Neuromuscular implants: Interfacing with skeletal muscle for improved clinical translation of prosthetic limbs

Abstract

After an amputation, advanced prosthetic limbs can be used to interface with the nervous system and restore motor function. Despite numerous breakthroughs in the field, many of the recent research advancements have not been widely integrated into clinical practice. This review highlights recent innovations in neuromuscular implants—specifically those that interface with skeletal muscle—which could improve the clinical translation of prosthetic technologies. Skeletal muscle provides a physiologic gateway to harness and amplify signals from the nervous system. Recent surgical advancements in muscle reinnervation surgeries leverage the “bio‐amplification” capabilities of muscle, enabling more intuitive control over a greater number of degrees of freedom in prosthetic limbs than previously achieved. We anticipate that state‐of‐the‐art implantable neuromuscular interfaces that integrate well with skeletal muscle and novel surgical interventions will provide a long‐term solution for controlling advanced prostheses. Flexible electrodes are expected to play a crucial role in reducing foreign body responses and improving the longevity of the interface. Additionally, innovations in device miniaturization and ongoing exploration of shape memory polymers could simplify surgical procedures for implanting such interfaces. Once implanted, wireless strategies for powering and transferring data from the interface can eliminate bulky external wires, reduce infection risk, and enhance day‐to‐day usability. By outlining the current limitations of neuromuscular interfaces along with potential future directions, this review aims to guide continued research efforts and future collaborations between engineers and specialists in the field of neuromuscular and musculoskeletal medicine.

Upper Limb Prostheses by the Level of Amputation: A Systematic Review

“…Direct Nerve Interfaces involve placing electrodes directly on or within peripheral nerves to record neural signals for control. It also works to provide sensory feedback [20,21].…”

A bioinspired neuromuscular system enabled by flexible electro-optical N2200 nanowire synaptic transistor

“…The information processed by artificial synapses could be relayed through efferent nerves to drive the actuators that execute the response [13]. In biological systems, skeletal muscles play a crucial role in driving the movements of human limbs [14,15]. Recently, some artificial neuromuscular systems focusing on mimicking the movement of skeletal muscles have been reported [16][17][18].…”