Toward higher-performance bionic limbs for wider clinical use

• Published in: Nature biomedical engineering Vol. 7; no. 4; pp. 473 - 485
• Main Authors: Farina, Dario, Vujaklija, Ivan, Brånemark, Rickard, Bull, Anthony M. J., Dietl, Hans, Graimann, Bernhard, Hargrove, Levi J., Hoffmann, Klaus-Peter, Huang, He (Helen), Ingvarsson, Thorvaldur, Janusson, Hilmar Bragi, Kristjánsson, Kristleifur, Kuiken, Todd, Micera, Silvestro, Stieglitz, Thomas, Sturma, Agnes, Tyler, Dustin, Weir, Richard F. ff, Aszmann, Oskar C.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2023; Nature Publishing Group
• Subjects: 631/1647/1453/1451; 631/378/2629; 631/378/2632; 639/166/985; 692/308/575; 9/10; Algorithms; amputation prostheses; Artificial Limbs; Biomedical and Life Sciences; Biomedical Engineering/Biotechnology; Biomedicine; Bionics; control; dexterous manipulation; Electrodes; Engineering; Extremities; Humans; Innervation; Limbs; machine interfaces; Medical Biotechnology; Medicinsk bioteknologi; Muscles; myoelectric prosthesis control; of-the-art; Osseointegration; pattern-recognition control; Peripheral nerves; Perspective; proportional; Prostheses; Prosthesis Design; real-time; Rehabilitation; Robotics; Sensory feedback; sensory-feedback-system; targeted muscle reinnervation
• ISSN: 2157-846X; 2157-846X
• DOI: 10.1038/s41551-021-00732-x

Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged towards the creation of a new generation of high-performance bionic limbs. These technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs. This Perspective argues that technologies for the neural interfacing of robotic devices with the body that have been clinically tested in humans should be leveraged toward the creation of a new generation of high-performance bionic limbs.