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https://www.readbyqxmd.com/read/27824734/targeted-muscle-reinnervation-for-transradial-amputation-description-of-operative-technique
#1
Emily N Morgan, Benjamin Kyle Potter, Jason M Souza, Scott M Tintle, George P Nanos
Targeted muscle reinnervation (TMR) is a revolutionary surgical technique that, together with advances in upper extremity prostheses and advanced neuromuscular pattern recognition, allows intuitive and coordinated control in multiple planes of motion for shoulder disarticulation and transhumeral amputees. TMR also may provide improvement in neuroma-related pain and may represent an opportunity for sensory reinnervation as advances in prostheses and haptic feedback progress. Although most commonly utilized following shoulder disarticulation and transhumeral amputations, TMR techniques also represent an exciting opportunity for improvement in integrated prosthesis control and neuroma-related pain improvement in patients with transradial amputations...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27638013/attachment-of-upper-arm-prostheses-with-a-subcutaneous-osseointegrated-implant-in-transhumeral-amputees
#2
Stefan Salminger, Andreas Gradischar, Richard Skiera, Aidan D Roche, Agnes Sturma, Christian Hofer, Oskar C Aszmann
BACKGROUND: The stump-socket interface is of utmost importance for prosthetic function in transhumeral amputees. Stability of this connection may be improved using a newly designed subcutaneous implant. OBJECTIVES: The purpose was to determine the effect of the implant together with customized socket designs on the range of motion of the shoulder and the prosthetic function compared to conventional fitting. STUDY DESIGN: Case series. METHODS: The range of motion was measured with scaled metrics and the prosthetic function evaluated with the Southampton Hand Assessment Procedure and the Box and Block Test...
September 16, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/27166714/an-anthropomorphic-transhumeral-prosthesis-socket-developed-based-on-an-oscillometric-pump-and-controlled-by-force-sensitive-resistor-pressure-signals
#3
N A Abd Razak, H Gholizadeh, N Hasnan, N A Abu Osman, S S Mohd Fadzil, N A Hashim
While considering the importance of the interface between amputees and prosthesis sockets, we study an anthropomorphic prosthesis socket whose size can be dynamically changed according to the requirements of the residual limb. First, we introduce the structure and function of the anthropomorphic prosthesis socket. Second, we study the dynamic model of the prosthesis system and analyze the dynamic characteristics of the prosthesis socket system, the inputs of an oscillometric pump, and the control mechanism of force-sensitive resistor (FSR) pressure signals...
May 11, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27164596/classification-of-phantom-finger-hand-wrist-and-elbow-voluntary-gestures-in-transhumeral-amputees-with-semg
#4
Nathanael Jarrasse, Caroline Nicol, Amelie Touillet, Florian Richer, Noel Martinet, Jean Paysant, Jozina Bernardina De Graaf
Decoding finger and hand movements from sEMG electrodes placed on the forearm of transradial amputees has been commonly studied by many research groups. A few recent studies have shown an interesting phenomenon: simple correlations between distal phantom finger, hand and wrist voluntary movements and muscle activity in the residual upper arm in transhumeral amputees, i.e., of muscle groups that, prior to amputation, had no physical effect on the concerned hand and wrist joints. In this study, we are going further into the exploration of this phenomenon by setting up an evaluation study of phantom finger, hand, wrist and elbow (if present) movement classification based on the analysis of surface electromyographic (sEMG) signals measured by multiple electrodes placed on the residual upper arm of 5 transhumeral amputees with a controllable phantom limb who did not undergo any reinnervation surgery...
May 4, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/26932982/cutaneous-sensory-outcomes-from-three-transhumeral-targeted-reinnervation-cases
#5
Jacqueline S Hebert, K Ming Chan, Michael R Dawson
BACKGROUND: Although targeted muscle reinnervation has been shown to be effective in enhancing prosthetic control for upper limb amputees, restored hand sensations have been variable. An understanding of possible sensory feedback channels is crucial in working toward more effective closed-loop prosthetic control. OBJECTIVES: To compare sensory outcomes of different targeted sensory reinnervation approaches. STUDY DESIGN: Case series, cross-sectional, and retrospective...
June 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/26780786/control-of-a-robotic-hand-using-a-tongue-control-system-a-prosthesis-application
#6
Daniel Johansen, Christian Cipriani, Dejan B Popovic, Lotte N S A Struijk
OBJECTIVE: The aim of this study was to investigate the feasibility of using an inductive tongue control system (ITCS) for controlling robotic/prosthetic hands and arms. METHODS: This study presents a novel dual modal control scheme for multigrasp robotic hands combining standard electromyogram (EMG) with the ITCS. The performance of the ITCS control scheme was evaluated in a comparative study. Ten healthy subjects used both the ITCS control scheme and a conventional EMG control scheme to complete grasping exercises with the IH1 Azzurra robotic hand implementing five grasps...
July 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/26737044/phantom-movements-from-physiologically-inappropriate-muscles-a-case-study-with-a-high-transhumeral-amputee
#7
Julie Gade, Rosa Hugosdottir, Ernest N Kamavuako
Individuals with high-level amputation have a great need for functional prostheses because of their vast functional deficits. Conventional techniques are considered inappropriate for high-level amputees due to the lack of physiologically appropriate muscles. This study investigates how accurate phantom movements (PMs) can be classified from physiologically inappropriate muscles. The study involves a case study of a 42-year-old transhumeral amputee. Suitable PMs and best electrode configuration were identified using the sequential forward selection method and brute-force technique...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/26314220/targeted-muscle-reinnervation-in-the-upper-extremity-amputee-a-technical-roadmap
#8
REVIEW
Michael S Gart, Jason M Souza, Gregory A Dumanian
Targeted muscle reinnervation (TMR) offers the potential for improved prosthetic function by reclaiming the neural control information that is lost as a result of upper extremity amputation. In addition to the prosthetic control benefits, TMR is a potential treatment for postamputation neuroma pain. Here, we present our surgical technique for TMR nerve transfers in transhumeral and shoulder disarticulation patients.
September 2015: Journal of Hand Surgery
https://www.readbyqxmd.com/read/26185472/designing-and-testing-lightweight-shoulder-prostheses-with-hybrid-actuators-for-movements-involved-in-typical-activities-of-daily-living-and-impact-absorption
#9
Masashi Sekine, Kahori Kita, Wenwei Yu
Unlike forearm amputees, transhumeral amputees have residual stumps that are too small to provide a sufficient range of operation for their prosthetic parts to perform usual activities of daily living. Furthermore, it is difficult for small residual stumps to provide sufficient impact absorption for safe manipulation in daily living, as intact arms do. Therefore, substitution of upper limb function in transhumeral amputees requires a sufficient range of motion and sufficient viscoelasticity for shoulder prostheses under critical weight and dimension constraints...
2015: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/25917956/life-without-limbs-technology-to-the-rescue
#10
Deirdre M Cooke, Matthew Ames, Saul Geffen
BACKGROUND: This article reports a rare and inspirational case of a four-limb amputee, the range of integrated technology solutions that enable him to be a productive member of his family and the process and pitfalls of seeking technology solutions. CASE DESCRIPTION AND METHODS: A complex case of bilateral transhumeral amputation and bilateral transfemoral amputation with residual upper limbs too short to oppose is presented. The multiple 'high-tech' and 'low-tech' devices used on a daily basis to move around his house and community, control his environment, communicate and feed himself without the use of limbs, prostheses or a second person are outlined...
August 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/25425411/comparison-of-transhumeral-socket-designs-utilizing-patient-assessment-and-in-vivo-skeletal-and-socket-motion-tracking-a-case-study
#11
Linda Resnik, Tarpit Patel, Shane G Cooney, Joseph J Crisco, Christopher Fantini
PURPOSE: This case study compares the impact of two prosthetic socket designs, a "traditional" transhumeral (TH) socket design and a Compression Released Stabilized (CRS) socket. METHODS: A CRS socket was compared to the existing socket of two persons with transhumeral amputation. Comparisons included assessments of patient comfort and satisfaction with fit, as well as dynamic kinematic assessment using a novel high-speed, high-resolution, bi-plane video radiography system (XROMM, for X-ray Reconstruction of Moving Morphology)...
2016: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/25208636/biomechanics-principle-of-elbow-joint-for-transhumeral-prostheses-comparison-of-normal-hand-body-powered-myoelectric-air-splint-prostheses
#12
COMPARATIVE STUDY
Nasrul Anuar Abd Razak, Noor Azuan Abu Osman, Hossein Gholizadeh, Sadeeq Ali
BACKGROUND: Understanding of kinematics force applied at the elbow is important in many fields, including biomechanics, biomedical engineering and rehabilitation. This paper provides a comparison of a mathematical model of elbow joint using three different types of prosthetics for transhumeral user, and characterizes the forces required to overcome the passive mechanical of the prosthetics at the residual limb. METHODS: The study modeled the elbow as a universal joint with intersecting axes of x-axis and y-axis in a plain of upper arm and lower arm...
2014: Biomedical Engineering Online
https://www.readbyqxmd.com/read/25176817/b-67cognitive-predictors-of-proficient-use-of-an-advanced-upper-limb-multifunction-prosthesis
#13
L Hancock, D Ahern, S Correia, D Knepp, L Resnik
OBJECTIVE: To examine cognitive predictors of functional performance and dexterity using an advanced upper-limb prosthetic device. METHOD: Veterans (n = 14) with upper-limb amputation (transradial, transhumeral, or full-arm) underwent tests of neuropsychological functioning and dexterity (Jebsen-Taylor Hand Function Test [JTHF]), and a clinician-based functional rating (Activities Measure for Upper-Limb Amputees [AM-ULA]) using the prosthetic device at study baseline...
September 2014: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/25095092/liquid-fueled-actuation-for-an-anthropomorphic-upper-extremity-prosthesis
#14
K B Fite, T J Withrow, K W Wait, M Goldfarb
This paper describes the design of a 21 degree-of-freedom, nine degree-of-actuation, gas-actuated arm prosthesis for transhumeral amputees. The arm incorporates a direct-drive elbow and three degree-of-freedom wrist, in addition to a 17 degree-of-freedom underactuated hand effected by five actuators. The anthropomorphic device includes full position and force sensing capability for each actuated degree of freedom and integrates a monopropellant-powered gas generator to provide on-board power for untethered operation...
August 2006: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/25085005/prosthetics-socket-that-incorporates-an-air-splint-system-focusing-on-dynamic-interface-pressure
#15
Nasrul Anuar Abd Razak, Noor Azuan Abu Osman, Hossein Gholizadeh, Sadeeq Ali
BACKGROUND: The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee's satisfaction and comfort. This paper presents the design and performance of a new prosthetic socket that uses an air splint system. METHODS: The air splint prosthetic socket system was implemented by combining the air splint with a pressure sensor that the transhumeral user controls through the use of a microcontroller. The modular construction of the system developed allows the FSR pressure sensors that are placed inside the air splint socket to determine the required size and fitting for the socket used...
2014: Biomedical Engineering Online
https://www.readbyqxmd.com/read/24834047/epidural-electrocorticography-of-phantom-hand-movement-following-long-term-upper-limb-amputation
#16
Alireza Gharabaghi, Georgios Naros, Armin Walter, Alexander Roth, Martin Bogdan, Wolfgang Rosenstiel, Carsten Mehring, Niels Birbaumer
INTRODUCTION: Prostheses for upper-limb amputees are currently controlled by either myoelectric or peripheral neural signals. Performance and dexterity of these devices is still limited, particularly when it comes to controlling hand function. Movement-related brain activity might serve as a complementary bio-signal for motor control of hand prosthesis. METHODS: We introduced a methodology to implant a cortical interface without direct exposure of the brain surface in an upper-limb amputee...
2014: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/24760915/novel-targeted-sensory-reinnervation-technique-to-restore-functional-hand-sensation-after-transhumeral-amputation
#17
Jacqueline S Hebert, Jaret L Olson, Michael J Morhart, Michael R Dawson, Paul D Marasco, Todd A Kuiken, K Ming Chan
We present a case study of a novel variation of the targeted sensory reinnervation technique that provides additional control over sensory restoration after transhumeral amputation. The use of intraoperative somatosensory evoked potentials on individual fascicles of the median and ulnar nerves allowed us to specifically target sensory fascicles to reroute to target cutaneous nerves at a distance away from anticipated motor sites in a transhumeral amputee. This resulted in restored hand maps of the median and ulnar nerve in discrete spatially separated areas...
July 2014: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/24562875/targeted-muscle-reinnervation-a-novel-approach-to-postamputation-neuroma-pain
#18
MULTICENTER STUDY
Jason M Souza, Jennifer E Cheesborough, Jason H Ko, Mickey S Cho, Todd A Kuiken, Gregory A Dumanian
BACKGROUND: Postamputation neuroma pain can prevent comfortable prosthesis wear in patients with limb amputations, and currently available treatments are not consistently effective. Targeted muscle reinnervation (TMR) is a decade-old technique that employs a series of novel nerve transfers to permit intuitive control of upper-limb prostheses. Clinical experience suggests that it may also serve as an effective therapy for postamputation neuroma pain; however, this has not been explicitly studied...
October 2014: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/24287238/amputation-surgery
#19
REVIEW
David Schnur, Robert H Meier
The best level of amputation must take into consideration the newest socket designs, methods of prosthetic suspension, and technologically advanced components. In some instances stump revision should be considered, to provide a better prosthetic fitting and function. Targeted reinnervation is a new neural-machine interface that has been developed to help improve the function of electrically powered upper prosthetic limbs. Osseointegrated implants for prosthetic suspension offer amputees an alternative to the traditional socket suspension, and are especially useful for transfemoral and transhumeral levels of amputation...
February 2014: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/24110509/using-speech-for-mode-selection-in-control-of-multifunctional-myoelectric-prostheses
#20
Peng Fang, Zheng Wei, Yanjuan Geng, Fuan Yao, Guanglin Li
Electromyogram (EMG) recorded from residual muscles of limbs is considered as suitable control information for motorized prostheses. However, in case of high-level amputations, the residual muscles are usually limited, which may not provide enough EMG for flexible control of myoelectric prostheses with multiple degrees of freedom of movements. Here, we proposed a control strategy, where the speech signals were used as additional information and combined with the EMG signals to realize more flexible control of multifunctional prostheses...
2013: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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