Individuals with limb loss present significant challenges to testing and evaluating prosthetic devices, such as medical approval processes and participant availability. Prosthesis simulators, designed for mimicking prosthesis use with able-bodied individuals, offer an alternative to conducting controlled experiments and enhancing the development of prosthetic technologies. This review examines the design features, applications, and limitations of lower limb prosthesis simulators. A literature search identified 73 studies that have used lower limb prosthesis simulators. Most studies have focused on transfemoral prosthesis simulators (TFsims) and testing prosthetic designs and control mechanisms. The most frequently assessed movement was walking, while other movements, were explored only sporadically. The findings reveal significant variability in simulator configurations, training protocols, and the range of movements assessed. Additionally, a notable research gap exists in evaluations of the effect of transtibial prosthesis simulators (TTsims) and hip disarticulation prosthesis simulators (HDsims) on gait. Despite these challenges, prosthesis simulators offer promising potential for accelerating and improving prosthesis development while putting less stress on the relatively small target group of individuals with limb loss. Further research is needed to standardize methodologies and better understand the effects of simulator design and training on gait performance to facilitate advancements in prosthetic research.

Background: Pneumatic actuators are widely used in applications like (medical) robots, or prostheses. Pneumatic actuators require a complex manufacturing process and are produced in standardized dimensions to reduce costs. Over the last decade 3D-printing has emerged as a cost-effective and efficient production method in medical applications. 3D-printing can also function as a cost-efficient alternative production method for pneumatic actuators. Objective: The goal of this research is to study the possibility of creating a pneumatic linear actuator with 3D-printing. Furthermore, the aim is to use the advantage of 3D-printing to create pneumatic actuators with non-circular cross-sections. Methodology: To evaluate the performance of a 3D-printed pneumatic actuator, a test setup was designed and built to measure the leakage and sliding friction force. Furthermore, two pneumatic actuators with a non-conventional cross-sectional shape were designed and their performance was tested and compared with a 3D-printed cylindrical pneumatic actuator, since these tests only ran once, the results are more a guideline. During the manufacturing of the cylinders, no post-processing techniques were used. Results: The functioning of a 3D-printed circular pneumatic actuator was proven with low static leakage rates of 2.5%, low dynamic leakage rates of approximately 1%, and a maximum friction force of [Formula presented]. Furthermore, the results show that it is possible to print functioning pneumatic cylinders with a non-cylindrical concave cross-section. The non-conventional cylinders were tested up to [Formula presented] with maximum dynamic leakage of [Formula presented]. Conclusion: This study demonstrates a method to create functional pneumatic linear actuators with 3D-printing. It was possible to create 3D-printed actuators with a conventional shape, e.g. circular and unconventional shapes e.g. stadium/oval shape and a kidney shape. The leak rates for conventional and unconventional shapes were in the same range. This opens up the world for more design freedom in pneumatic actuators.