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

2. 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)

3. 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.

4. Earlier Upper Limb Prosthetic Solutions

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

6. The Kuiken Nerve-Prosthetic Interface

7. Mechanism for Targeted Muscle Reinnervation
(Kuiken 2009)

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

9. Results in TMR Prosthetic Patients
(Kuiken, 2009)

10. 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)

11. TMR and the DEKA “Luke” Arm
The basic principle behind TMR can be used to provide output to a variety of artificial arms. (

12. Sources
Arndt, Michael. "Dr. Todd A. Kuiken: Bionic Sensation." Bloomberg Businessweek 8 Jan Web. 28 Apr <
Cullen, D. Kacey, and Douglas H. Smith. "How Artificial Arms Could Connect to the Nervous System." Scientific American 14 Jan Web. 28 Apr <
De Lange, Catherine. "Amputees Regain Control with Bionic Arm Wired to Chest." New Scientist TV. 3 Feb Web. 28 Apr <
Kuiken, T. A., G. A. Dumanian, R. D. Lipschutz, L. A. Miller, and K. A. Stubblefield. "The Use of Targeted Muscle Reinnervation for Improved Myoelectric Prosthesis Control in a Bilateral Shoulder Disarticulation Amputee." Prosthetics and Orthotics International. Web. 27 Apr <
Kuiken, T. A., G. Li, B. A. Lock, R. D. Lipschutz, L. A. Miller, K. A. Stubblefield, and K. B. Englehart. "Targeted Muscle Reinnervation for Real-time Myoelectric Control of Multifunction Artificial Arms." JAMA: The Journal of the American Medical Association (2009): Web. <
Meier, Robert H., III. "History of Arm Amputation, Prosthetic Restoration, and Arm Amputation Rehabilitation." Web. 27 Apr <
Smith, Douglas G. "Notes From the Medical DirectorUpper-Limb Prosthetics: Part 2Insights from Those Who Have Lost One Arm." InMotion. Web. 28 Apr <
A Prosthetic Arm That "feels" Perf. Todd Kuiken. TED Talk. Oct Web. 28 Apr <
"Can You Build a Bionic Body? The Arm." BBC News. 03 Feb Web. 28 Apr <
"For Upper Limb Amputees, the Real Advances Lie in the Future." U.S. Medicine. June Web. 28 Apr <