Procedural challenges: • Resistance to change and user training: clinicians and patients require simple calibration and clear protocols. • Develop standardized calibration scenarios for different amputation sites. • Classify users’ skin types to simplify and speed up calibration and adaptation. Technical challenges: • Electrode contact stability and impedance drift (humidity, perspiration, temperature) pose risks of overstimulation or understimulation. • Develop real-time measurement of stimulation parameters—current, voltage, charge per phase—for each pulse, with auto-adjustment based on bioimpedance calibration data. • Use biocompatible materials for long-term dev-kit operation: conductive gels, electrode matrices, and wristband materials.

Positive factors for implementation • Involvement of more clinics for cross-laboratory research and global metrics. • Partnerships with prosthetic and VR manufacturers for de monstrations. • Growing demand for non-pharmacological rehabilitation methods. Best practices and implications (scalability/sustainability) Policy: Create an evidence base for reimbursement codes through data on rehabilitation time reduction and improved functional independence. Practice: Develop plug-and-play modules (sensory surface, HV-block, electrode glove/insole), standardized connectors, and calibration protocols. Technology: On-board telemetry (current, voltage, charge, temperature, impedance) and event logging for safety, auditing, and machine-learning improvement. Research: Publish open stimulus-recognition protocols and datasets for independent validation; conduct comparative studies with vibro- and thermo-stimulation approaches. Scalability and sustainability: Pursue B2B licensing (OEM integration into prosthetics, gloves, insoles, and VR devices), modular architecture, and locally manufactured series of electrode materials.