Targeted Muscle Reinnervation in Next-Gen Upper Limb Prosthetics By: Emma Gilsanz and Steven Arroyo

Motion and Sensation of the Arm and Hand The human hand has 27 degrees of freedom Peripheral innervation gives rise to motion of skeletal muscles, as well as tactile sensation and proprioception (Kuiken et al, 2009)

Scope of the Problem – Upper Limb Amputations Trauma is the leading cause of upper limb amputations, though in rare cases there are congenital or pathogenic reasons for amputation. Upper limb amputations have become more prevalent in the military; in 2009, upper limb amputations accounted for 22% of all amputations (historically, 3%) The DoD’s DARPA founded the Revolutionizing Prosthetics Program in 2006 to encourage research into more advanced solutions for amputees.

Earlier Upper Limb Prosthetic Solutions

Central Nervous System Approaches Invasive procedure – runs risks of brain inflammation, infection Noninvasive, yet clunky solution

The Kuiken Nerve-Prosthetic Interface http://armdynamics.com/pages/tmr

Mechanism for Targeted Muscle Reinnervation (Kuiken 2009) http://biomedinova.blogspot.com/2012_05_01_archive.html

Neuromuscular Mapping (Kuiken et al, 2004) (Kuiken, 2007)

Results in TMR Prosthetic Patients (Kuiken, 2009)

Human Trials As of July 2011, more than 50 patients were using a TMR-based prosthetic device Trials have shown a 96% success rate on nerve transfers Learning to use the device has proven to be a very intuitive process Potential for regaining tactile sensations in the prosthetic. (Kuiken, 2009)

TMR and the DEKA “Luke” Arm The basic principle behind TMR can be used to provide output to a variety of artificial arms. (http://www.nhjes.org/pdf/5A%20Bio-Robotics.pdf)

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