Improving the function of prosthetic arms remains a challenge, because access to neural-control information for arm is lost during amputation. A surgical technique called targeted muscle reinnervation (TMR) transfers residual nerves alternative sites. After reinnervation, these target muscles produce electromyogram (EMG) signals on surface skin that can be measured and used control arms.To assess performance patients with upper-limb amputation who had undergone TMR surgery, using...

A novel method for the control of a myoelectric upper limb prosthesis was achieved in patient with bilateral amputations at shoulder disarticulation level. Four independently controlled nerve-muscle units were created by surgically anastomosing residual brachial plexus nerves to dissected and divided aspects pectoralis major minor muscles. The musculocutaneous nerve anastomosed major; median transferred middle region; radial lower ulnar muscle which moved out lateral chest wall. After five...

Recently commercialized powered prosthetic arm systems hold great potential in restoring function for people with upper-limb loss. However, effective use of such devices remains limited by conventional (direct) control methods, which rely on electromyographic signals produced from a set muscles. Targeted Muscle Reinnervation (TMR) is nerve transfer procedure that creates additional recording sites myoelectric prosthesis control. The effects TMR may be enhanced when paired pattern recognition...

Targeted reinnervation is a surgical technique developed to increase the number of myoelectric input sites available control an upper-limb prosthesis. Because signals from nerves related specific movements are used those missing degrees-of-freedom, prosthesis using this procedure more physiologically appropriate compared conventional control. This has successfully been performed on three people with shoulder disarticulation level amputation and transhumeral amputation. Performance timed...

With existing conventional prosthesis control (direct control), individuals with a transradial amputation use two opposing muscle groups to each motor. As component complexity increases, subjects must switch the into different modes in sequence. Pattern recognition offers ability multiple movements seamless manner without switching. In this paper, three completed home trial compare direct and pattern of degree-of-freedom prosthesis. Outcome measures before after trial, together subject...

Background: The control of shoulder-level disarticulation prostheses is significantly more difficult than that for distal amputations. Amputees have significant difficulties coordinating the separate functions prosthetic shoulder, elbow, wrist, and hand/hook components. user must lock one joint at a particular position in space before subsequently moving different joint. Methods: A patient with bilateral humeral disarticulations after an electrical injury underwent novel nerve transfer...

Maripuri, Subramanyam Naidu MS(Ortho), MRCS; Mehta, Hemang FRCS; Mohanty, Khitish DNB(Ortho), FRCS, FRCS(Ortho) Author Information

Despite the growing availability of multifunctional prosthetic hands, users' control and overall functional abilities with these hands remain limited. The combination pattern recognition targeted muscle reinnervation (TMR) surgery, an innovative technique where amputated nerves are transferred to reinnervate new targets in residual limb, has been used improve prosthesis individuals more proximal upper limb amputations (i.e., shoulder disarticulation transhumeral amputation).

Objective: The number of students with a disability requesting test accommodations has been steadily increasing in higher education settings. present study examined the effects extra time on reading comprehension performance college and without ADHD. Method: A modified version Nelson–Denny Reading Test was completed by 38 ADHD matched controls under three conditions: standard time, one half, double time. Results: Groups did not differ items attempted or correctly answered at Comparing group...

Targeted muscle reinnervation (TMR) is a surgical intervention to improve the control of myoelectric prostheses in high-level upper-limb amputation. This article briefly describes procedure and presents protocol for postoperative, preprosthetic care. We also recommend guide patient training using standard-of-care prosthetic devices controlled by up four intuitive, independent, isolated signals. discuss advantages this new paradigm methods optimizing clinical outcomes patients with...

With the increasing availability of more advanced prostheses individuals with a transradial amputation can now be fit single to multi-degree freedom hands. Reliable and accurate control these multi-grip hands still remains challenging. This is first multi-user study investigate at-home use hand prosthesis under pattern recognition direct control. Individuals were fitted trained an OSSUR i-Limb Ultra Revolution Coapt COMPLETE CONTROL system. They participated in two 8-week home trials using...

Background: This study examined symptom reports and neurocognitive outcomes in children (8–17 years) with mild traumatic brain injury (mTBI) or orthopaedic (OI).Method: Children parents were initially assessed upon presentation the Emergency Department of a local hospital again at 3 months. completed Immediate Post-Concussion Assessment Cognitive Testing battery (ImPACT) Behavior Rating Inventory Executive Function (BRIEF). The Peabody Picture Vocabulary Test, 3rd edition (PPVT-III) was by...

Advances such as targeted muscle reinnervation and pattern recognition control may provide improved of upper limb myoelectric prostheses, but evaluating user function remains challenging. Virtual environments are cost-effective immersive tools that increasingly used to practice evaluate prosthesis control, the relationship between virtual physical outcomes—i.e., whether in a environment translates performance—is not understood. Nine people with transhumeral amputations who previously had...

Although more multi-articulating hand prostheses have become commercially available, replacing a missing remains challenging from control perspective. This study investigated myoelectric direct and pattern recognition home use of prosthesis for individuals with transradial amputation. Four participants were fitted an i-limb Ultra Revolution Coapt COMPLETE CONTROL system. An occupational therapist provided training each style how to the various grips. The number grips available individual was...

The Academy's Ninth State of the Science Conference included a group engineers, prosthetists, and therapists brought together to discuss upper limb prosthetic outcome measures. After presentation evidence based review discussions on history field various perspectives from professions, panel reviewed those measures found be recommended thought worth consideration by Evidence Based Review Upper Limb Prosthetics Outcome Measures Group. with potential address certain research questions are...

Abstract Objective To describe the patient population, injuries, and treatment received on battlefield, ultimate outcome of U . S military working dogs that incurred gunshot wound ( GSW ) injury in O peration E nduring F reedom A fghanistan) or I raqi raq). Design Retrospective study between J anuary 2003 D ecember 2009. Animals Twenty‐nine from with confirmed injuries combat reedom. Interventions None. Measurements Main Results Clinical data battlefield treatment, which includes care point...

High-level upper-limb amputations result in prostheses with many degrees-of-freedom to be controlled, very few control signals. A novel method for the of myoelectric upper limb has been developed. By transferring residual nerves spare muscles or near limb, additional signals are created that allow simultaneous multiple prostheses. Since nerve function correlates physiologically prosthetic function, operation is more natural and thus easier than current paradigms. This surgical procedure...

Military working dogs (MWDs) are a major asset in the theater of operations. Their unique abilities make them ideal for tasks such as tracking, patrol, and scent detection. MWDs deployed to war zone exposed harsh environments battlefield dangers that increase their risk disease, injuries, death. Although canines have been used extensively Operation Iraqi Freedom (OIF) Enduring (OEF), no published studies reported detailed causes death among these conflicts. Potential cases were defined U.S....

Persons with an upper-limb amputation who use a body-powered prosthesis typically control the prehensor through contralateral shoulder movement, which is transmitted Bowden cable. Increased cable tension either opens or closes prehensor; when released, some passive element, such as spring, returns to default state (closed open). In this study, we used Southampton Hand Assessment Procedure examine functional differences between these two types of prehensors in 29 nondisabled subjects (who...

In Brief Functional prosthetic restoration is challenging for individuals with high-level upper extremity amputations. It of greater consequence when the individual has sustained bilateral limb loss. possible to denervate expendable regions muscle in or near an amputated and transfer residual peripheral nerves this muscle. The surface EMG signals from reinnervated can then be used as additional control externally powered prosthesis. This technique, called "targeted reinnervation," allows...

Abstract Background State-of-the-art bionic hands incorporate hi-tech devices which try to overcome limitations of conventional single grip systems. Unfortunately, their complexity often limits mechanical robustness and intuitive prosthesis control. Recently, the translation neuroscientific theories (i.e. postural synergies) in software hardware architecture artificial is opening new approaches for design control upper-limb prostheses. Methods Following these emerging principles, previous...