Targeted Muscle Reinnervation for the Upper and Lower Extremity

Area of Science:

• Biomedical Engineering
• Neuroscience
• Rehabilitation Medicine

Background:

• Myoelectric prostheses utilize electromyographic signals from residual muscles for control.
• Amputation severs motor nerves, losing access to intended motor control signals for the missing limb.
• Existing control methods for prostheses can be cumbersome and require mode switching.

Purpose of the Study:

• To introduce and evaluate Targeted Muscle Reinnervation (TMR) as a novel strategy for improving myoelectric prosthesis control.
• To create intuitive and amplified neural control signals for upper limb prostheses.
• To explore TMR's potential in preventing or treating amputation neuromas.

Main Methods:

• Targeted Muscle Reinnervation (TMR) surgically transfers severed motor nerves to the motor points of denervated target muscles.
• Reinnervated target muscles contract in response to neural signals intended for the missing limb.
• This creates new, accessible control sites for myoelectric prostheses.

Main Results:

• TMR has been successfully performed in high-level upper limb amputations, significantly improving functional prosthesis control.
• Control becomes more intuitive as prosthesis operation aligns with attempted movements of the missing limb.
• TMR is being investigated for transradial, lower limb amputations, and for neuroma treatment.

Conclusions:

• Targeted Muscle Reinnervation (TMR) offers a significant advancement in prosthetic limb control by leveraging residual neural signals.
• The technique provides intuitive, amplified biological control signals, enhancing prosthesis functionality and user experience.
• TMR shows promise in various amputation levels and in managing post-amputation complications like neuromas.