journal article·2025-11-28Open access

Design and Implementation of an Ontology-Driven Cyber–Physical Prosthesis Service System for Personalised and Adaptive Care

Nicholas Patiniott, Jonathan Borg, Philip Farrugia, Adrian Mercieca, Alfred Gatt, Owen Casha

Applied Sciences· Volume 15· Issue 23

Abstract

As prosthetic technologies become increasingly data-rich and embedded in care systems, traditional human-centred approaches often fall short of addressing evolving use realities. This paper contributes an applied computing framework that enables semantic reasoning and data-driven adaptation within prosthesis aftercare. We present an ontology-driven, cyber–physical prosthesis service system designed to enable personalised and adaptive care. Implemented through the Adaptive Prosthesis Life-Cycle Service System (adProLiSS) framework and demonstrated via a smart prosthesis prototype, the system treats the prosthesis as a semi-autonomous actor within an emotionally responsive and semantically mediated ecosystem. The proposed architecture integrates sensor data acquisition, ontology-based knowledge representation, and semantic reasoning to enable context-aware decision support and adaptive personalisation. A layered cyber–physical infrastructure, comprising embedded sensors, semantic reasoning, and user feedback through a digital twin interface, supports personalised aftercare, cross-disciplinary collaboration, and reflective design engagement. Evaluation with 26 participants across clinical, engineering, and user groups confirmed the system’s value in enhancing functionality, reducing downtime, and supporting emotional well-being. By positioning ontologies as both computational enablers and design support mechanisms, this research contributes a practical and scalable model for prosthetic service systems that adapt across bodily, emotional, and ecological dimensions, advancing more responsive and consequence-aware care practices.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Prosthetics and Rehabilitation Robotics · Muscle activation and electromyography studies · Context-Aware Activity Recognition Systems

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Industrial & Manufacturing Engineering, Faculty of Engineering, University of Malta, 2080 MSD Msida, Malta

Department of Podiatry, Faculty of Health Sciences, University of Malta, 2080 MSD Msida, Malta

Department of Microelectronics & Nanoelectronics, Faculty of Information & Communication, University of Malta, 2080 MSD Msida, Malta

Funding

FUSION R&I Technology Development Programme LITE, Xjenza Malta

References (40)

Show source-provided references
1. Designing feelings into lower-limb prostheses—A kansei engineering approach to understand lower-limb prosthetic cosmeses
2. Vlachaki, A. (2020). Emotionally-Driven Prostheses: Exploring the Effects on Users’ Lives and Societies’ Attitudes in the UK and Greece. [Ph.D. Thesis, Loughborough University].
3. Technology and More-Than-Human Design10.1162/desi_a_00612 ↗
4. Yoo, D., Bekker, T., Dalsgaard, P., Eriksson, E., Fougt, S.S., Frauenberger, C., Friedman, B., Giaccardi, E., Hansen, A.-M., and Light, A. (2023, January 23–28). More-Than-Human Perspectives and Values in Human-Computer Interaction. Proceedings of the Conference on Human Factors in Computing Systems, Hamburg, Germany.10.1145/3544549.3583174 ↗
5. Towards More-Than-Human-Centred Design: Learning from Gardening
6. Escobar, A. (2018). Designs for the Pluriverse: Radical Interdependence, Autonomy, and the Making of Worlds, Duke University Press. Available online: https://www.researchgate.net/publication/324812401_Designs_for_the_Pluriverse_Radical_Interdependence_Autonomy_and_the_Making_of_Worlds.10.1215/9780822371816 ↗
7. Leitao, R., Noel, L.-A., Rogal, M., Torretta, N., Montalvan, J., Beniwal, S., Braga, M.F., Onafuwa, D., and Ibarra, M.C. (2024, January 24–28). Pluriversal Design as a Paradigm. Proceedings of the DRS Biennial Conference Series, Boston, MA, USA.10.21606/drs.2024.169 ↗
8. Sansoni, S., Wodehouse, A., and Buis, A. (2025, August 13). The Aesthetics of Prosthetic Design: From Theory to Practice. Available online: https://www.pixeldiva.co.uk.
9. Elements of a Prescriptive and Adaptive Prosthesis Development Service Framework10.1017/pds.2023.161 ↗
10. An AI-based prosthesis framework fostering an adaptive amputee healthcare service10.1017/pds.2024.221 ↗
11. Patiniott, N., Vella, P., Borg, J.C., Gatt, A., Francalanza, E., Paetzold-Byhain, K., and Zammit, J.P. (2023, January 14–15). Towards an Ontology for a Smart and Adaptive Prosthesis Service System Framework. Proceedings of the International Conference on Integrated Systems in Medical Technologies, ISMT 2023, Erlangen, Germany.
12. Functionality and Comfort Design of Lower-Limb Prosthetics: A Review10.57197/JDR-2023-0031 ↗
13. Acosta, G.G., and Romeva, C.R. (2010, January 17–20). From anthropocentric design to ecospheric design: Questioning design epicentre. Proceedings of the International Design Conference, Dubrovnik, Croatia. Available online: https://www.researchgate.net/publication/289724464_From_anthropocentric_design_to_ecospheric_design_Questioning_design_epicentre.
14. van Zeeland, E. (2024, January 24–28). Design principles of the pluriversal design paradigm. Proceedings of the DRS Biennial Conference Series, Boston, MA, USA.10.21606/drs.2024.295 ↗
15. AlQahtani, N.J., Al-Naib, I., and Althobaiti, M. (2024). Recent progress on smart lower prosthetic limbs: A comprehensive review on using EEG and fNIRS devices in rehabilitation. Front. Bioeng. Biotechnol., 12.10.3389/fbioe.2024.1454262 ↗
16. Ontological engineering for supporting semantic reasoning in design: Deriving models based on ontologies for supporting engineering design10.1080/09544828.2019.1633626 ↗
17. An automatic ontology-based approach to support logical representation of observable and measurable data for healthy lifestyle management: Proof-of-concept study10.2196/24656 ↗
18. Asprino, L., Gangemi, A., Nuzzolese, A.G., Presutti, V., Recupero, D.R., and Russo, A. (2019). Ontology-Based Knowledge Management for Comprehensive Geriatric Assessment and Reminiscence Therapy on Social Robots. Data Science for Healthcare: Methodologies and Applications, Springer.10.1007/978-3-030-05249-2_6 ↗
19. OCRA—An ontology for collaborative robotics and adaptation10.1016/j.compind.2022.103627 ↗
20. Tekinerdogan, B., Mittal, R., Al-Ali, R., Iacono, M., Navarro-López, E., Bandyopadhyay, S., Vanherpen, K., Barišić, A., and Taveter, K. (2020). A feature-based ontology for cyber-physical systems. Multi-Paradigm Modelling Approaches for Cyber-Physical Systems, Elsevier.10.1016/B978-0-12-819105-7.00008-8 ↗
21. Mohamad, U.H., Ahmad, M.N., Benferdia, Y., Shapi’i, A., and Bajuri, M.Y. (2021). An Overview of Ontologies in Virtual Reality-Based Training for Healthcare Domain. Front. Med., 8.10.3389/fmed.2021.698855 ↗
22. Inoue, Y., Kuroda, Y., Yamanoi, Y., Yabuki, Y., and Yokoi, H. (2024). Development of Wrist Separated Exoskeleton Socket of Myoelectric Prosthesis Hand for Symbrachydactyly. Cyborg Bionic Syst., 5.10.34133/cbsystems.0141 ↗
23. Kuroda, Y., Yamanoi, Y., Jiang, H., Yabuki, Y., Inoue, Y., Bai, D., Jiang, Y., Zhu, J., and Yokoi, H. (2025). Toward Cyborg: Exploring Long-Term Clinical Outcomes of a Multi-Degree-of-Freedom Myoelectric Prosthetic Hand. Cyborg Bionic Syst., 6.10.34133/cbsystems.0195 ↗
24. Duffy, A., and O’Donnell, F.J. (2023, July 06). A Design Research Approach. Available online: https://www.researchgate.net/publication/2824982_A_Design_Research_Approach.
25. Design Research Through Practice: From the Lab, Field, and Showroom10.1109/TPC.2013.2274109 ↗
26. Bang, A.L., Krogh, P.G., Ludvigsen, M., and Markussen, T. (2012, January 28–29). The Role of Hypothesis in Constructive Design Research. Proceedings of the The Art of Research, Helsinki, Finland. Available online: https://www.researchgate.net/publication/276264315_The_Role_of_Hypothesis_in_Constructive_Design_Research.
27. Elkin, P.L. (2023). Terminology, Ontology and Their Implementations, Springer International Publishing. [2nd ed.]. Health Informatics.10.1007/978-3-031-11039-9 ↗
28. Balduccini, M., Griffor, E., Huth, M., Vishik, C., Burns, M., and Wollman, D. (2018, January 28–29). Ontology-Based Reasoning about the Trustworthiness of Cyber-Physical Systems. Proceedings of the Living in the Internet of Things: Cybersecurity of the IoT–2018, London, UK.10.1049/cp.2018.0012 ↗
29. Borg, J.C. (1999). Design Synthesis for Multi-X-A ‘Life-Cycle Consequence Knowledge’ Approach. [Ph.D. Thesis, University of Strathclyde].
30. Pour, A.N., Kruit, B., Chen, J., Webers, G., Kruizinga, P., and Schlobach, S. (2025, October 16). Knowledge Representation and Engineering for Smart Diagnosis of Cyber Physical Systems. Available online: https://github.com/Ameneh71.
31. The Role of Digital Twins in Collaborative Cyber-Physical Systems
32. Zhang, P., and Boulos, M.N.K. (2023). Generative AI in Medicine and Healthcare: Promises, Opportunities and Challenges. Future Internet, 15.10.3390/fi15090286 ↗
33. Patiniott, N. (2025). A ‘Prosthesis Life-Cycle Ontology’—Based Service System Framework to Cater for Amputees’ Evolving Needs: Compiled Evaluation Responses and Raw Data (Internal Report No CERU/ITR/01/2025), CERU, University of Malta. Available online: https://drive.google.com/file/d/1dZuRS3DIaQj17wF3qg4rFKpsAsVGhq0O/view?usp=drive_link.
34. Creswell, J.W. (2013). Qualitative Inquiry & Research Design. Choosing Among Five Approaches, Sage Publications.
35. Implications of Small Samples for Generalization: Adjustments and Rules of Thumb10.1177/0193841X16655665 ↗
36. Vasileiou, K., Barnett, J., Thorpe, S., and Young, T. (2018). Characterising and justifying sample size sufficiency in interview-based studies: Systematic analysis of qualitative health research over a 15-year period. BMC Med. Res. Methodol., 18.10.1186/s12874-018-0594-7 ↗
37. Blessing, L.T.M., and Chakrabarti, A. (2009). DRM: A Design Reseach Methodology, Springer.10.1007/978-1-84882-587-1 ↗
38. The importance of small samples in medical research10.4103/jpgm.JPGM_230_21 ↗
39. Patiniott, N., and Borg, J.C. (2025, January 11–14). Advancing Prosthesis Design: Ontology Driven Multi-Disciplinary Framework for Evolving Amputee Needs. Proceedings of the Design Society ICED25, Dallas, TX, USA.10.1017/pds.2025.10049 ↗
40. Patiniott, N., and Borg, J.C. (2025, January 11–12). Ontological Modelling for Consequence-Driven Learning: A Human-Centred Simulation Approach to Smart Prosthesis Design and Education. Proceedings of the International Conference on Engineering and Product Design Education (E&PDE 2025), Msida, Malta.10.35199/EPDE.2025.29 ↗