Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation
Despite advancements in prosthetic technologies, patients with amputation today suffer great diminution in mobility and quality of life. We have developed a modified below-knee amputation (BKA) procedure that incorporates agonist-antagonist myoneural interfaces (AMIs), which surgically preserve and...
| Main Authors: | , , , , , , , , |
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| 格式: | Article |
| 語言: | English |
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Proceedings of the National Academy of Sciences
2021
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| 在線閱讀: | https://hdl.handle.net/1721.1/134133 |
| _version_ | 1826210054334840832 |
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| author | Srinivasan, Shriya S Gutierrez-Arango, Samantha Teng, Ashley Chia-En Israel, Erica Song, Hyungeun Bailey, Zachary Keith Carty, Matthew J Freed, Lisa E Herr, Hugh M |
| author2 | Massachusetts Institute of Technology. Center for Extreme Bionics |
| author_facet | Massachusetts Institute of Technology. Center for Extreme Bionics Srinivasan, Shriya S Gutierrez-Arango, Samantha Teng, Ashley Chia-En Israel, Erica Song, Hyungeun Bailey, Zachary Keith Carty, Matthew J Freed, Lisa E Herr, Hugh M |
| author_sort | Srinivasan, Shriya S |
| collection | MIT |
| description | Despite advancements in prosthetic technologies, patients with amputation today suffer great diminution in mobility and quality of life. We have developed a modified below-knee amputation (BKA) procedure that incorporates agonist-antagonist myoneural interfaces (AMIs), which surgically preserve and couple agonist-antagonist muscle pairs for the subtalar and ankle joints. AMIs are designed to restore physiological neuromuscular dynamics, enable bidirectional neural signaling, and offer greater neuroprosthetic controllability compared to traditional amputation techniques. In this prospective, nonrandomized, unmasked study design, 15 subjects with AMI below-knee amputation (AB) were matched with 7 subjects who underwent a traditional below-knee amputation (TB). AB subjects demonstrated significantly greater control of their residual limb musculature, production of more differentiable efferent control signals, and greater precision of movement compared to TB subjects (P < 0.008). This may be due to the presence of greater proprioceptive inputs facilitated by the significantly higher fascicle strains resulting from coordinated muscle excursion in AB subjects (P < 0.05). AB subjects reported significantly greater phantom range of motion postamputation (AB: 12.47 ± 2.41, TB: 10.14 ± 1.45 degrees) when compared to TB subjects (P < 0.05). Furthermore, AB subjects also reported less pain (12.25 ± 5.37) than TB subjects (17.29 ± 10.22) and a significant reduction when compared to their preoperative baseline (P < 0.05). Compared with traditional amputation, the construction of AMIs during amputation confers the benefits of enhanced physiological neuromuscular dynamics, proprioception, and phantom limb perception. Subjects' activation of the AMIs produces more differentiable electromyography (EMG) for myoelectric prosthesis control and demonstrates more positive clinical outcomes. |
| first_indexed | 2024-09-23T14:40:21Z |
| format | Article |
| id | mit-1721.1/134133 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T14:40:21Z |
| publishDate | 2021 |
| publisher | Proceedings of the National Academy of Sciences |
| record_format | dspace |
| spelling | mit-1721.1/1341332023-10-13T20:17:46Z Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation Srinivasan, Shriya S Gutierrez-Arango, Samantha Teng, Ashley Chia-En Israel, Erica Song, Hyungeun Bailey, Zachary Keith Carty, Matthew J Freed, Lisa E Herr, Hugh M Massachusetts Institute of Technology. Center for Extreme Bionics Harvard University--MIT Division of Health Sciences and Technology Massachusetts Institute of Technology. Department of Mechanical Engineering Despite advancements in prosthetic technologies, patients with amputation today suffer great diminution in mobility and quality of life. We have developed a modified below-knee amputation (BKA) procedure that incorporates agonist-antagonist myoneural interfaces (AMIs), which surgically preserve and couple agonist-antagonist muscle pairs for the subtalar and ankle joints. AMIs are designed to restore physiological neuromuscular dynamics, enable bidirectional neural signaling, and offer greater neuroprosthetic controllability compared to traditional amputation techniques. In this prospective, nonrandomized, unmasked study design, 15 subjects with AMI below-knee amputation (AB) were matched with 7 subjects who underwent a traditional below-knee amputation (TB). AB subjects demonstrated significantly greater control of their residual limb musculature, production of more differentiable efferent control signals, and greater precision of movement compared to TB subjects (P < 0.008). This may be due to the presence of greater proprioceptive inputs facilitated by the significantly higher fascicle strains resulting from coordinated muscle excursion in AB subjects (P < 0.05). AB subjects reported significantly greater phantom range of motion postamputation (AB: 12.47 ± 2.41, TB: 10.14 ± 1.45 degrees) when compared to TB subjects (P < 0.05). Furthermore, AB subjects also reported less pain (12.25 ± 5.37) than TB subjects (17.29 ± 10.22) and a significant reduction when compared to their preoperative baseline (P < 0.05). Compared with traditional amputation, the construction of AMIs during amputation confers the benefits of enhanced physiological neuromuscular dynamics, proprioception, and phantom limb perception. Subjects' activation of the AMIs produces more differentiable electromyography (EMG) for myoelectric prosthesis control and demonstrates more positive clinical outcomes. 2021-10-27T19:58:16Z 2021-10-27T19:58:16Z 2021 2021-06-24T17:46:57Z Article http://purl.org/eprint/type/JournalArticle https://hdl.handle.net/1721.1/134133 en 10.1073/pnas.2019555118 Proceedings of the National Academy of Sciences of the United States of America Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use. application/pdf Proceedings of the National Academy of Sciences PNAS |
| spellingShingle | Srinivasan, Shriya S Gutierrez-Arango, Samantha Teng, Ashley Chia-En Israel, Erica Song, Hyungeun Bailey, Zachary Keith Carty, Matthew J Freed, Lisa E Herr, Hugh M Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation |
| title | Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation |
| title_full | Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation |
| title_fullStr | Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation |
| title_full_unstemmed | Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation |
| title_short | Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation |
| title_sort | neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation |
| url | https://hdl.handle.net/1721.1/134133 |
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