Cited by 143Muscle activation and electromyography studiesNeuroscience and Neural EngineeringProsthetics and Rehabilitation Robotics

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Targeted Muscle Reinnervation for the Upper and Lower Extremity

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Kuiken, Todd A., Barlow, Ann K., Hargrove, Levi J., Dumanian, Gregorgy A.·2017·Techniques in Orthopaedics

DOI 10.1097/bto.0000000000000194PMC PMC5448419

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Abstract

Myoelectric devices are controlled by electromyographic signals generated by contraction of residual muscles, which thus serve as biological amplifiers of neural control signals. Although nerves severed by amputation continue to carry motor control information intended for the missing limb, loss of muscle effectors due to amputation prevents access to this important control information. Targeted muscle reinnervation (TMR) was developed as a novel strategy to improve control of myoelectric upper limb prostheses. Severed motor nerves are surgically transferred to the motor points of denervated target muscles, which, after reinnervation, contract in response to neural control signals for the missing limb. TMR creates additional control sites, eliminating the need to switch the prosthesis between different control modes. In addition, contraction of target muscles, and operation of the prosthesis, occurs in reponse to attempts to move the missing limb, making control easier and more intuitive. TMR has been performed extensively in individuals with high-level upper limb amputations and has been shown to improve functional prosthesis control. The benefits of TMR are being studied in individuals with transradial amputations and lower limb amputations. TMR is also being investigated in an ongoing clinical trial as a method to prevent or treat painful amputation neuromas.

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Authors: Kuiken, T. A., Barlow, A. K., Hargrove, L. J., & Dumanian, G. A.
Affiliations: Northwestern University (US)
Shirley Ryan AbilityLab (US)
Departments of Surgery
Corresponding author: Kuiken, Todd A.
Barlow, Ann K.
Hargrove, Levi J.
ORCID: Kuiken, Todd A.
Hargrove, Levi J.
Venue: Techniques in Orthopaedics
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2017-06
Volume: 32
Issue: 2
Pages: 109-116
ISSN: 0885-9698 (ISSN-L)
DOI: 10.1097/bto.0000000000000194
PMC: PMC5448419
OpenAlex: W2616534643
Cited by: 143
References: 48
Citations by year: 2026: 13 · 2025: 19 · 2024: 20 · 2023: 15 · 2022: 14 · 2021: 25 · 2020: 21 · 2019: 9 · 2018: 6 · 2017: 1
FWCI: 4.56
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Techniques in Orthopaedics (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD079428, R01HD081525, N01 HD053402)
Topics: Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
Physical Sciences › Engineering › Biomedical Engineering › Prosthetics and Rehabilitation Robotics
Keywords: targeted muscle reinnervation, myoelectric prosthesis, upper limb amputation, lower limb amputation, transradial amputation, amputation neuroma, electromyography, prosthetic control, denervated muscle, amputee rehabilitation

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Targeted Muscle Reinnervation for the Upper and Lower Extremity

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