Targeted Reinnervation to Improve Prosthesis Control in Transhumeral Amputees

O’Shaughnessy, Kristina; Dumanian, Gregory A.; Lipschutz, Robert D.; Miller, Laura A.; Stubblefield, Kathy; Kuiken, Todd A.

doi:10.2106/jbjs.g.00268

Cited by 97 publications

(70 citation statements)

References 14 publications

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“…Multiple tasks were executed to judge performance of the pre-surgical prosthesis compared to the control system used after TMR [8]- [10], [13], [17]. The Box and Blocks test of gross manual dexterity required the subject to move one-inch blocks from one compartment to another, modified to allow 120s instead of 60s, and performed standing instead of sitting (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Target muscles have included the medial biceps for the median nerve and the lateral triceps or brachialis muscles for the distal radial nerve. The procedure has been successfully performed on three people with transhumeral amputations (see [8] for surgical detail). At the shoulder disarticulation level, all four brachial plexus nerves that descend to the missing arm can be transferred to target muscle segments.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Improved Myoelectric Prosthesis Control Using Targeted Reinnervation Surgery: A Case Series

Miller

Stubblefield

Lipschutz

et al. 2008

IEEE Trans. Neural Syst. Rehabil. Eng.

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138

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Targeted Reinnervation is a surgical technique developed to increase the number of myoelectric input sites available to control an upper-limb prosthesis. Because signals from the nerves related to specific movements are used to control those missing degrees-of-freedom, the control of a prosthesis using this procedure is more physiologically appropriate compared to conventional control. This procedure has successfully been performed on three people with a shoulder disarticulation level amputation and three people with a transhumeral level amputation. Performance on timed tests, including the box-and-blocks test and clothespin test, has increased two to six times. Options for new control strategies are discussed.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Improved Myoelectric Prosthesis Control Using Targeted Reinnervation Surgery: A Case Series

Miller

Stubblefield

Lipschutz

et al. 2008

IEEE Trans. Neural Syst. Rehabil. Eng.

Self Cite

138

View full text Add to dashboard Cite

show abstract

“…5), this landmark procedure allowed the patient to perform simultaneous control of two degrees of freedom at the elbow and wrist of a prosthetic arm, using standard reconstructive techniques and without the need for implantable devices [70]. TMR has since developed, incorporating more patients [71,72], and also describing the transfer of hand sensation to the area where nerves have been re-directed [73]. Notably, this technique has not only allowed multifunctional control of prosthetic limbs in realtime [74] but has also acted as a catalyst for further development into EMG processing for prosthetic control.…”

Section: Surgical Methods To Improve Controlmentioning

confidence: 99%

Prosthetic Myoelectric Control Strategies: A Clinical Perspective

et al. 2014

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Control algorithms for upper limb myoelectric prostheses have been in development since the mid-1940s. Despite advances in computing power and in the performance of these algorithms, clinically available prostheses are still based on the earliest control strategies. The aim of this review paper is to detail the development, advantages and disadvantages of prosthetic control systems and to highlight areas that are current barriers for the transition from laboratory to clinical practice. Current surgical strategies and future research directions to achieve multifunctional control will also be discussed. The findings from this review suggest that regression algorithms may offer an alternative feed-forward approach to direct and pattern recognition control, while virtual rehabilitation environments and tactile feedback could improve the overall prosthetic control.

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“…In the United States, the Defence Advanced Research Program Agency (DARPA) has a goal of restoring full upper limb functionality via a prosthetic limb and using a technique called 'targeted re-innervation' to provide 'meaningful sensory feedback' from such a limb [72].…”

Section: Heterotopic Ossificationmentioning

confidence: 99%

Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the Royal Centre for Defence Medicine

Evriviades

Jeffery

Cubison³

et al. 2011

Phil. Trans. R. Soc. B

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The conflict in Afghanistan has produced injuries similar to those produced from military conflicts for generations. What distinguishes the modern casualty of the conflict in Afghanistan from those of other conflicts is the effectiveness of modern field medical care that has led to individuals surviving with injuries, which would have been immediately fatal even a few years ago. These patients present several challenges to the reconstructive surgeon. These injured individuals present early challenges of massive soft-tissue trauma, unstable physiology, complex bony and soft-tissue defects, unusual infections, limited reconstructive donor sites, peripheral nerve injuries and traumatic amputations. Late challenges to rehabilitation include the development of heterotopic ossification in amputation stumps. This paper outlines the approach taken by the reconstructive team at the Royal Centre for Defence Medicine in managing these most difficult of reconstructive challenges.

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Targeted Reinnervation to Improve Prosthesis Control in Transhumeral Amputees

Cited by 97 publications

References 14 publications

Improved Myoelectric Prosthesis Control Using Targeted Reinnervation Surgery: A Case Series

Improved Myoelectric Prosthesis Control Using Targeted Reinnervation Surgery: A Case Series

Prosthetic Myoelectric Control Strategies: A Clinical Perspective

Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the Royal Centre for Defence Medicine

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