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Related Experiment Video

Updated: Oct 13, 2025

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers
07:59

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Published on: October 29, 2021

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Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers.

Agnes Sturma1, Laura A Hruby2, Anna Boesendorfer3

  • 1Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna; Bioengineering Department, Imperial College London.

Journal of Visualized Experiments : Jove
|November 15, 2021
PubMed
Summary

Targeted Muscle Reinnervation (TMR) offers improved prosthetic control for above-elbow amputees. This study presents a TMR rehabilitation protocol, detailing pre- and post-surgery therapies for optimal outcomes.

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Last Updated: Oct 13, 2025

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Area of Science:

  • Biomedical Engineering
  • Rehabilitation Medicine
  • Neuroscience

Background:

  • Targeted Muscle Reinnervation (TMR) enhances myoelectric prosthesis control by re-routing nerves for selective muscle activation.
  • High-level upper limb amputees require specialized rehabilitation for TMR success.

Purpose of the Study:

  • To present a comprehensive rehabilitation protocol for high-level upper limb amputees undergoing TMR.
  • To outline interventions from pre-surgery assessment to post-prosthetic fitting and long-term management.

Main Methods:

  • Expert Delphi study to establish the rehabilitation protocol.
  • Pre-surgery: patient assessment, pain control, endurance, strength, balance, and range of motion.
  • Post-surgery: edema/scar management, cortical activation, surface electromyographic (sEMG) biofeedback, prosthetic training, and functional assessments.

Main Results:

  • The protocol integrates pre-operative conditioning with post-operative TMR-specific training.
  • It progresses from basic muscle activation to complex activities of daily living.
  • Continuous monitoring ensures prosthetic function and timely intervention.

Conclusions:

  • A structured rehabilitation protocol is crucial for maximizing the benefits of TMR in upper limb amputees.
  • This Delphi-based approach provides a framework for effective patient management.
  • The protocol aims to optimize prosthetic control and functional independence.