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Targeted Muscle Reinnervation for Control of Myoelectric Arm Prostheses By. Rory Makuch Need for a functional upper limb Prosthetic ● ● ● There are an estimated 1.7 million people in the United States alone that have had an amputation of some kind. Between 1988 and 1996, 68.6 percent of trauma related amputations were upper limb amputations. There are Three main types of arm prostheses Cosmetic- provide realistic looking replacement. Body Powered- use body and shoulder muscles to move arm prosthesis. Myoelectric.... Myoelectric Arm Prostheses ● ● ● ● Myoelectric prostheses are artificial limbs controlled through sensors connected to remaining muscles of the arm Sensors pick up Electromyograph signals which are processed and converted to movements by a computer. This method is sometimes not intuitive because the patient has to flex muscles not normally associated with a movement to complete the movement. Some patients cannot generate strong enough signals to be picked up. Others such as shoulder disarticulation amputees simply do not have the muscles necessary. Targeted Muscle Reinnervation ● ● ● ● A surgical process where the residual nerves in the arm are transported to the shoulder upper chest or back. After 11-70 months of recovery, nerve impulses from the brain to the amputated limb will activate the muscle areas that the nerves have been transplanted to. This new muscle activation serves as an amplifier for EMG signal detection. It allows patients without any arm muscles to be fitted with a myoelectric prosthesis, as well as allowing more intuitive control of the prosthesis. Technical Information ● ● ● For testing twelve EMG electrodes are placed on the patient in the new muscular activation areas. When the patients think about a certain movement the activation of the EMG sensors is mapped and processed. This data is used to train a myoelectric Testing ● ● ● ● ● This type of prosthesis interface is still in the research phase. Five amputees that had undergone targeted muscle reinnervation and five non amputees were chosen to test the interface. The first tests were done on a virtual arm, patients chose 11 arm motions including 3 different grips to attempt. The control subjects completed the motions 97% of the time and the amputees 88% of the time. Three of the TMR participants were then chosen to attempt to manipulate a real prosthesis. They were able to attain proficiency in the first day. With great Limitations ● ● ● One of the limitations of the device is movement reaction time. While the results are much better than without TMR, the reaction speed is nowhere near non prosthesis speeds. Weight of the device. The patient has to wear a small computer on their back for processing and retraining on the go. The amputation must be recent (within 10 years) and there cannot be severe nerve damage. Sources http://www.amputeecoalition.org/fact_sheets/amp_stats_cause. html http://www.amputeecoalition.org/inmotion/nov_dec_07/history_p rosthetics.html http://www.myoelectricprosthetics.com/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC 3036162/ http://archive.laptopmag.com/NR/rdonlyres/ev