Improved control of a prosthetic limb by surgically creating electro-neuromuscular constructs with implanted...

Area of Science:

• Biomedical Engineering
• Neuroscience
• Rehabilitation Medicine

Background:

• Residual limb muscles are primary sources for prosthetic hand control signals via myoelectric signals.
• High-level amputations (e.g., transhumeral) lack sufficient muscles for intuitive prosthetic joint control.

Purpose of the Study:

• To investigate the feasibility of redistributing severed nerves to innervate diverse muscle targets for enhanced prosthetic control.
• To engineer neuromuscular constructs for bidirectional prosthetic communication and skeletal attachment.

Main Methods:

• Dividing severed nerves along fascicles and redistributing them to denervated muscles and muscle grafts.
• Engineering neuromuscular constructs with implanted electrodes via an osseointegrated interface.
• Assessing nerve reinnervation and myoelectric signal strength over time.

Main Results:

• Demonstrated effective reinnervation of target muscles by transferred nerves.
• Observed a gradual increase in myoelectric signal strength, indicating successful nerve integration.
• Enabled individual finger control (flexion/extension) of a prosthetic hand for a transhumeral amputee.
• Reported improved prosthetic function in daily life tasks.

Conclusions:

• Distributed nerve transfers to multiple muscle targets can increase motor neural command signals.
• Engineered electro-neuromuscular constructs with osseointegrated interfaces facilitate improved prosthetic limb control.
• This approach offers a promising solution for intuitive prosthetic hand and arm function restoration.