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targeted muscle reinnervation

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https://www.readbyqxmd.com/read/28813784/longitudinal-high-density-emg-classification-case-study-in-a-glenohumeral-tmr-subject
#1
Meike A Schweisfurth, Jennifer Ernst, Ivan Vujaklija, Arndt F Schilling, Dario Farina, Oskar C Aszmann, Gunther Felmerer
Targeted muscle reinnervation (TMR) represents a breakthrough interface for prosthetic control in high-level upper-limb amputees. However, clinically, it is still limited to the direct motion-wise control restricted by the number of reinnervation sites. Pattern recognition may overcome this limitation. Previous studies on EMG classification in TMR patients experienced with myocontrol have shown greater accuracy when using high-density (HD) recordings compared to conventional single-channel derivations. This case study investigates the potential of HD-EMG classification longitudinally over a period of 17 months post-surgery in a glenohumeral amputee...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28769755/broadband-prosthetic-interfaces-combining-nerve-transfers-and-implantable-multichannel-emg-technology-to-decode-spinal-motor-neuron-activity
#2
Konstantin D Bergmeister, Ivan Vujaklija, Silvia Muceli, Agnes Sturma, Laura A Hruby, Cosima Prahm, Otto Riedl, Stefan Salminger, Krisztina Manzano-Szalai, Martin Aman, Michael-Friedrich Russold, Christian Hofer, Jose Principe, Dario Farina, Oskar C Aszmann
Modern robotic hands/upper limbs may replace multiple degrees of freedom of extremity function. However, their intuitive use requires a high number of control signals, which current man-machine interfaces do not provide. Here, we discuss a broadband control interface that combines targeted muscle reinnervation, implantable multichannel electromyographic sensors, and advanced decoding to address the increasing capabilities of modern robotic limbs. With targeted muscle reinnervation, nerves that have lost their targets due to an amputation are surgically transferred to residual stump muscles to increase the number of intuitive prosthetic control signals...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28767716/factors-associated-with-interest-in-novel-interfaces-for-upper-limb-prosthesis-control
#3
Susannah M Engdahl, Cynthia A Chestek, Brian Kelly, Alicia Davis, Deanna H Gates
BACKGROUND: Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual's decision to try one. METHODS: We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc...
2017: PloS One
https://www.readbyqxmd.com/read/28657487/delayed-spinal-cord-brachial-plexus-reconnection-after-c7-ventral-root-avulsion-the-effect-of-reinnervating-motoneurons-rescued-by-riluzole-treatment
#4
Balázs Gloviczki, Dénes G Török, Gábor Márton, László Gál, Tamás Bodzay, Sándor Pintér, Antal Nógrádi
Ventral root avulsion induces dramatic loss of the affected spinal cord motoneurons. The neuroprotective effect of riluzole has been previously proven on the injured motoneurons: the vast majority of them can be rescued even when they have no possibility to regenerate their axons. In this study the number of injured motoneurons rescued by riluzole treatment and their capacity to reinnervate the denervated forelimb muscles was investigated. Surgical reconnection with a peripheral nerve graft between the affected spinal cord segment and the C7 spinal nerve was established immediately or with 1- and 3-week delay after avulsion...
August 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28638701/reinnervation-of-denervated-muscle-by-implantation-of-nerve-muscle-endplate-band-graft-to-the-native-motor-zone-of-the-target-muscle
#5
Liancai Mu, Stanislaw Sobotka, Jingming Chen, Themba Nyirenda
INTRODUCTION: Motor endplate reinnervation is critical for restoring motor function of the denervated muscle. We developed a novel surgical technique called nerve-muscle-endplate band grafting (NMEG) for muscle reinnervation. METHODS: Experimentally denervated sternomastoid muscle in the rat was reinnervated by transferring a NMEG from the ipsilateral sternohyoid muscle to the native motor zone (NMZ) of the target muscle. A NMEG pedicle contained a block of muscle (~ 6 × 6 × 3 mm), a nerve branch with axon terminals, and a motor endplate band with numerous neuromuscular junctions...
June 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28579692/targeted-muscle-reinnervation-for-the-upper-and-lower-extremity
#6
Todd A Kuiken, Ann K Barlow, Levi Hargrove, Gregorgy A Dumanian
Myoelectric devices are controlled by electromyographic signals generated by contraction of residual muscles, which thus serve as biological amplifiers of neural control signals. Although nerves severed by amputation continue to carry motor control information intended for the missing limb, loss of muscle effectors due to amputation prevents access to this important control information. Targeted Muscle Reinnervation (TMR) was developed as a novel strategy to improve control of myoelectric upper limb prostheses...
June 2017: Techniques in Orthopaedics: TIO
https://www.readbyqxmd.com/read/28396957/-transcutaneous-osseointegrated-prosthesis-top-after-limb-amputation-status-quo-and-perspectives
#7
Christian Willy, Christian Krettek
The majority of transfemoral and transtibial amputees can be functionally fitted with conventional suspension sockets; however, due to socket problems using conventional stump care, 60% of the patients have limited function and even in younger patients approximately one sixth are unable to wear the prosthesis daily. After the introduction of transcutaneous osseointegrated prostheses (TOP) the inherent problems of socket-stump care can be avoided for these patients. Against this background this article reviews the recent clinical development of TOP in Sweden, Germany, the Netherlands, Australia and USA currently in nine centers...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28293499/proximal-versus-distal-nerve-transfer-for-biceps-reinnervation-a-comparative-study-in-a-rat-s-brachial-plexus-injury-model
#8
Aleksandra M McGrath, Johnny Chuieng-Yi Lu, Tommy Naj-Jen Chang, Frank Fang, David Chwei-Chin Chuang
BACKGROUND: The exact role of proximal and distal nerve transfers in reconstruction strategies of brachial plexus injury remains controversial. We compared proximal with distal nerve reconstruction strategies in a rat model of brachial plexus injury. METHODS: In rats, the C6 spinal nerve with a nerve graft (proximal nerve transfer model, n = 30, group A) and 50% of ulnar nerve (distal nerve transfer model, n = 30, group B) were used as the donor nerves. The targets were the musculocutaneous nerve and the biceps muscle...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28269705/real-time-evaluation-of-a-myoelectric-control-method-for-high-level-upper-limb-amputees-based-on-homologous-leg-movements
#9
Kenneth R Lyons, Sanjay S Joshi
Electromyography-based gesture classification methods for control of advanced upper limb prostheses are limited either to individuals with amputations distal to the elbow or to those willing to undergo targeted muscle reinnervation surgery. Based on the natural similarity between gestures of the lower leg and the arm and on established methods in electromyography-based gesture classification, we propose a noninvasive system with which users control an upper limb prosthesis via homologous movements of the leg and foot...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227966/real-time-evaluation-of-a-myoelectric-control-method-for-high-level-upper-limb-amputees-based-on-homologous-leg-movements
#10
Kenneth R Lyons, Sanjay S Joshi, Kenneth R Lyons, Sanjay S Joshi, Sanjay S Joshi, Kenneth R Lyons
Electromyography-based gesture classification methods for control of advanced upper limb prostheses are limited either to individuals with amputations distal to the elbow or to those willing to undergo targeted muscle reinnervation surgery. Based on the natural similarity between gestures of the lower leg and the arm and on established methods in electromyography-based gesture classification, we propose a noninvasive system with which users control an upper limb prosthesis via homologous movements of the leg and foot...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28203223/impaired-axonal-regeneration-in-diabetes-perspective-on-the-underlying-mechanism-from-in-vivo-and-in-vitro-experimental-studies
#11
REVIEW
Kazunori Sango, Hiroki Mizukami, Hidenori Horie, Soroku Yagihashi
Axonal regeneration after peripheral nerve injury is impaired in diabetes, but its precise mechanisms have not been elucidated. In this paper, we summarize the progress of research on altered axonal regeneration in animal models of diabetes and cultured nerve tissues exposed to hyperglycemia. Impaired nerve regeneration in animal diabetes can be attributed to dysfunction of neurons and Schwann cells, unfavorable stromal environment supportive of regenerating axons, and alterations of target tissues receptive to reinnervation...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28111229/surgical-repair-in-humans-after-traumatic-nerve-injury-provides-limited-functional-neural-regeneration-in-adults
#12
REVIEW
Winnie A Palispis, Ranjan Gupta
Traumatic nerve injuries result in devastating loss of neurologic function with unpredictable functional recovery despite optimal medical management. After traumatic nerve injury and denervation, regenerating axons must traverse a complex environment in which they encounter numerous barriers on the way to reinnervation of their target muscle. Outcomes of surgical intervention alone have unfortunately reached a plateau, resulting in often unsatisfactory functional recovery. Over the past few decades, many improvements were developed to supplement and boost the results of surgical repair...
April 2017: Experimental Neurology
https://www.readbyqxmd.com/read/27879592/reinnervated-split-muscle-technique-for-creating-additional-myoelectric-sites-in-an-animal-model
#13
Maria Florencia Deslivia, Hyun-Joo Lee, Rizki Fajar Zulkarnain, Bin Zhu, Arnold Adikrishna, In-Ho Jeon, Keehoon Kim
BACKGROUND: This study proposes a novel reinnervated split-muscle operation to create additional myoelectric sites as sources of command signals of myoelectric prostheses for enhanced dexterous hand-to-wrist motions. The aim of this study was to investigate the postprocedure electromyographic properties of the muscles as distinct myoelectric sites in a rat model. METHODS: The reinnervated split-muscle group (n = 6) had the gastrocnemius muscle separated along its longitudinal axis and nerves transferred to each new muscle (peroneal nerve to lateral muscle head and tibial to medial one); the non-split-muscle group (n = 6) only had nerve transfers with its muscle intact...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27824734/targeted-muscle-reinnervation-for-transradial-amputation-description-of-operative-technique
#14
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/27737470/outcomes-of-muscle-reinnervation-with-direct-nerve-implantation-into-the-native-motor-zone-of-the-target-muscle
#15
Stanislaw Sobotka, Jingming Chen, Themba Nyirenda, Liancai Mu
Background Our recent work has demonstrated that the native motor zone (NMZ) within a given skeletal muscle is the best site for muscle reinnervation. This study was designed to explore the outcomes of direct nerve implantation (DNI) into the NMZ of denervated sternomastoid (SM) muscle in a rat model. Methods The right SM muscle was experimentally denervated by transecting its innervating nerve. The proximal stump of the severed SM nerve was immediately implanted into a small muscle slit made in the NMZ of the muscle where denervated motor endplates were concentrated...
February 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27661421/what-is-new-in-trauma-related-amputations
#16
Scott M Tintle, Christopher LeBrun, James R Ficke, Benjamin K Potter
Traumatic and trauma-related amputations represent unfortunate sequelae of severe injury, but should not be viewed as a treatment failure and may represent the best reconstructive option for some patients. Lessons from recent military conflicts have guided the evolution of modern surgical techniques and rehabilitation management of this challenging patient population, and treatment at a specialty center may improve patient outcomes. Despite appropriate management, however, surgical complications remain common and revision surgery is often necessary...
October 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27585036/the-fibular-nerve-injury-method-a-reliable-assay-to-identify-and-test-factors-that-repair-neuromuscular-junctions
#17
William Dalkin, Thomas Taetzsch, Gregorio Valdez
The neuromuscular junction (NMJ) undergoes deleterious structural and functional changes as a result of aging, injury and disease. Thus, it is imperative to understand the cellular and molecular changes involved in maintaining and repairing NMJs. For this purpose, we have developed a method to reliably and consistently examine regenerating NMJs in mice. This nerve injury method involves crushing the common fibular nerve as it passes over the lateral head of the gastrocnemius muscle tendon near the knee. Using 70 day old female mice, we demonstrate that motor axons begin to reinnervate previous postsynaptic targets within 7 days post-crush...
August 11, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27508011/collateral-development-and-spinal-motor-reorganization-after-nerve-injury-and-repair
#18
Youlai Yu, Peixun Zhang, Na Han, Yuhui Kou, Xiaofeng Yin, Baoguo Jiang
Functional recovery is often unsatisfactory after severe extended nerve defects or proximal nerve trunks injuries repaired by traditional repair methods, as the long regeneration distance for the regenerated axons to reinnervate their original target end-organs. The proximal nerve stump can regenerate with many collaterals that reinnervate the distal stump after peripheral nerve injury, it may be possible to use nearby fewer nerve fibers to repair more nerve fibers at the distal end to shorten the regenerating distance...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27475929/muscle-specific-nucleus-ambiguus-neurons-isolation-and-culturing
#19
Ignacio Hernández-Morato, Michael J Pitman, Sansar Sharma
BACKGROUND: Peripheral nerve injury leads to a regenerative state. However, the reinnervation process is highly non-selective. Growing axons are often misrouted and establish aberrant synapsis to abductor or adductor muscles. Determining the complex properties of abductor and adductor motoneurons in a neuron culture, may lay the groundwork for future studies on axon guidance, leading to a clinical treatment for a selective reinnervation. NEW METHOD: In the present study we develop a neuron culture protocol to isolate recurrent laryngeal nerve abductor and adductor motoneurons in order to study their unique properties...
July 27, 2016: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/27466130/upslope-treadmill-exercise-enhances-motor-axon-regeneration-but-not-functional-recovery-following-peripheral-nerve-injury
#20
Jill Cannoy, Sam Crowley, Allen Jarratt, Kelly LeFevere Werts, Krista Osborne, Sohee Park, Arthur W English
Following peripheral nerve injury, moderate daily exercise conducted on a level treadmill results in enhanced axon regeneration and modest improvements in functional recovery. If the exercise is conducted on an upwardly inclined treadmill, even more motor axons regenerate successfully and reinnervate muscle targets. Whether this increased motor axon regeneration also results in greater improvement in functional recovery from sciatic nerve injury was studied. Axon regeneration and muscle reinnervation were studied in Lewis rats over an 11 wk postinjury period using stimulus evoked electromyographic (EMG) responses in the soleus muscle of awake animals...
September 1, 2016: Journal of Neurophysiology
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