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In vitro studies
Published in Ze Zhang, Mahmoud Rouabhia, Simon E. Moulton, Conductive Polymers, 2018
A. Lee Miller, Huan Wang, Michael J. Yaszemski, Lichun Lu
During nerve regeneration, the axon growth cone continuously moves toward the reinnervation target. Regenerating axons find their way into endoneurium tubes and eventually reconnect with the terminal organ. The ones that are not successful in reestablishing connection with their targets will retract and disappear, known as the pruning process. It is apparent that both neurite outgrowth and directionality are important aspects, and a treatment that promotes both would be ideal.
Upper and Lower Limb Robotic Prostheses
Published in Pedro Encarnação, Albert M. Cook, Robotic Assistive Technologies, 2017
Patrick M. Pilarski, Jacqueline S. Hebert
Surgical reconstruction of the amputated limb plays an essential role in maximizing outcomes for prosthetic applications. In addition to advances in bone management, residual muscle management, and skin coverage, advanced nerve procedures have been developed to improve the ability to extract the rich control signals that are lost after upper limb amputation. Targeted reinnervation (TR) surgically redirects the amputated nerve endings that used to innervate the hand and wrist muscles to new muscle sites to provide physiologically natural motor command signals for myoelectric control (Kuiken, Schultz Feuser, and Barlow 2013). The surgically redirected nerves reinnervate purposely denervated remaining muscles, which then act as biological amplifiers for the neural signals that are still under voluntary (brain) control. These muscle responses, which are intuitively activated, are then linked to the action of the prosthesis. After reinnervation, patients are able to operate multiple degrees of freedom of advanced prosthetic devices with increased ease. Combining newer surface EMG recording techniques (such as pattern recognition) with TR may allow even more signals to be extracted for prosthetic control. Recently, in subjects with upper limb amputation having undergone TR, simultaneous pattern recognition control was found to be superior in preference and performance to both sequential pattern recognition and conventional myoelectric control (Young et al. 2013).
A review on the advancements in the field of upper limb prosthesis
Published in Journal of Medical Engineering & Technology, 2018
Nilanjan Das, Nikita Nagpal, Shailee Singh Bankura
Through targeted muscle reinnervation technique motor nerves which previously controlled muscles of an amputated limb, are surgically rerouted such that they reinnervate a small region of an intact muscle, such as pectoralis major resulting contraction of a small area of muscle on patient’s chest when patient thinks about moving the thumb of missing hand. By insertion of sensors at an appropriate position over the reinnervated muscle, these contractions can be made to control the movement of an appropriate part of the robotic prosthesis [84].
Identifying the benefits and risks of emerging integration methods for upper limb prosthetic devices in the United States: an environmental scan
Published in Expert Review of Medical Devices, 2019
Marcella A Kelley, Heather Benz, Susannah Engdahl, John F P Bridges
The community advisory board members were enthusiastic about engaging with other stakeholders from the onset of this study. During the conference call and interviews, CAB members addressed contributors to low device adoption rates amongst individuals with upper limb loss. These included socket discomfort, inadequate training, a scarcity of prosthetists, and phantom limb pain. Researchers on the board noted that peripheral nerve integration and targeted muscle reinnervation mitigate much of the socket, nerve, and phantom limb pain.