Myo-Hand XP: User-Centered Co-Design, Clinical Implementation, and Commercial Translation of an Immersive Virtual Reality Intervention for Myoelectric Prosthesis Training.

Myoelectric prostheses offer functional restoration for people living with upper limb loss or differences, but mastery requires intensive, often monotonous training, leading to high abandonment rates. Virtual Reality (VR) presents a promising solution for engaging and motivating training. However, existing work in VR-based prosthesis training is still focused on research purposes only. This paper details the user-centred co-design, development, clinical implementation, and commercial translation of Myo-Hand XP. Myo-Hand XP is the first commercial immersive VR intervention for myoelectric prosthesis training, which was registered in the Australian Register of Therapeutic Goods (ARTG) and brought to market in 2023. The development followed an iterative process, beginning with problem-idea validation through stakeholder interviews. This informed the creation of a Proof of Concept (PoC) prototype, which gathered initial user feedback. Subsequent development of a more advanced Research Prototype, incorporating feedback on hardware and software, underwent further user testing. This iterative co-design, involving continuous feedback from 60 multinational stakeholders across various stages, was central to refining Myo-Hand XP. Following regulatory approval, clinical pilots in prosthetic clinics with 20 people living with limb loss and 6 clinicians demonstrated increased patient motivation and confidence, and the value of early functional training. Key challenges identified included setup complexity and sensor ergonomics. The commercially released Myo-Hand XP incorporates expanded sensor compatibility and refined activities. Ongoing user-centred development continues to address feedback, focusing on usability, expanded features like progress reporting and prosthetic elbow support, and further clinical validation to optimize this VR rehabilitation tool. This paper shares insights into translating research into a clinically viable and commercially available product.