How AI is helping in the development of smarter and adaptable Prostheses

On a global level, the need for prosthetic limbs is rising sharply. The Clinton Health Access Initiative, in fact, estimates that around the world, 65 million people live with limb amputations. Yet, despite this need, fewer than 20% of those who can benefit from prostheses actually have access to them.

There are several converging medical and demographic trends that are behind this rising need, such as population aging and the consequent global share of older adults, the rise in chronic diseases like diabetes that leads to complications and leads to amputations, and the trauma resulting from unfortunate situations like road accidents, occupational injuries or conflict.

As a result of these pressures, the global prosthetic limb market keeps growing, and is projected to expand further. But this is not just a matter of demand and supply; it’s also about how good those prosthetics are, and how much they actually contribute to one’s quality of life, mobility, independence and comfort.

While life-changing when compared to not having a limb at all, traditional prosthetics come with certain limitations such as heavy materials, limited mobility, and a “one-size-fits-many” design that may not suit a user’s anatomy, lifestyle, or needs, often forcing clinicians and designers to rely on manual trial-and-error adjustments. For many amputees, fitting, comfort, and adaptability remain serious challenges.

Recent technological advances are changing that landscape. The prosthetics market is now trending toward modular, lightweight, sensor‑supported and microprocessor‑controlled limbs, offering far greater mobility and adapting more closely to the dynamics of daily life. However, designing these advanced systems still requires balancing biomechanics, materials, manufacturability and patient-specific needs, a challenge that is increasingly being addressed through computational and AI-supported design methods.

Even beyond purely mechanical improvements, there is growing interest in integrating more intelligent, adaptive capabilities: limbs that respond to motion, adjust to terrain, provide better stability and potentially merge with rehabilitative and human‑centred care models.    In this case, research becomes absolutely critical; with innovation coming from rethinking how we design, customise and deliver them to match individual needs.

That brings us to the work being done at the University of Malta. Through the TDP LITE Programme (under the umbrella of the FUSION Awards 2025), the PRAGMA team led by Prof. Ing. Jonathan C. Borg from the Faculty of Engineering, aims to transform how prosthetic limbs are designed, customised and manufactured, placing intelligent design decision-making at the centre of the process. Prof. Jonathan Borg explains:

"PRAGMA is a natural evolution of our PREMIERTOGO work. While PREMIER focused on developing smart, modular above-the-knee prostheses and improving the user experience, PRAGMA takes it a step further. We’re now building an AI-driven framework that accelerates design, optimises manufacturing, and supports designers and clinicians in exploring better-informed design alternatives, allowing each prosthetic to be truly personalised to the user’s needs."

PRAGMA uses the latest in generative design and artificial intelligence (AI) including prompt‑driven design leveraging large language models (LLMs), allowing engineers and designers to translate clinical, functional and manufacturing requirements into actionable design concepts, while supporting a multi‑disciplinary team of engineers, medical professionals, physiotherapists and designers.

PRAGMA sets out to make prosthetic design more efficient, personalised, adaptive and accessible. By speeding up the design‑to‑prototype cycle, the project could help lower costs, reduce waiting times, and enable tailored prosthetics that fit users better than standard models ever could.

The implications of PRAGMA (and similar initiatives) go far beyond engineering or market growth. Customised, well‑fitted limbs can contribute to better mobility, reduced complications (like pressure sores or gait problems), and greater comfort, supporting both physical and mental well‑being.

“Projects like PRAGMA show how academic research can directly address real‑world needs, by combining human-centred design with AI-supported engineering tools”, said Dr Nicholas Patiniott, an RSO working on the project.

The PRAGMA research project at the University of Malta isn’t just building better prosthetic limbs: it’s helping reimagine how we deliver prosthetic care through smarter design processes, adaptive technologies, combined with speed, sensitivity, customisation and humanity.

More info on PRAGMA can be found online.