Myoelectric prosthesis hand grasp control following targeted muscle reinnervation in individuals with transradial amputation

Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves a...

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Published inPloS one Vol. 18; no. 1; p. e0280210
Main Authors Simon, Ann M., Turner, Kristi L., Miller, Laura A., Dumanian, Gregory A., Potter, Benjamin K., Beachler, Mark D., Hargrove, Levi J., Kuiken, Todd A.
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 26.01.2023
Public Library of Science (PLoS)
Subjects
Activities of daily living
Amputation
Amputation, Surgical
Analysis
Artificial Limbs
Availability
Biology and Life Sciences
Care and treatment
Electrodes
Electromyography
Electromyography - methods
Engineering and Technology
Health aspects
Humans
Implants, Artificial
Limbs
Medical errors
Medicine and Health Sciences
Muscle contraction
Muscle, Skeletal - innervation
Muscles
Muscular function
Myoelectric control
Myoelectric prosthesis
Myoelectricity
Nerves
Pain
Patient outcomes
Pattern recognition
Pattern recognition systems
Phantom Limb
Prevention
Prostheses
Prosthesis
Reinnervation
Research and Analysis Methods
Smartphones
Surgery
Upper Extremity
United States
Online AccessGet full text
ISSN1932-6203
1932-6203
DOI10.1371/journal.pone.0280210

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Abstract Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation). The goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery. Eight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial. Three outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9-12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR. The potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.
AbstractList BackgroundDespite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation).ObjectiveThe goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery.MethodsEight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial.ResultsThree outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9-12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR.ConclusionsThe potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.
Background Despite the growing availability of multifunctional prosthetic hands, users’ control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation). Objective The goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery. Methods Eight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial. Results Three outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9–12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR. Conclusions The potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.
Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation).BACKGROUNDDespite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation).The goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery.OBJECTIVEThe goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery.Eight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial.METHODSEight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial.Three outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9-12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR.RESULTSThree outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9-12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR.The potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.CONCLUSIONSThe potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.
Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation). The goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery. Eight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial. Three outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9-12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR. The potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.
Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation). The goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery. Eight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial. Three outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9-12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR. The potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.
Background Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination of pattern recognition control and targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new muscle targets in the residual limb, has been used to improve prosthesis control of individuals with more proximal upper limb amputations (i.e., shoulder disarticulation and transhumeral amputation). Objective The goal of this study was to determine if prosthesis hand grasp control improves following transradial TMR surgery. Methods Eight participants were trained to use a multi-articulating hand prosthesis under myoelectric pattern recognition control. All participated in home usage trials pre- and post-TMR surgery. Upper limb outcome measures were collected following each home trial. Results Three outcome measures (Southampton Hand Assessment Procedure, Jebsen-Taylor Hand Function Test, and Box and Blocks Test) improved 9-12 months post-TMR surgery compared with pre-surgery measures. The Assessment of Capacity for Myoelectric Control and Activities Measure for Upper Limb Amputees outcome measures had no difference pre- and post-surgery. An offline electromyography analysis showed a decrease in grip classification error post-TMR surgery compared to pre-TMR surgery. Additionally, a majority of subjects noted qualitative improvements in their residual limb and phantom limb sensations post-TMR. Conclusions The potential for TMR surgery to result in more repeatable muscle contractions, possibly due to the reduction in pain levels and/or changes to phantom limb sensations, may increase functional use of many of the clinically available dexterous prosthetic hands.
Audience Academic
Author Kuiken, Todd A.
Hargrove, Levi J.
Beachler, Mark D.
Simon, Ann M.
Potter, Benjamin K.
Turner, Kristi L.
Miller, Laura A.
Dumanian, Gregory A.
AuthorAffiliation 5 Orthotic & Prosthetic Service, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, United States of America
6 Department of Biomedical Engineering, Northwestern University, Evanston, IL, United States of America
4 Uniformed Services University–Walter Reed National Military Medical Center Department of Surgery, Bethesda, MD, United States of America
Szegedi Tudomanyegyetem, HUNGARY
1 Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, United States of America
3 Division of Plastic Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, United States of America
2 Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, United States of America
AuthorAffiliation_xml – name: 6 Department of Biomedical Engineering, Northwestern University, Evanston, IL, United States of America
– name: 3 Division of Plastic Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, United States of America
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– name: 5 Orthotic & Prosthetic Service, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, United States of America
– name: Szegedi Tudomanyegyetem, HUNGARY
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/36701412$$D View this record in MEDLINE/PubMed
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Copyright Copyright: © 2023 Simon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2023 Simon et al 2023 Simon et al
2023 Simon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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– notice: 2023 Simon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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License Copyright: © 2023 Simon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Coapt LLC was launched in 2012 and has a technology transfer and license agreement with the Shirley Ryan AbilityLab for the development of certain control technologies. Authors TK and LJ in the Center for Bionic Medicine at Shirley Ryan AbilityLab are responsible for the design, conduct and reporting of this research, and also have financial, management and ownership interests in Coapt LLC, which manufactures the device being tested in this research. These interests have been fully disclosed to Shirley Ryan AbilityLab and Northwestern University, and there is a conflict of interest management plan in place relative to this research study.
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SSID ssj0053866
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Snippet Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The...
Background Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain...
Background Despite the growing availability of multifunctional prosthetic hands, users’ control and overall functional abilities with these hands remain...
BackgroundDespite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain...
Background Despite the growing availability of multifunctional prosthetic hands, users’ control and overall functional abilities with these hands remain...
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SubjectTerms Activities of daily living
Amputation
Amputation, Surgical
Analysis
Artificial Limbs
Availability
Biology and Life Sciences
Care and treatment
Electrodes
Electromyography
Electromyography - methods
Engineering and Technology
Health aspects
Humans
Implants, Artificial
Limbs
Medical errors
Medicine and Health Sciences
Muscle contraction
Muscle, Skeletal - innervation
Muscles
Muscular function
Myoelectric control
Myoelectric prosthesis
Myoelectricity
Nerves
Pain
Patient outcomes
Pattern recognition
Pattern recognition systems
Phantom Limb
Prevention
Prostheses
Prosthesis
Reinnervation
Research and Analysis Methods
Smartphones
Surgery
Upper Extremity
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Title Myoelectric prosthesis hand grasp control following targeted muscle reinnervation in individuals with transradial amputation
URI https://www.ncbi.nlm.nih.gov/pubmed/36701412
https://www.proquest.com/docview/2769974960
https://www.proquest.com/docview/2769996211
https://pubmed.ncbi.nlm.nih.gov/PMC9879512
https://doaj.org/article/18aa6e247e7f4fa9b35d822798326c7c
http://dx.doi.org/10.1371/journal.pone.0280210
Volume 18
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