops, as shown in Fig. 1. The

first loop is a feedforward control loop responsible on driving

the prosthetic’s motors based on the electromyogram (EMG)

signals detected from the muscles of the amputee’s residual

part. On the other hand, the second loop is the haptic feedback

stimulation loop, which is in charge of recovering the lack of

sensation due to the mutilation of the original biological hand.

Focusing on the haptic feedback stimulation loop,

different tactile techniques have been developed to enable the

amputees to detect the contact pressure, the slippage, surface

texture, surface material, and the object temperature by

mounting sensors either on one prosthetic fingertip, all

fingertips, or covering the entire hand. On the other side, two

feedback stimulation techniques have been suggested for

providing the haptic information to the amputees’ brain. The

first technique is the surgical intervention to reach the nerve of

the patient and pass the tactile information directly to the

amputees’ nervous system, which is known as the invasive

feedback stimulation technique. Nevertheless, most opinions

encourage the nonsurgical intervention as the alternative

stimulation technique by exciting another part of the body using

An Extended Systematic Literature Review on

the Non-Invasive Haptic Feedback Prostheses in

Upper Extremity

Mohammed Najeh Nemah1,2, Muayad M. Maseer1, Cheng Yee Low1*, Pauline Ong1, O M Fakhri1,

Hayfaa J. Jebur3

1Faculty of Mechanical and Manufacturing Engineering, University Tun

Hussein Onn Malaysia, 86400, Parit Raja, Batu Pahat, Johor, Malaysia

([email protected]). 2Engineering Technical College-Najaf, Al-Furat Al-Awsat Technical

University, 54001, Najaf, Iraq ([email protected]). 3General Company for the production of electric power / Southern, Iraqi

Ministry of Electricity, 64001, Dhi Qar, Iraq.

mailto:[email protected]



an external stimulus. This technique is called haptic non-

invasive feedback stimulation technique.

Fig. 1. Haptic feedback and feedforward control loops for upper limb

prostheses.

The main objective of this study is to provide a useful vision

for technological environments and support researchers by

understanding the available options and gaps in this field of

haptic non-invasive feedback stimulation technique. It also

aims to focus on the efforts of investigators in response to the

new technology, map the research landscape into a coherent

taxonomy, and identify the methods and instruments used in the

development of the haptic upper limb prostheses.

This chapter is organized as follows: the motivation for using

the haptic prosthetic hand and its design techniques are

introduced in the introduction of Section I. In method Section

II, the research methods, scope, literature sources, and steps in

filtering articles are described. The research landscape based on

literature is also mapped into a coherent taxonomy in the same

section. Also, the final papers set filtered from the previous

section are reviewed in the next Section III and the statistical

information of articles section. The benefit, statistical analysis,

challenges, and limitation of the studies in the field of the haptic

feedback stimulation prostheses from 2007 to 2018 are

discussed and classified in the next Section IV. Finally, in the

last Section VI, the summary of this review is presented.

II. METHOD

The most important keyword in this investigation study is the

haptic upper limb prostheses as one of the smart health

applications, focusing on helping the amputees in restoring the

sensation of the external environment parameters. The scope of

the searching method is limited to English literature articles,

however, it also considers all the haptic feedback stimulation

prostheses including the investigation study, sensors and

actuators development, the haptic stimulation novelty

techniques, and the duration of the training with haptic

prostheses. Three digital databases were scouted to search for

the target articles. (1) ScienceDirect which is a massive

database of scientific technique and medical research. (2) IEEE

Explore which is a great database dealing with computer

science, electrical engineering, and electronics. It

fundamentally covers the paper articles from the Institute of

Electrical and Electronics Engineers (IEEE) and the Institution

of Engineering and Technology. (3) Scopus which is Elsevier’s

abstract and citation database that covers the sciences in the

fields of life, social, physical, health, and smart health. The

three databases sufficiently covered the artificial prosthetic

hand and the feel recovering technology, which prepared a

broad vision of existing research in a wide but pertinent range

of disciplines.

Study election embroiled a search for literature sources

followed by three steps of checking and filtering iteration. All

unrelated articles were taken away in the first step of checking

and filtering, while in the second step, the duplicates and

irrelevant literature articles were extracted by scanning the titles

and the abstracts. Finally, in the last step of checking and

filtering, the full-text articles screened from the second step

were neatly checked out. The authors succeed similar eligibility

criteria for filtering the articles in the three iteration steps. The

searching operation started in November 2017 and was

completed in November 2018 by utilizing ScienceDirect,

Scopus, and IEEE Explore databases, in order to identify the

studies relative to the haptic upper limb prostheses. The mix of

keywords was classified into three main parts referring to the

function of the haptic upper limb prostheses. The main part is

the desired addition of the prosthetic hand in order to develop

its performance and increase the amputees' desire to use it, with

its continuing tactile, haptic, sensing, sensation, and sensor. On

the other hand, the second part is the sensors and the actuators

part including feeling, feedback, stimulation, "contact

pressure", texture, and thermal. While the third part is the user

and the feedback stimulation location which comprises of

fingertip, "prosthetic arm", "prosthetic hand", "upper limb",

prostheses, amputation, and amputee. The keywords at the same

party is split by (OR), while the three parts are collected by

(AND). The text full query, described in Fig. 2, was used to

search the articles in the three searching engines filtered on the

journal and conference paper articles only terminating the book

chapter, letter, short communication, and correspondence. The

keywords were chosen depending on the pre-survey study

including 46 articles.

Every article following the inclusion criteria listed in Fig. 2

were included in this investigation. After the initial termination

of duplicates, articles were eliminated in two steps of screening

and filtering in case they did not follow the eligibility criteria.

The exclusion criteria included the following. (1) The article is

published in an English journal or conference paper. (2) The

study case involves the external non-invasive haptic stimulation

system without surgical intervention. (3) The main focus is the

haptic feedback stimulation system of the upper limb prostheses

in either one or more of the following aspects: sensing restoring

of upper limb amputees (lower limb and foot are excluded). The

robotic development with a prosthetic hand. The direct contact



sensory system (the studies dealing with virtual visual feedback

technique and image processing are terminated). To simplify

the steps, the final set of articles were read and analyzed in

Excel formats. Additionally, the articles were categorized in

detail using taxonomy and collection of highlights and

comments.

Fig. 2. Flowchart of study selection, including the search query and

inclusion criteria.

III. RESULTS AND STATISTICAL INFORMATION OF

ARTICLES

The primary query resulted in 5155 papers: 258 from the

ScienceDirect database, 2092 from IEEE Explore, and 2805

from Scopus. The filtered articles published from 2007 to 2018

were implemented in this research. In the three databases, 2412

out 5155 papers were duplicates. This high duplicate number is

due to the use of the Scopus database which includes the articles

of the other databases. Thus, most articles obtained from

ScienceDirect and IEEE Explore were duplicates by using

Scopus. However, the Scopus database is a very important

searching engine because it contains important journals in the

field of prostheses and smart health such as the International

Society for Prosthetics and Orthotics journal, Advanced

Robotics journal and IOP Publishing. After scanning the titles

and abstracts, 2303 papers were omitted. The final full-text

review excluded 281 papers, leaving a total of 159 papers in the

final set, all of which were related to the haptic prosthetic hand

technology over dissimilar topics. The highest streams of

research focusing on the haptic upper limb prostheses were

classified to generate the taxonomy as presented in Fig. 3. This

taxonomy shows the comprehensive development of various

studies and applications. The taxonomy recommends different

classes and subclasses. The first class contain reviews and

survey articles related to the haptic upper limb prostheses

(11/159 papers) while the second class contain papers on the

demands of equipping the artificial prosthetic hand with the

haptic feedback stimulation system (5/159 papers). The third

class comprises of the tactile sensory system and the

development of the sensor technology in the prostheses field of

study (44/159 papers). The articles dealing with the feedback

stimulation system and the design of the stimulation actuators

are classified in the fourth class of the taxonomy (64/159

papers). The final class contains the articles dealing with the

completely haptic-tactile feedback stimulation system that

studies the sensory system and the feedback stimulation system

at the same time (35/159 papers). The spotted categories are

listed and explained in the following section.

Fig. 3. Taxonomy of literatures on the haptic upper limb prostheses.

A. Review and survey articles

It comes as no surprise that most literature researches focused

on the merits and demerits of the tactile sensory technologies

and the haptic feedback stimulation technologies, which are

used to interface the upper limb prostheses with the

surrounding. This is because it represents the main parts of the

haptic feedback stimulation system. The smart haptic sensation

systems and its single processing focusing on the principles and

structures of the tactile sensory system was reviewed, in order

to highlight the main challenges and the state of the art of the



artificial skin [6]. Furthermore, the modern technologists of

using the biomedical tactile sensory system to recover the touch

sensation were clearly studied to determine the problems that

accompany the simulation of the skin mechanoreceptors

characteristic utilizing different kinds of smart tactile sensors

[7] and the biocompatible nanomaterials [8].

The main issues of the tactile sensory systems including the

grasp detection, shape recognition, and the pressure level

estimation between the holding objects and the prosthetic hand

are summarized [9, 10]. Meanwhile, the challenges and the

issues related to the design of the smart fabric sensor having the

ability to measure the contact force, pressure, temperature, and

humidity are demonstrated in the previous study [11]. The pros

and cons of the biomedical tactile technologies are surveyed

comprehensively, focusing on the applications of the prosthetic

hand and its motion capturing [12].

Several of the previous researches focused on utilizing the

haptic wearable devices to help the patients of upper limb

mutilation to recover the sensation by externally simulating the

skin and nervous systems without surgery intervention [13, 14].

On the other hand, the structure of the peripheral nerve and its

significant role in conveying the tactile information to the

patient's brain was examined [15]. In addition, the functionality

of smart controlling the artificial sensory perception and haptic

feedback stimulation system of myoelectric prosthetic hand by

mean of using the Internet of Things (IoT) was briefly

investigated [16].

B. Demands of feedback stimulation system

The design’s priorities of the haptic upper limb prostheses

must reflect the consumers’ demands, in order to be able to help

the amputees to perform their life activities as perfect as

possible. Several types of statistical studies have been

performed to determine the patients’ satisfaction with their

upper limb prostheses. During the studies, the analysis

examined the type, design, response, weight, and the feedback

sensation as the main parameters of the haptic prostheses.

Firstly, a statistical study on the customers’ satisfaction with

the upper prostheses was accomplished by examining 242

participants with different ages and various level of amputation

[17], in order to create an enumerated list referring to the design

priorities of the prostheses to serve this as a start point for the

future developments in this field of study. The statistical study

concluded that 69%, 47%, and 50% of the participants favored

using the myoelectric hand, passive hand, and body bowered

hand, respectively. The same statistical survey technique was

repeated, but in a specific geographical area by limiting the

study with the users of the upper- extremity prostheses in the

United Kingdom and Sweden [18]. The study depended on the

research sample of 156 volunteers with upper limb amputation.

It was established that the patients want to improve the weight,

grip function, operation noise, the sensory feedback, and the

usage control of the prosthetic hand. On the other hand, the

tactile glove material, independent movement parts of the

prostheses, and the contact force feedback have been identified

as other amputees’ requirements depending on 54 patients of

upper limb amputation [19].

Depending on the above studies, it can be concluded that the

feedback sensation has high priority for the upper limb

amputees, however, what activities that would be more

effective during the usage of the upper limb prostheses and

what are the main kind of information that must be provided to

the patients, are very significant questions which requires

further investigation. These questions were carefully discussed

based on 108 patients utilizing artificial prosthetic hand

equipped with a haptic feedback stimulation system [20].

Controlling the gripping force and the prosthetic movement

recorded the highest percentage of demand around 66.3% and

56.3%, respectively, as shown in Fig. 4. Nevertheless, the touch

position, the first of contact, and the end of contact appears as

the second level priorities, because around 47% of the testing

objects thought that these types of excitation are so important

for helping amputees to recover the feeling of touch. Finally,

the touch detection without grip, the texture surface detection,

and the temperature recorded the lowest proportion of

importance.

Fig. 4. The importance of feedback of the sensory information to amputees

[20].

In the end, it is crucial to point out that the pre-training hours

is a highly important factor for users of the haptic prostheses, in

order to improve the accuracy of the haptic feedback

stimulation system. The investigation study with eight forearm

amputees concluded that during the training periods, the

functionality of the haptic prosthetic hand would increase day-

by-day and lead to the reduction of the phantom limb pain [21].

C. Tactile Sensory system

Measuring the environment parameters of the haptic

prosthetic hand and converting it to analog signals are the main

purpose of the tactile sensory system. Generally, the design

concept of sensors that mount on the prosthetic hand uses a

material, resistor, capacitor, conductive rubber, or anything else

which has the ability to change its resistance and then change

its output voltage when the sensor contacts with an external

disturbance like force, temperature, vibration and so on. In

general, the type of feedback information depends entirely on

the type of sensors used in the tactile system. Therefore, the

tactile sensory system is divided into six sub-systems

depending on the main function of each system. The sub-

33

26.2

17.8

11.5

9.5

7.8

5.8

5.8

29.1

34

18.8

7.7

8.6

13.6

11.7

4.8

20.4

21.4

30.7

33.7

35.2

30.1

26.2

23.1

17.5

18.4

32.7

47.1

46.7

48.5

56.3

66.3

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Temperature

Surface Texture

Touch (No grip)

End of Contact

First of Contact

Position

Movement

Grip Force

0 1 2 3Not important at all Absolutely important



systems are discussed as follows:

C.1 Contact pressure sensory system

Generally, the contact force acting on the prosthetic hand was

studied to provide the sensory information to the amputee’s

brain and to improve the performance of the haptic feedback

stimulation system. The kinematics of the human’s hand was

measured, in order to understand the pathophysiological aspects

of the fingers movements [22]. A tactile glove equipped with

two different sizes (8 mm and 12.5 mm in diameter) force-

sensing resistor (FSR) sensors modified by a rigid silicon layer

was used. Furthermore, the mechanical response of the

pressure sensors attached to the prosthetic hand’s fingertip was

investigated by utilizing the silicon thin-film piezoresistive

sensor [23]. The comparison between the piezoresistive sensor

and the strain gauge sensor concluded that the sensitivity of the

piezoresistive sensor was more compared to the sensitivity of

the strain gauge sensor, but it reduced when the sensors were

attached to the prosthetic hand. The limitation of the study is

that it did not examine the force response near the fingertip

because the structure of the design did not support this kind of

study.

A new robot fingertip shape modification was designed to

check the fingertip fabrication and the sensory performance as

near as possible [24]. A thin and flexible strip-type force sensor

was used to measure the static and the dynamic force between

the prosthetic hand and the gripping objects. On the other hand,

a BioTac haptic sensor was attached to the fingertip of the

Myoelectric prosthetic hand with the EMG command signals in

order to feedback the information about the contact force and

enables the prosthetic hand to control its motor [25]. The

control system with the force feedback signal enabled the

amputees to prevent excessive gripping contact force during

contact with the objects and create a new system independent

on the visual feedback.

Fabricable and stretchable piezoresistive sensor combined

with a soft silicon padding cover were presented as a new tactile

technique [26-28]. This new technique has the ability to easy

covering the natural object from all sides because it was

fabricated from multilayers, which is similar to the human skin.

The wearable data glove consists of 54 tactile cells interfaced

with special design communication board to overcome the

human life activity with 0 to 30 N force range. A flexible and

multilayers capacitive microfluidic normal force sensor with a

5×5 fabric array and 0 to 2.5 N normal force range was

developed, in order to measure the contact force applied at any

sides around the fingertips of the prosthetic hand [29].

Finally, the flexible optical shear sensor became increasingly

significant in the medical field and robotic design to recover the

tactile information. Usually, the optical sensor is an unobtrusive

flexible sensor, which has the ability to wrap around the

prosthetic fingertip or any moving body parts [30-32]. The

principle design of the optical shear sensor is based on the

relative movement between the Vertical-Cavity Surface-

Emitting Laser (VCSEL), a photodiode, and the deformable

transparent layer. The optical sensor’s sensitivity can be

modified to measure 2 to 2.5 N linear force range. However, the

measuring sensing range and the sensitivity of the flexible

optical sensor can be tuned according to its specific application.

C.2 Slip detection sensory system

The gripping strength of the prosthetic hand is completely

controlled by the electromyogram (EMG) signals, depending

on the contraction of the remaining muscles on the patient’s arm

as the desired input to the controller. The performance of

gripping strength is typically controlled by obtaining

information about the object slippage from the hand. Measuring

the contact force and processing it to prevent the slipping action

was studied several times in previous studies due to the

importance of this subject.

Several experimental tests have been performed on a five

degree of freedom (DOF) robotic hand operated by the micro

servomotors [33]. The robotic hand was modified by a group of

FSR force sensors fixed on each fingertip and the palm of the

hand. The results of the experiments proved the importance of

equipping the prosthetic hand with the slipping control

technique to prevent the slippage.

The force sensing resistor (FSR) sensor was fixed at the

index fingertip of the electrically-operated RFID prosthetic

hand (MORPH) [34]. Likewise, the force sensors were fixed on

each fingertip and the hand palm [35]. The main purpose of this

modification is to study the slipping action and the requiring

gripping power when the prosthetic hand holds a polyethylene

terephthalate (PET) bottle. A radio frequency identification

(RFID) was used as a new technique with the tactile sensory

system. Moreover, a thin film piezoelectric force sensor was

fixed on a thumb’s fingertip in order to feedback the

information of the slip action [36]. In the other level of the smart

tactile system design, a bicolor light emitting diode (LED) was

integrated to the thumb fingertip of the prosthetic hand, in order

to supply additional feedback and provide the sensory signals

to the hybrid force-velocity controller [37].

The collection of a Hall Effect sensor, load cells, and Otto

Bock’s sensory prosthetic hand were used to study the objects

slipping behaviors [38-41]. Two types of controllers were

designed to inhibit the gripped objects from slipping down. The

slippage of the dropping objects was determined by the hand

pass filtering method. The main objective of the study is to

enable the prosthetic hand for holding the objects with the lower

possible power to prevent the smashing. At the same time, the

gripping power must be high enough to prevent the object from

dropping down. In order to understand the role of the skin to

recognize the slippage objects and to improve the performance

of the tactile sensory system, a Beam Bundle Model (BBM) and

Magnetic Resonance (MR) images were utilized to simulate the

human’s fingertip during the slippage [42]. Furthermore, a

(3x3) unit of pressure-conductive rubber sensing material was

designed to detect the slipping in three axes of contact [43].

C.3 Surface texture detection sensory system

When a healthy human fingertip slides over different

surfaces, the human brain perceives information about the types

of the surfaces and identify the objects. The sliding vibration is

the main factor that enables the human brain to recognize the



surface texture by utilizing the mechanoreceptors, which

distributes under the skin. This is based on the fact that the

vibration signals differ from a surface to other depending on the

roughness of each surface. The artificial prosthetic hand can be

modified by adding the vibration sensors to detect the surface

texture. The distinguishing of the surface roughness depends on

the slid condition and the surface properties, like, the material

properties, the hydration, the mutual roughness, and the finger

sliding speed [44].

The ability of amputees, who use the micro tactile

transceiver, to recognize the surface roughness and texture was

experimentally established by utilizing the tactile interface

device and the SiO2-SiO2 contact interface [45]. On the other

hand, a polymathic methacrylate (PMMA) bar and two

perpendicular polyvinylidene difluoride (PVDF) film sensors

were used to develop a new bioinspired tactile fingertip suitable

for the prosthetic hand to identify the surface roughness by

processing the feedback vibration signals [46].

The problem of detecting the surface texture must be listed

under the biology and the tribology study fields because the

relationship between the skin friction and the haptic perception

is an ideally bio-tribology interdisciplinary issue [47, 48].

Therefore, the biomimetic finger (BioTac, Syntouch LLC) was

experimentally tested with twenty volunteers engaged in the

experimental test. The test was concentrated on three fabric

samples (silk, linen, and cotton) and three paper samples

(normal paper, Kraft paper, and photo paper). After several

experimental tests, it was found that there is a directly

proportional relationship between the brain response sensitivity

and the frictional impulse on the fingertip [48]. Additional to

the relationship between the slid friction and the surface

properties, the tactile vibrational sensing system affects the

sliding direction and the amplitude of the normal force applied

by the sliding finger [49]. Furthermore, it was concluded that

the friction coefficient between the frictional tactile sensation

(FTS) fingertip and the surface depends on the contact area and

the contact location [50, 51].

Several previous studies used the finite element model,

numerical model, or image-processing model in order to

increase the performance of the prosthetic hand. The vertical

load calculation and the parameters of the texture ridge

geometry were studied depending on the finite element model.

The numerical model was designed to study the relationship

between the generation contact vibration and the scanning

conditions of the finger over surfaces [52]. In addition, the

scanning geometry factor and its relationship with the surface

texture using the image-processing model was investigated

[53].

Lastly, one of the most significant purposes of virtual

environments is to afford an immersive rendering of real-world

objects [2]. Therefore, the feature of surface texture detecting

the ability of the prosthetic hand can be satisfied by integrating

sensors and the mechanical links of the smart prosthetic hand

[54].

C.4 Surface material detection sensory system

Some information about the objects’ properties can be

recognized by the human brain depending on the visual

feedback, using different angles of view. On the other hand,

other properties can only be measured depending on the direct

contact methods, like the object’s material. Therefore, the

amputees must have alternative methods to obtain this

advantage in order to recognize the material properties. The

identification of the surface material types by direct contact

between the objects and the robotic hand was investigated [55],

in which the biomedical sensor was used to classify the object’s

materials into multi groups depending on the data collecting by

the contact accelerations sensor. Finally, the features of

different materials were classified into seven different groups,

based on the comparison of the smart robotic hand with a

healthy human hand.

The ability of the patient who wears the prosthetic hand,

especially who have undergone targeted nerve reinnervation

(TR) surgery, to recognize the martial hardness of the contact

objects was classified as the main challenge of the previous

studies [56-58]. The impact speed and acceleration of the finger

with different materials are primed to create a strong database

in future work, in order to use it as a scale for real-time

applications, as shown in Fig. 5. Due to the divergent waveform

features of different materials, the hardness of different objects

was identified depending on the acceleration’s rate change.

Thus, the acceleration recording signals can be translated to

patients as a feeling using a special electro tractor which is fixed

directly on the clavicle bone of the patient.

Fig. 5. Experimental setup for measuring contact acceleration data [56].

C.5 Temperature detection sensor system

Some of the major significant factors, which have a direct

effect on the humans’ daily living activities, are the temperature

of the contact objects and the heat transferred from it. The

human can recognize some of the grasped objects’ properties

depending on the changes of temperature and the heat flux

between the objects and the hand’s skin. For compensating the

sensation lack of the amputees, the prosthetic hand has to be

modified with the temperature sensors to recover the thermal



sensation.

Two types of wireless temperature sensors of types MICA2

and MICA2DOT were integrated to the Otto Bock prosthetic

hand [59], as described in Fig. 6. The purpose of this

modification is to prove that the patients of upper limb

amputation will be able to recognize the temperature ranges

during grasping objects, by using haptic prosthetic hand

equipped with the temperature sensory system. In addition, the

temperature feedback signals were considered as paramount

importance information that must be delivered to the amputees

to improve the prosthetic hand performance. On the other hand,

the effect of the increasing temperature in prosthetic hand on

the amputees’ comfort was studied to enhance the amputees’

quality of life [60].

Fig. 6. Wireless temperature sensors adding to Otto Bock prosthetic hand

[59].

C.6 Hybrid sensory system

Although lightweight and low power consumption are major

consideration during the designing and manufacturing of the

prosthetic hand, the tactile sensory system which consists of

multi-sensors type usage is increasing nowadays to provide the

amputees with the helpful perceptual feedback. The tactile

robotic glove is designed with multi number of interlink

electronics with 0.2 diameter and short tail FSR sensors to

detect the contact pressure, TC77 9 sensors for temperature

measurement, and the temperature and humidity silicon labs

Si7006-A10-IM1 6-Pin for sensing humidity which were used

as a hybrid tactile sensory system of the prosthetic hand [61].

The number of pressure, temperature, and humidity sensors are

assigned as 18, 9, and 6, respectively, connected to a flexible

printed circuit (FPC) board and mounted to the glove, as shown

in Fig. 7. Furthermore, the functionality of the hybrid thick film

piezoelectric sensor to measure the grasping force and

temperature in addition to the slippage detection were studied

as well [62].

At the same direction, a hybrid tactile sensory system was

designed to develop a new generation of haptic upper limb

prostheses to be used by amputees [63]. The hybrid system has

the ability to detect the contact pressure, vibration, and the

objects' temperature at the same time. The tactile information

has been generated by mean of four FSR pressure sensors, a

piezoelectric vibration sensor, and a digital temperature sensor.

The system was examined with five able-body volunteers and

the results show that a hybrid system leads to an increase in the

user’s ability to efficiently perform object recognition tasks.

Fig. 7. The components of hybrid tactile sensory glove [61].

Moreover, the d-arched hybrid Nanogenerator (NG)

vibration sensor was developed in minimum size for easier

integrating with other tactile devices like prostheses. The d-

arched hybrid consists of two main parts. The first part is a

piezoelectric NG that represents the upper layer of the sensor,

made from a 200 μm polarized PVDF film, while the second

part is the triboelectric NG which consists of the silicon rubber

membrane micro-patterned structures on the surface and

represents the lower layer of the d-arched sensor. The design

has the ability to measure the surface’s vibration by converting

the mechanical energy to an electrical energy with a real-time

self-power action due to the operational behaviour of the

sensor’s components, i.e. the piezoelectric NG and the

triboelectric NG [64].

D. Feedback stimulation system

As introduced in the previous section, the main function of

the sensory system is to measure and integrate the environment

parameters and convert it to a direct proportional electrical

signal. The main question on how to regenerate the sensation’s

signal and deliver it to the amputees’ brain will be presented in

this section. The feedback stimulation display is an electronic

or mechanical device design to form the sensing electro signals

to the kinesthetic sensation by activating the mechanoreceptors

under the skin of the patients’ residual parts. The non-invasive

feedback stimulation techniques are divided into seven displays

based on the method of excitation on the skin of the residual

parts.

D.1 Pressure feedback display

A pressure feedback display is commonly used to restore the



sense of touch and grasp to the users of the prostheses. The

haptic pressure feedback display transmits the sensory

information mechanically to the amputees, when fixed in

contact with any healthy part of the patient’s body like

fingertips of the second healthy hand, residual forearm, residual

upper arm, clavicle bone, foot, or abdomen. A miniature linear

actuator was designed, utilizing magnetorheological fluid [65-

67]. The main aim of these studies is to create a full pressure

feedback glove to recover the tactile feeling, depending on a

scientific phenomenon such that the fluid is capable to change

its viscosity when undergoing a magnetic field. The

experimental tests found out that, the actuator prototype has the

ability to generate 7.5 N applying force for 0.5 A reasonable

current. Additionally, it is suitable to be integrated with

artificial prostheses as a wearable haptic device. Thus, the

pneumatic actuation has the ability to present opportunities for

lightweight wearable haptic devices that provide distributed

haptic feedback stimulation to the patient's skin [68].

A wearable voice coil stimulation device which consists of

five actuators was mounted on the participants’ forearm as a

pressure feedback display [69]. Each actuator is a wire coil

spooled on a non-ferrous core and a neodymium magnet housed

in a plastic component distributing on the user's forearm. The

experimental results indicated that 86% of the volunteers were

acceptably locating a single stimulus, while the four stimulation

patterns detection test recorded 97% identification accuracy.

Finally, it can be clearly decided that the haptic pressure

feedback display has the ability to enhance the effectiveness of

the upper extremity prostheses during grasping objects. In

addition, it has the ability to increase the perceptibility and

acceptability of the prostheses' users [70].

D.2 Vibration feedback display

The principle of operating the vibration feedback display is

stimulating the patient’s skin by a mechanical vibration

excitation. The human’s sensation usually varies depending on

the amplitude and the frequency range of the feedback vibration

signals. The generating of both amplitude and frequency of the

feedback vibration were modulated on a small size, low cost,

and low power consumption vibrational motors [71-73]. The

small size of a flexible vibrational actuator enables it to be

easily integrated with the prostheses, in order to present an

effective feeling recovering sensation system.

Low-cost vibration motors are used as feedback actuators by

fixing it on the wrist and the elbow joints of the Apraxic stroke

patientsin order to help the patients to carry out a repetitive

joints functionality [74-76]. The vibration feedback stimulators

assisted the patients to track the medical rehabilitation

movements of the arm’s joints and reduce the movement’s

deviation due to the effect of using the feedback vibration on

the patients’ skin. On the other hand, several researchers studied

the increase in performance of the prosthetic hand while using

the vibrational feedback stimulation system [77-80].

Furthermore, the effect of the haptic actuator frequency on the

response of the volunteers was investigated [81-83].

In general, the installing location of the vibration feedback

actuators depend on the type and the level of amputation, nerves

density under the skin, and the size of the stimulation device.

The C2 vibration motor (from Engineering Acoustics, Inc.) was

mounted on the upper arm, the fingertip, and the foot of five

participants in a real-time and lack of vision experimental work

[84]. The main challenge of this study is to investigate what is

the best location to install the vibration actuator. The patient’s

foot was decided as a promising location for the vibrational

stimulator because the foot has the highest sensitivity to the

stimulation signals than the upper arm and the fingertip.

Furthermore, the patient’s shoe is an ideal container for the

power sources of the haptic system.

Finally, the functionality of using the haptic feedback system

to configure a virtual hand’s movement at invisible stat was

discussed, utilizing a waist belt which consists of four C2

vibrational actuators [85]. The ability of the vibrational belt to

stimulate the amputees when fixed around the waist has been

improved. In the same direction, a new method of

communicating movement sensations was offered through the

application of tactile apparent movement [86]. The study was

performed by overlapping vibration created by arrays of linear

resonant actuators. The effectiveness of the proposed haptic

device to communicate stimulations for up to three degrees of

actuation in a prosthetic is the main finding of this experimental

study.

D.3 Skin stretch feedback display

The skin stretch feedback display is a stimulator device

which has the ability to move and excite the external layer of

the amputees’ skin, in order to provide helpful information

about the amount and the direction of the tactile contact

pressure to the user of the prostheses [87]. A new wearable

haptic tactor, which is capable to deliver the sensation of

position and motion to the amputees, was presented by utilizing

free rotating contact points to stretch the patient’s skin [88-90].

A small size, lightweight, average torque, and the low noise

piezoelectric motor was used to create a new wearable skin

stretch device which has the ability to feedback the

environment’s information to the user at high accuracy level

and acceptable degree of comfort, as presented in Fig. 8. The

authors recommended that the wearable rotational skin stretch

actuator is a very effective stimulation device that can be

integrated with the Myoelectric prostheses, in order to enable

the amputees to use their prosthetic hands at the absence of a

real vision.

Fig. 8. The design assembly and the main dimensions of the wearable

rotational skin stretch actuator [90].



Four lightweight servomotors with a cylindrically shaped

end effector were utilized to fabricate a skin stretch feedback

stimulation device [91-93]. The main aim of the design is to

help the user in navigating the desired rotational and

translational of the forearm. The experimental tests concluded

that 90% of the participants were able to recognize the

navigation information at the fully comfortable and high

accuracy. On the other hand, a skin stretch wearable band was

designed to recover the normal force sensation [94]. The haptic

device consists of three mechanical cranks driven individually

by three servomotors to longitudinally stimulate the user's skin

based on the measuring tactile information. The evaluation tests

with 18 engaged healthy subjects show that 88% of the subjects

were able to successfully recognize six different grips. In

addition, the recognition accuracy reduced to 80% at the six

grips of two different pressure levels. In general, it can be

concluded that the skin stretch display is a viable option for

proprioceptive feedback lacking in robotic prosthetic hands

[95].

D.4 Squeeze feedback display

The lack of the feedback sensation is often classified as a

major impediment for the user of the prosthetic hand. Thus, the

squeeze feedback display can be one of the effective solutions

for this problem. The process of circumferential compression

on the amputees’ remaining limbs is the principle of the squeeze

stimulation feedback display. The effect of the axillary haptic

feedback stimulator on helping the amputees to control their

myoelectric hand was studied by designing a special squeeze

actuator [96]. A squeeze actuator was developed with a HITEC

HS – 485HB servo motor, 3D printed motor house, squeeze

band, and a contact pulley. Following from there, the stimulator

was tested with six non-amputees’ participants who are

required to evaluate the effectiveness of the squeeze stimulator.

During the grasping of an object, a high strength will lead to

the damage of the object, while too smooth force will lead to

the slippage of the object. A haptic wearable stimulator with a

single DC motor and two squeezing belts was designed and

evaluated, in order to control the grasp force of the prosthetic

hand within a suitable range and stable grasp [97]. The

advantage of the wearable actuators during the grasping objects

was proven by producing normal force frequencies of (1.5 – 5.0

Hz) approximate range, and slip speeds of (50 – 200 mm/sec).

D.5 Electro feedback display

The muscle electrical feedback display is one of the

successful methods for somatosensory feedback method to

convey the tactile information from the myoelectric prosthetic

hand to the patient of upper limb amputation [98-100].

Moreover, it has a prominent role in reducing the unnecessary

motor movements of the prosthetic hand and increase its

operation performance [101-103]. In addition, the electro

feedback display is frequently used in long-term user training

to enhance the control performance of the upper limb

prostheses[104].

A novel matrix electrode stimulator was mounted on the

forearm of eight healthy volunteers to realize the shape,

trajectory, and direction of different dynamic movements [105].

The subjects who wear the electro feedback display recognized

the object’s shape at a good performance (86 ± 8% single lines,

73 ± 13% geometries, and 72 ± 12% letters) and identified the

movement direction with an acceptable dependability.

Furthermore, two types of 16 circular shape multi-pad

(common anode configuration (CAC) and concentric electrode

configuration (CEC)) electrical feedback display were designed

[106, 107]. The programmable actuator and flexible electrodes

are the main design features of this novel electrical stimulator.

The experimental tests have been conducted with six amputees

and ten healthy participants during aperture, grasping force, and

wrist rotation activates. The results evidenced that the feedback

stimulation device is easy to use with a success rate of more

than 90 % in a short training time.

Lastly, the concentric stimulation electrodes have been used

to investigate the possibility equipping the prosthesis with

artificial cutaneous sensing through an electronic skin [108-

110]. The result indicates the probability of achieving the

embodiment of the artificial skin into the body scheme of the

human subject. This outcome depends on the brain ability to

successfully process the artificial tactile information.

D.6 Thermal feedback display

The thermal feedback display is a method of conveying the

thermal information of the grasping objects to the amputees of

upper limb mutilation. Thus, the amputees will be able to

recognize multi-information about the surfaces and bodies by

depending on the difference in temperatures and the heat flux

between the objects and the tactile prosthetic hand. Indeed,

there are different geometrical properties of each material such

as heat capacity and thermal conductivity that affect directly on

the thermal feeling. For example, a healthy human can

distinguish between two objects of different material located in

the same environment, i.e. have the same temperature [111,

112]. Therefore, this type of the haptic display is called thermal

feedback display not temperature feedback display because the

feeling depends on the entire object’s thermal properties not

only on its temperature degree.

A novel thermal feedback display for transient heat rendering

in virtual environments was developed in the previous studies

[113, 114]. The main objective of the miniature haptic device is

to convey the tactile thermal information in a high level of

performance. The haptic device is designed to be installed on

the user's fingertip and generate the heat flux by mean of two

Peltier elements. The evaluation results show that the proposed

thermal feedback stimulation device was stable during

temperature tracking. In addition, the device appeared to be of

a good performance in terms of settling time and response to

external disturbances.

The main issue of the Peltier element is a high response time

during changing its surfaces from warm state to the cool state

or vice versa [115, 116]. Therefore, four Peltier devices have

been arranged in a matrix form. Thus, the elements were



configurated to enable rapid temporal change of temperature,

because each of two opposite elements was programmed to

work independently, two elements for cooling the skin and the

other two elements utilized for the warming sensation. Two

thermistor temperature sensors were used to build a feedback

control loop, in order to control the temperature of the Peltier

elements and inhibit too much cooling and warming during

thermal feedback. The recognition time of variation of

temperature was improved 36% on average more than using one

Peltier element.

Finally, a novel thermo-tactile multimodal display was

designed [117]. The haptic device consists of a Peltier cell with

two heat exchangers attached on its sides, in order to cool down

and warm up the water and collect it in two separated

containers. Thus, the warm and cool water was pumped to the

haptic device and mixed together in different proportions to

convey the required thermal sensation to the skin of the user.

The device is designed to provide temperature sensation in a

range of 20°C to 40°C. Consequently, the evaluation results

concluded that the design conception of the haptic device with

very high-temperature variations response allows it to simulate

the contact with many bodies found in our daily environment.

D.7 Hybrid feedback display

Several previous studies investigated on how to use the

simultaneous application of two or more different types of

haptic feedback to impact on the human sensory perception,

where such system is called the hybrid feedback stimulation

system. It has been performed to prove that the hybrid system

has a performance higher than each of the separated feedback

type [118]. For example, gathering the squeeze and the skin

stretch feedback displays [119] or the pressure and the skin

stretch feedback displays [120, 121], in order to smoothly

convey the feeling of the contact pressure to the patient’s brain

during grasping the objects.

A novel approach comprising of hybrid vibro-electrotactile

(HyVE) combined stimulation has been designed in the

previous studies [122, 123]. The main principle of the haptic

device is to stimulate the patient's nervous system with a multi-

mode of excitation by mean of vibrotactile or electrotactile

feedback displays. The vibrotactile or electrotactile actuators

are placed one on top of the other and fixed on the participants'

forearm. The results show that multiple HyVE units are able to

convey multi-channel tactile information with equivalent

performance (~ 95% for single stimuli and ~ 80% for pattern).

The results proved the superiority of the hybrid feedback

system than the individual system. For instance, the

participants' average stimulation accuracy reduced to 73% for

single stimuli and 69% for the pattern when depended on just

vibration stimulator. Therefore, it can be concluded that the

companion of the vibration and electro feedback displays have

high potential to provide the lack of the sensation to the users

of the upper limb prostheses [124].

A novel small size, lightweight, low power consumption

preliminary prototype of a hybrid feedback device has been

designed [125]. A new multi-model haptic device consists of

pressure and vibration feedback stimulators to provide useful

tactile information to the users of prosthetic hand about the

grasping force and the contact pressure, respectively. The

validation tests evidence that the hybrid haptic device has an

acceptable design and preparedness for future experiment tests

with the amputee’s volunteers.

On the other hand, the researches that focused on the

comparisons between two or more types of simulators can be

classified under the hybrid feedback display. The comparisons

have been done to identify which is the best stimulator capable

to help the amputees to recover the normal sensation. Fifteen

participants (fourteen males and one female) were engaged in

an investigation study to evaluate two types of vibration

stimulation display [126]. The linear resonant actuator (LRA)

was used as a first stimulation device, while the eccentric

rotating mass (ERM) was utilized as the second stimulator, with

each actuator possessing nine exciting points mounted on the

participant’s upper arm. It was concluded that the LRA actuator

is more useful than ERM, depending on the binary information

and power consumption points of view. On the other hand, the

ERM can be utilized to handover the complex signals.

A new comparison between the vibration and skin stretch

feedback display has been experimentally studied with a virtual

contact force between the virtual arm and the object [127]. A

C2 Tactor and a bench top skin stretch device were used to

present the vibration and skin stretch actuators, respectively.

The result concluded that the functionality of the skin stretch

feedback stimulator was better than the vibration stimulator,

especially when the skin stretch actuators were used with virtual

environments and in motion training for rehabilitation or sports.

In the same field area, the design of both mechano-tactile and

vibro-tactile actuator was presented using lightweight, small

size, and power efficient rotary and linear servomotors [128].

E. Tactile-haptic completely feedback stimulation system

Many previous studies focused on the significance of

realizing intuitive operation for the upper limb amputees when

utilizing the haptic prosthetic hand. The main challenges of the

traditional prosthetic hand like exaggeration grasping force and

loss enough training time have been solved by using the haptic

prosthetic hand with a suitable feedback stimulation system.

Many normal daily-activities like the sensing of the touch, the

touch position, the start and the end of the touch, the contact

force range, the surface temperature, roughness and texture,

become possible to be recognized by amputees when using the

haptic prosthetic hand. In this section, the previous studies

dealing with the completely haptic system (sensory system,

feedback stimulation system, and the interfacing system) will

be discussed to understand the operation’s behavior of the

tactile prosthetic hand. The articles were classified depending

on the type of the feedback stimulator used in each article,

regardless of the type and the distribution of the tactile sensory

system.



E.1 Sensory system with pressure feedback display

The main purpose of studying this type of the haptic feedback

simulation system is to demonstrate the functionality of an

inexpensive mechanic tactile sensory feedback system for the

artificial upper limb prostheses [129]. A new tactile technique

that enables a healthy human hand to sense and recognize the

amount of the contact force on the other prosthetic hand was

developed [130]. A 10 mm diameter, piezoresistive sensors of

0-110 N working range was used to detect both the static and

dynamic pressures applied on the fingertip. The pressure

sensors were fixed on the participants’ healthy hand by using a

complete glove-based master-slave tactile feedback system, as

shown in Fig. 9. The sensor signals are delivered by the

Bluetooth transmission module (Roving Networks RN-800S) to

the controller, in order to process it and manipulate the

command signals to drive the silicone-based pneumatically

controlled balloon actuators. The balloon actuators were

designed to apply an amount of pressure on the healthy fingertip

according to the value of the measured pressure at the sensory

system.

Fig. 9. Force sensory system with pressure feedback display: a) tactile

glove with piezoresistive force sensors in each fingertip, and b) Silicone-based

pneumatically controlled balloon stimulator on each fingertip [130].

Another design technique of a pressure wearable haptic

device was performed by using a twisting wire actuator to

convert the rotational motor movement to linear pressing

movement [131]. The main objective of the study is to supply

pressure on the patient’s forearm that is proportional to the

contact pressure measured by a linear Hall Effect force sensor

of type (SS495) placed under a force test stand (Mark-1 ES20).

In the same study field, a master foot interface with rotary

motors were used to transfer the tactile information of the

grasping force to a pressure stimulus [132, 133]. The device is

capable in pressing the foot’s big toe, in order to create a

flexible adaptation with the object's shape during grasping

objects.

The previous articles demonstrated that it is possible to

transfer the tactile sensory information from an artificial hand

to the amputees' brain by vertically deforming the skin of their

residual parts [134]. In addition, in sequential days of training

with the haptic stimulation devices, the ability of the

participants to perception the tactile sensory input will be

increased [135].

E.2 Sensory system with vibration feedback display

Several previous studies investigate whether adding

vibration feedback to myoelectric upper limb prostheses, when

visual feedback is disturbed, can improve its performance

during a functional test [136, 137]. These investigations are

highly required to demonstrate the effectiveness of the vibration

feedback display for prosthetic control in daily life conditions

[138]. In addition, it can be used to reduce grasp failures [139]

and prevent slipping objects [140] which leads to increase the

amputees' confidence in the haptic feedback device.

The haptic feedback stimulation system consists of FSR

pressure sensor, 3D printer prosthetic hand, and 8 - 12 mm

diameter range vibration coin motors stimulators was

developed [141]. The main aim of the work is to enable the

amputees to recover the touching sensation with a suitable

response while holding and relaxing objects in a convenience

methodology. A stimulation sequence is used to make the

amputees to interact with the environment comfortably. The

sequences were programmed as high vibration during 0.5 sec at

the instant of grasping and relaxing the objects and periodically

excitation in between to provide the user with the sense that the

user is continuing to hold the object, as described in Fig. 10

during holding the empty bottle.

Fig. 10. The stimulation response during holding the empty bottle [141].



The availability of using tactile force sensors (310 - 101

series, Precision Microdrives UK) and the two distinct

miniature haptic vibration display on muscle rehabilitation in

higher efficiency with nine volunteers amputees was proved

[142]. The specifications of these instruments such as low cost,

lightweight, little size, and low power consumption suggested

its suitability for re-sensation and rehabilitation applications. A

piezoelectric sensor mounted on a Southampton Robot Hand’s

fingertip and vibrational eccentric rotation mass (ERM) motor

with a data acquisition board of type NIDAQPad-6016 were

connected together, in order to develop a haptic feedback

stimulation system, which was capable to detect the surface

texture and feedback the surface properties to the patient’s brain

[143]. The effect of the training period to increase the

volunteers’ response when using the haptic vibration feedback

stimulator was investigated [144]. With 21 volunteers engaged

in this work, it was found that the ability of the participants in

detecting the surface texture was improved from 64% to 80%

between the first and the fourth weeks of training, respectively.

E.3 Sensory system with skin stretch feedback display

The ability of the amputees to control their prostheses using

skin stretch feedback display without high and continuous

visual attention was evaluated [145]. The Pisa/IIT Soft Hand

was modified with Rice Haptic Rocker skin stretch stimulator

driven by a servo motor (Futaba S3154), in order to feedback

the tactile sensory information to the brain by stretching the

skin of the upper residual arm, as presented in Fig. 11. The

modified haptic system was experimentally tested to

discriminate the size of different spherical balls. The results

showed that the healthy volunteers were capable to successfully

distinguish between the spherical balls of different sizes with

an average accuracy of 73.3 ± 11.2%.

Fig. 11. Skin stretch feedback display: a) CAD assembly. b) The skin

stretch actuator fixed on the patient’s upper limb [145].

E.4 Sensory system with squeeze feedback display

The main idea of this type of haptic feedback system is

usually to measure the grasping force applied on the fingertips

of the prosthetic hand and transfers it to a sensible deformation

on the patient’s skin [146]. During this study, the skin

deformation happened by tightening the patient's upper arm,

while the winding force was generated due to the use of a

rectangular belt rounded over the arm and driven by a DC

motor.

A fabric-based haptic actuator was utilized as a squeeze

feedback display to stimulate the patient’s forearm. The

wearable device is designed to move forward and backward to

excite the human caress [147]. The actuator consists of (60 mm

x 160 mm) rectangular-shaped elastic fabric and two motors

(HITEC digital DC servo motor HS-7954 H with an input

voltage of 7.4 V). The velocity and the strength of the squeeze

force applied on the participant’s forearm can be adjusted by

controlling the movement velocity and the strength of the

elastic fabric belt.

On the other hand, the comparison between the native hand

and the prosthetic hand dealing with grasping and sliding

objects was investigated [148, 149]. The Clenching Upper-limb

Force Feedback device (CUFF) blended with the Soft Hand Pro

(SHP) was used to grasp and lift objects of different weights.

The CUFF wearable stimulator was capable to squeeze the

user’s upper arm by generating normal and tangential forces

related to the grasping and relaxing objects, respectively. The

squeeze forces are generated by utilizing an elastic belt driven

by a Maxon DCX16S motor. The researchers experimentally

proved that the native hand used lower force and energy than

the CUFF and SHF. However, the functionality of SHF

equipped with CUFF wearable squeeze actuator was verified.

E.5 Sensory system with electro feedback display

Several researchers believe that the electro feedback display

is an effective technique to face the challenge of restoring

sensory function from prosthetic hand to amputees [150, 151].

The electro feedback display is preferred compare to other

feedback stimulator types because it has advantages such as

lightweight, no electro-mechanical part or moving parts, and

low cost, in addition to its ability to provide a wide verity of

sensation in a short time [152]. The TENS electrodes stimulator

with a vibration sensor as a sensory system were used to detect

the surface texture of different surfaces (smooth plastic, bonded

sand, rice, and matchsticks), as shown in Fig. 12. The rotational

platter was utilized in order to enable the vibration sensor to

slide over the four different surfaces. The experimental study

with five healthy participants found that 100 % of the engaged

volunteers were capable to sort the surface texture correctly,

while 75 % of them were able to recognize the applied pressure

[152].

Fig. 12. The different surfaces texture arranged on the rotational platter

[152].



On the other hand, 8 x 2 rectangular electrode arrays were

used to stimulate the forearm of the prosthetic hand’s user after

receiving the touch information from an artificial electro skin

array which consists of a piezoelectric polymer sheet, called

Polyvynilidene Fluoride (PVDF) of (50 Pa - 1 MPa) sensing

pressure range [153]. Furthermore, a transcutaneous electrical

stimulation actuator was used to modify the performance of the

artificial neural network myoelectric prosthetic hand [154]. The

tickling, pressure, and pain sensation were tested with this kind

of feedback system in order to identify the ability of the

stimulation system to regenerate the senses and provide it to the

user’s brain.

Finally, the electro-tactile feedback comprised with a

programmable multichannel stimulation unit (MaxSens,

Tecnalia, ES) and a flexible multi-pad electrode with a

Bluetooth connection was utilized to study the effect of training

on the performance of the prosthetic hand when the multi-pad

electrode was fixed around the forearm of twenty volunteers

[155] and nine amputees [156]. The investigation study

concluded that the feedback electrode stimulator increased the

feedforward control’s performance of the myoelectric

prosthetic hand during grasping objects.

E.6 Sensory system with thermal feedback display

An extensive study associated with helping the amputees to

recover the thermal sensation in high response and perfect

accuracy was presented by the authors in [157, 158]. The main

objective of this study was to restore the thermal sensation by

using low price equipment and solving its technical problems.

First, the low response problem of the K-type (AD-1214)

thermocouple temperature sensor was solved by proposing a

new temperature prediction algorithm technique. Thus, the

temperature can be estimated in a few seconds. Second, the

thermocouple temperature sensor with the temperature

prediction algorithm technique was used to control the

temperature of the rectangular Peltier element, which is a

semiconductor device with two faces, competent to transfer

heat flux from one side to the other. Consequently, the

instability behavior of the Peltier element, especially when the

operation time exceeds 5 sec, was disbanded. The evaluation

experiment of the thermal feedback stimulation device has been

prepared with ten healthy volunteers, myoelectric prosthetic

hand, and five levels of temperature variations which are: hot

(approximately 40 ℃), lukewarm (approximately 35 ℃), not

much (25 ℃-30 ℃), a little cold (approximately 20 ℃), and

cold (approximately 15 ℃). The temperature distinction

evaluation tests for ten participants present that the average

success rate is 88% for all the volunteers and 80% for each one.

E.7 Sensory system with hybrid feedback display

The ability of amputees to discriminate multi-site tactile

stimuli in sensory refinement tasks was studied [159]. The

study was performed by facing two main challenges. The first

challenge was to transfer the pressure sensing from each finger

to the amputee as a pressure stimulation on his residual forearm;

known as multi-site mechano-tactile (MT) display. The second

challenge was to convert the pressure sensing to the vibration

feedback stimulation; known as multi-site vibro-tactile (VT)

display. The results verified that there is no significant

difference in the performance of the MT feedback and VT

feedback, however, there exists a simple superior in preference

of MT system over VT system. This conclusion was built on the

fact that, the volunteer who has a good response due to MT

system also has high stimulation level when excited with VT

system. The prosthetic hand equipped with force sensors on

each fingertip are presented in Fig. 13.a, while the VT and MT

displays are shown in the Fig. 13.b and Fig. 13.c, respectively.

A complete haptic feedback stimulation system for upper

limb prostheses was developed, in order to study the

effectiveness of using two different types of vibration feedback

displays [5]. The proposed haptic system consists of three main

parts: the sensory part, interfacing part, and stimulator part.

Five piezoelectric barometric force sensors (MPL115A2 from

NXP) were attached to each prosthetic fingertip covered by a

single layer of silicone to fabricate the first part of the system.

Meanwhile, the second part formed the data communication

system between the sensory and stimulator parts, presented by

Bluetooth low energy (BLE) communication modules

(CC2640R2F, Texas Instrument). Finally, the third part is the

stimulation system, in fact, it is a hybrid system which consists

of two arrays of the vibro-tactile stimulators. The two arrays are

the tubular eccentric rotating mass (ERM) vibrator (Ineed

Technology) and mechano-tactile stimulation linear resonant

actuators (LRA) utilizing two DC servomotors (Spektrum) to

generate the excitation effect. The feedback information

generated by the tactile sensors was transferred to the computer

control unit by a multiplexer into a package. The experimental

results manifested that the hybrid feedback stimulation system

which consists of two types of stimulation systems (ERM and

LRA) is more effective than other system which depends on just

one type of vibration excitation.

Another study gathered two types of the haptic feedback

displays, pressure, and vibrational actuators, to provide the

amputees the sensing ability for the grasping force and the

slippage at the same operating time [160]. The haptic wearable

device is designed with two displays: pressure and vibration.

Three mechano-tactile unit equipped with a servo Turnigy

TGY-210DMH Coreless of nominal torque reaching up to

382.2 N.mm were used as the pressure display to detect the

grasping force, while one vibration motor for the slippage

representing the vibration feedback display. On the other hand,

three force sensors (Flexiforce A301 from American company

Interlink Electronics) with operating range from (0 – 100 N)

and one slip sensor (SR-D-15 from Japanese company Inaba

Rubber) were used to measure the environmental parameters.

The ability of the amputees to recover the feeling of the

grasping force and the object slippage, in addition to the surface

texture detection were studied [161]. To realize the idea, three

sensor types, and two haptic feedback stimulators were

developed as a hybrid system. The first actuator squeezes the

user’s upper arm due to the grasping force action by using a

custom pressure CUFF. Meanwhile the second haptic device



provides information about the surface texture and the slippage

utilizing vibrational feedback actuators.

Fig. 13. The MT and VT displays on the prosthetic hand: a) the

experimental setup during the mechano-tactile experiments, b) Miniaturized

vibrators actuators, and c) digital servomotors mechanical actuator [159].

Finally, the benefit of using the hybrid feedback stimulation

system with the prosthetic hand was investigated [162]. The

study focused on restoring the sensation of force, vibration, and

thermal together at the same time. A BicTac multi-function

sensor was fixed on the fingertip of a custom prosthetic hand to

measure the contact force, the surface texture, and the object's

temperature. While for the multi-feedback display, a series of

pneumatic air muscles (30 mm Air Muscle, Shadow Robot

Company), tactor (C2, EAI), and a Peltier element (MCPF-031-

10-25) were utilized to present the grasp force, surface texture,

and temperature, respectively. A DAQ card (NI-USB 6218) and

Analog Output card (NI-PCI-6722) were used to connect the

sensory system with the stimulation system in addition to

collect and analyze the sensory data.

IV. DISCUSSION

This review presents the pertinent studies on state-of-the-art

of haptic upper limb prostheses. The objective of this

investigation is to highlight the research trends in this field of

study. Developing a taxonomy of the literature in a research

area, particularly an emerging one, can provide several benefits.

Firstly, a taxonomy of the previous studies systematizes

different publications. New researchers who aim to study the

ability to help the amputees to recover the feeling through their

haptic upper limb prostheses may be confused by the huge

number of articles dealing with this title. Thus, they may be

unsuccessful to gain an overview in this area. On the other hand,

a taxonomy can reveal gaps in research. Charting the literature

on haptic upper limb prostheses into separate categories

highlights the limitations and strong features in the expression

of research coverage. For example, the taxonomy in this work

shows different class and subclass classification, the

combination between two or more subclasses in the same class

or with another class leads to the new direction of study, thus

developing the study in this field.

The survey was directed to seven aspects of the literature

content: the domain and the direction of the previous studies,

the research progress over the years, the electronic instruments

used to develop the haptic feedback stimulation prostheses, the

setup position of the sensory and feedback stimulation systems,

the subject in previous, the types of the hand during the

experimental tests, the challenges to the effective employment

of these technologies, and the future direction of this study.

A. The domain of the previous studies

Several previous studies contribute to the development in the

field of haptic prosthetic hand and its application in the smart

health and bioengineering. The domain of these studies was

classified clearly in Fig. 14, by identifying the number of

articles in each domain of study related to the smart haptic

upper limb prostheses and helping the amputees to recover the

sensation. Some of the papers focused on the development of

the tactile sensory systems, while the other papers dealt with the

feedback stimulation displays. In addition, some of the articles

also dealt with the completely haptic-tactile feedback system.

Understanding the categories and the number of articles per

each category leads to opening the way for new research in the

development of this field of study.

Fig. 14. Number of studies per application domain.

5

2

7

4

1

9

7

11

7

13

2

9

16

6

4

2

4

12

11

11

5

11

0 2 4 6 8 10 12 14 16 18

Sensory system with hybrid feedback display

Sensory system with thermal feedback display

Sensory system with electro feedback display

Sensory system with squeeze feedback display

Sensory system with skin stretch feedback display

Sensory system with vibration feedback display

Sensory system with pressure feedback display

Hybrid feedback display

Thermal feedback display

Electro feedback display

Squeeze feedback display

Skin stretch feedback display

Vibration feedback display

Pressure feedback display

Hybrid sensory system

Temperature detection sensory system

Surface material detection sensory system

Surface texture detection sensory system

Slip detection sensory system

Contact pressure sensory system

Demands of feedback stimulation system

Review

Number of previous studies

Dom

ain

of

study



B. The research progress over the years

The number of articles included in the five categories, which

are presented in the previous section, according to years of

publication is indicated in Fig. 15. The distribution of 159 final

set articles from 2007 to 2018 was described. The distribution

shows that seven articles were published in 2007 and this

number has gradually increased to 26 articles in 2018, where

the largest number of publication was satisfied. While for the

rest of the years between 2007 to 2018, it recorded the lowest

rate of publication between the years from 2008 to 2012, which

is around 7.2 articles per year, on average. This ratio has

uncommonly increased to 18 articles per year in the years from

2013 to 2017. This remarkable increase in the rate and number

of publications as the years’ progress indicates the importance

and the novelty of this research field. These studies are a real

beginning for the development of the haptic upper limb

prostheses area in the near future.

In addition, Fig. 15 describes the distribution of the articles

that focused on the hybrid system over the years of publication.

The figure shows that, approximately, this type of study has

only appeared in the last few years at a low publication rate.

Accordantly, it can be conclude that the non-invasive hybrid

feedback stimulation system is the latest known search area and

represents the further direction of the non-invasive feedback

stimulation techniques.

C. The instruments used in designing the haptic prosthetic

hand

The types of sensors, feedback stimulation actuators, and the

interfacing boards used in the previous studies were collected.

Furthermore, the categories and the installing positions of the

sensors and actuators were highlighted, depending on the

location and the function of the sensory and feedback

stimulation systems.

Fig. 15. Number of included articles by year of publication.

In general, the instruments used in the designing and

manufacturing of the haptic prosthetic hand should possess

specific properties, like high sensitivity [23, 48], low power

consumption [142, 162], high response [131, 132], and

acceptable accuracy [5, 159]. Moreover, the instruments used

have to be selected with a lightweight [96, 126] and miniature

size [74, 76] to achieve the complete comfort of the user while

performing its function.

The haptic upper limb prostheses need to have the lowest

production cost (a result of using instruments of low price ) [49,

141]. For marketing purpose, it should be available in the

market for the users at any time [132] or can be easily requested

as a special order depending on the patient’s amputation level.

D. The setup position of the sensory and feedback

stimulation systems

Various setup positions for the sensory and feedback

stimulation systems were chosen in several investigations and

experimental studies. This is to identify which are the better

positions for the sensors and actuators when using it with the

haptic upper limb prostheses. Moreover, it is impossible to set

one position for sensors and stimulators as stated in the previous

studies, because the decision about the final setup position of

the instruments depends mainly on the level of amputation.

Fig. 16.a shows the percentage of the sensor setup positions

in 143 previous studies. It is easy to note that there are 38

articles (27%) studied the performance of the tactile sensor

mounted on one prosthetic fingertip, 26 articles (18%) used

several sensors (more than two sensors depending on the design

of the prosthetic hand and the number of its fingers), with one

or more sensors for each finger. Furthermore, only 8 articles

(6%) designed the tactile hands with its sensory systems as near

as possible to the normal real hand by using various techniques

to cover all the prosthetic hand by the tactile sensors. This type

of design leads to the development of a tactile hand which is

capable to measure the contact pressure when the touch occurs

at any position through the hand. Another 6 articles (4%)

evaluate the sensory system by using only the sensors itself

without any prosthetic or real hand for testing. Finally, 65

articles (45%) studied the performance of the feedback

stimulation system alone without including the sensory system

in the practical aspect of the study.

The used positions of the wearable feedback stimulation

devices for 143 articles is described in Fig. 16.b. Most of the

previous studies have chosen the forearm (49 articles, 34%) and

the upper arm (31 articles, 22%) as favorite positions to install

the stimulation devices. The main reasoning of this relatively

high rate is that the original nerves of the missing hand are

concentrated and passed through these positions, and thus

enables the amputees to recover the feeling as real as possible.

On the other side, 14 articles (10%) decided to choose the

fingertip of the healthy hand as an installation position of the

feedback actuates. In order to convey the tactile information to

the user’s brain but from the other side of the nervous system,

i.e. stimulate the nervous system of the second healthy arm.

This type of setup position is suitable for the amputees who lost

only one hand. Moreover, further groups of researchers (9

articles, 6%) nominated other positions like the amputee’s foot,

the clavicle bone, waist, and neck to investigate different

stimulators positions to feedback the information of the tactile

sensors to the amputees’ brain. Finally, 40 articles (28%)

7

4 4

87

1311

17

20

25

17

26

1 10 0 0

1 1

5

0

4 43

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Nu

mb

er o

f p

revio

us

arti

cles

Years of publication

All Catogaries. Only the hybrid studies.



studied the development of the sensory system individually

without providing feedback of the sensory signals to the

subjects’ nervous system.

Fig. 16. Percentage of sensors and actuators setup positions: a) using

sensors positions, and b) using actuators positions.

E. The subject in the previous studies

The percentage of the subjects classified according to the

types and numbers of the participants in addition to the usage

testing hand from 143 previous articles is presented in this

section. Fig. 17.a describes an indication about the available

types of hand in conducting the experimental tests in the haptic

prostheses development. It can be noted that 40 articles (28%)

fixed the tactile sensors or the haptic feedback system on the

real hand of the healthy volunteers. The main reason for this

high ratio is to focus on the development of the haptic feedback

stimulation system alone, therefore, using a prosthetic hand was

not very important. Moreover, 44 articles (31%) examined the

tactile system at the typical experimental environment by

testing it with a prosthetic or robotic hand. This is to evaluate

the entire system at the same time and to study the effect of

using the tactile system on the prosthetic hand’s performance

on the aspects of response, accuracy, applying force and the

power consumption. Lastly, 59 articles (41%) evaluated the

tactile sensors by using it individually without any hand. For

instance, fixing the tactile sensors on the table, flat surface, or

round surface which is similar to the rounding of the human’s

fingertip.

The types and the numbers of the subjects that volunteered in

the previous experimental works are described in Fig. 17.b.

Depending on the previous articles, healthy volunteers recorded

the highest level of the participants in 79 articles (55%) for two

major reasons. The first reason is, exciting the human’s nervous

system is the main goal of the experimental testing, hence, it is

not very important to use amputees’ volunteers. While the

second reason is the difficulty to get amputees at any time or

place. On the other hand, 18 articles (13%) involved amputees

during the experimental tests, where they performed the tests

with a prosthetic hand like a myoelectric hand. Next group (11

articles, 8%) used both types of participants, the healthy and the

amputee volunteers in the same study, in order to investigate

the difference in the response between the healthy and the

amputee subjects. Moreover, sometimes the number of the

amputees’ volunteers is not enough to complete the subjects’

number. Therefore, the healthy volunteers could be used.

Finally, 35 articles (24%) worked on evaluating, designing,

stress analysis, or just preparing the first step of their projects,

therefore, no volunteers were involved in their study.

It is important to highlight that, there is no mathematical or

experimental rules to judge the number of volunteers engaged

in each previous study. By obtaining the minimum and

maximum number of the volunteers for each group (i.e. healthy

volunteers, amputees’ volunteers, and the healthy and amputees

volunteers), the acceptable range of the engaging volunteers is

concluded in Table 2.1, as a suitable guide for future work.

Fig. 17. Subject of the previous studies:

a) type of the used hands, and b) type of the tested volunteers.

One fingertip,

38, 27%

Each fingertip,

26, 18%

Cover all the hand,

8, 6%

Sensors without hand,

6, 4%

No sensor,

65, 45%

(a)

Forearm,

49, 34%

Upper arm,

31, 22%Fingertip,

14, 10%

Other positions,

9, 6%

No actuator,

40, 28%

(b)

Healthy hand,

40, 28%

Robotic hand,

44, 31%

No hand,

59, 41%

(a)

Healthy volunteers,

79, 55%

Amputee volunteers,

18, 13%

Healthy and

Amputee

volunteers,

11, 8%

No volunteers,

35, 24%

(b)



TABLE I

The acceptable number range of the engaging volunteers.

Type of volunteers Minimum number Maximum number

Healthy volunteers

1 volunteers used

in references [26, 27,

29, 43, 56-58, 65, 74,

76]

28 volunteers used

in reference [87]

Amputees

volunteers

1 volunteers used

in references [25, 129,

132, 133, 148, 149,

162]

9 volunteers used

in references [142,

156]

Healthy and

amputee volunteers

7 volunteers used

in reference [102,

141]

17 volunteers used

in reference [100]

F. Challenges

In general, the main challenges faced by the researchers in

this field is how to restore the feeling to the amputees using

alternative haptic upper limb prostheses. To accelerate the

progress on sundry aspects of this field of development, several

researchers developed the sensory system alone without

feedback stimulation system, based on highly sensitive sensors

to detect the touch and grasp force [22-32], slipping the grasped

objects [33-43], the surface texture depending on the vibrational

frequencies of the surfaces [2, 44-54], the object’s material

relied on the impact test and the test’s history saved on special

databases [55-58], and the temperature of the grasped or

touched objects [59, 60]. Meanwhile other previous studies

focused on how to increase the sensing performance by using

multi types of sensors at the same time as a hybrid sensory

system, in order to enable the amputees to detect various

variables at the touch or grasp as close as possible to the

performance of the real healthy hand [61-64].

At the opposite side, other articles faced the challenges of

dealing with improving the performance and the accuracy of the

feedback stimulation actuators, depending on the methods of

the skin’s excitation or how to pass the sensing signals to the

amputees’ brain in a faster and clearer way. The challenges of

designing and developing wearable stimulation devices

depending on the pressure display [65-70], vibration display

[71-86], skin stretch display [87-95], squeeze display [96, 97],

electro display [98-110] , and thermal display [111-117] were

faced in order to reach to the optimal feedback stimulation

actuators. Dealing with the optimization point, the researchers

made comparisons between two or more types of excitation

stimulators [118-128].

The other articles confronted with the next level of

challenges dealing with designing, developing, and experiment

testing the completely haptic feedback stimulation system by

gathering the sensory system and the feedback stimulation

system with a suitable interfacing microcontroller board, in

order to simulate the functionality of the haptic upper limb

prostheses [129-158]. The complex and modern challenges by

using multi types of haptic system [5, 159], or hybrid haptic

system [160, 162] at the same operation time were faced, in

order to evaluate the benefits and performance in conscious

perception of amputees, and try to reduce the confusion that

occurs on the patients’ brain when getting a large amount of

information at the same time.

However, secondary challenges were fought by researchers

for developing the haptic upper limb prostheses, like using a

twisting wire actuator to convert the rotational motor movement

to linear press skin displacement [131], achieve an adaptation

to the shape of objects during grasping operating with the haptic

prosthetic hand [132, 133], the effect of the amount of training

on the response of the prostheses’ users [88], and designing a

comfortable lightweight wearable feedback device [148, 149].

G. Future direction

The state-of-art and the future direction of the research and

development on the haptic upper limb prostheses, depending on

the previous studies and the authors’ point of view are

suggested as follows:

For smart health direction, the haptic prosthetic hand should

connect to the care centre and the designer’s monitoring servers

as an Internet of Think (IoT) [16] or Visible Light

Communication (VLC) utilizing same IP address (Internet

Protocol) to share the prosthetic’s performance data and the

tactile information directly to the cloud, in order to:

Collect, analyse, and monitor the data streams as fast as

possible with higher accuracy.

Enable the patient’s doctor and the prosthetic’s designer to

support the user at the abnormal operating cases instantly.

Modifying new training methods to increase the adaptability

of the user with his prostheses is another direction to be

pursued. Generally, the prosthetic hand’s user must have

programming hours of training depending on virtual sensing

signals providing from the designer to the user directly by the

cloud and the IoT servers.

The haptic feedback stimulation system must get a user

psychophysical evaluation in order to recognize the

psychological impact of the haptic system on the patients. In

addition, to study to what extent the community will accept this

new smart technology.

Provide the feeling of touch, level of touch, slippage, surface

texture, surface material, and temperature to the amputees at the

same operation time (hybrid tactile system) [131] and modify

the haptic system to examine the feasibility of recognizing the

complex object’s shape like a thin or geometrical shape [153].

The haptic sensory system has to design as a complete

sensory glove to detect the touch and other parameters at any

spot over the tactile hand [147].

Minimizing the size of the haptic wearable stimulation

device as much as possible and decreasing its power

consumption [5], lead to the production of an alternative low-

cost, smart prosthetic hand [161].

Performed the daily normal human's tasks with the

experimental test of the haptic stimulation system to create an

experimental environment as close as possible to reality [132,

133].



H. Limitations of the study

The first limitation of the study deals with the databases that

used in the searching stage. Some of an important database like

a Web of Science didn’t include because the own educational

institution does not have the permission access to this database.

Second, the limitation related to the short investigation schedule

time. Third, the quick progress in this field of the study limits

the timeliness of the survey.

V. CONCLUSIONS

The review of using non-invasive haptic feedback

stimulation system with the upper limb prostheses during

touching or grasping objects was studied in this work. The

haptic system was classified into three main parts: a tactile

sensory system for detecting the external environment, a haptic

feedback stimulation system for recovering the sensation to the

amputees’ brain, and the interfacing system with the computer

or any monitor system. The previous works in this field of study

were reviewed in order to present the contribution of each

article on the development of the haptic upper limb prostheses.

The domain of study in all previous works was summarized and

the research gaps that could be addressed in subsequent studies

were identified. Likewise, the novelty of this field of study has

been demonstrated by extracting the increasing published

research during the last twelve years. Moreover, the electronic

and the mechanical instruments that used in the experimental

tests of the previous studies and the installing position for each

instrument were highlighted.

After extensive study of the previous research in the field of

the haptic system of the upper limb prostheses and its

subsystems, it is possible to conclude that, there is possibility to

study the performance of each subsystem separately with

healthy volunteers, amputees’ volunteers, or with both groups

of volunteers. Additional to the possibility of evaluating the

system with a real hand, prosthetic hand, or without any using

hand. It also concluded that using the haptic system as an

auxiliary device with a myoelectric prosthetic hand leads to

improve the prosthetic hand’s performance, increase the

accuracy, reduce the user’s time response, minimize the

applying force during grasping objects, and decrease the power

consumption used to drive the myoelectric hand. Moreover, it

is concluded that the performance of the hybrid feedback

stimulation system to help the amputees to recover the sensation

is more effective than using each feedback display individually.

Finally, an in-depth analysis of the previous articles helped

to identify and describe the challenges and the future direction

pertinent to haptic upper limb prostheses and the ways of

developing, depending on analyzing the challenges and the

future work of the previous studies and on the future vision of

the authors.

ACKNOWLEDGMENTS

The authors would like to express their gratitude to Research

Fund RMC [Vot E15501] from University of Tun Hussein Onn

Malaysia for funding the research work.

List of abbreviations and symbols:

EMG : Electromyogram.

IEEE : Institute of Electrical and Electronics Engineers.

FSR : Force-sensing resistor sensor.

VCSEL : Vertical-Cavity Surface-Emitting Laser.

DOF : Degree of freedom.

RFID : Radio-frequency identification.

MORPH : Moyelectrically – operated RFID prosthetic hand.

PET : A polyethylene terephthalate.

LED : Light-emitting diode.

BBM : A Beam Bundle Model.

MR : Magnetic Resonance.

PMMA : Polymathic methacrylate.

PVDF : Perpendicular polyvinylidene difluoride.

FTS : Frictional tactile sensation.

TR : Targeted nerve reinnervation.

FPC : Flexible printed circuit.

NG : Nanogenerator.

CAC : Common anode configuration.

CEC : Concentric electrode configuration.

LRA : Linear resonant actuator.

ERM : Eccentric rotating mass.

CUFF : Clenching Upper-limb Force Feedback device.

SHP : Soft Hand Pro.

MT : Mechano-tactile display.

VT : Vibro-tactile display.

BLE : Bluetooth low energy.

FPCB : Flexible printed circuit board.

FTSA : Flexible tactile sensor array.

SEM : Scanning electron microscope.

EDR : Electrodermal response.

MRFs : Magnetorheological fluids.

IRB : Institutional review board.

SAMs : Southampton adaptive manipulation scheme.

ADC : Analog-to-digital convertor.

DSP : A digital signal processor.

CA : Charge Amplifier.

IoT : Internet of Think.

VLC : Visible Light Communication.

IP : An Internet Protocol address.

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