In UCBM the pioneer of targeted muscle re-innervation, Todd Kuiken, held a keynote
18 May 2018 - We can imagine how the amputation of a hand, let alone a limb, is very disabling from an emotional, physical and social point of view. For people who have suffered these traumas today, myoelectric prostheses are currently available which are then activated through the signal produced by the residual muscles. In the case of the hand, the muscles of the arm are directly involved in the control of the prosthesis while in higher amputations, for example above the elbow, it is more difficult to obtain control of several articular joints.
Yet the frontier in the control of upper limb prostheses exists and was crossed in the early 2000s by prof. Todd Kuiken, director emeritus of the Center for Bionic Medicine (CBM) and present these days at theUniversità Campus Bio-Medico di Roma directly from Northwestern University of Chicago. Kuiken is in fact the creator of targeted muscle reinnervation (TMR, Targeted Muscle Reinnervation), a technique based on a neurosurgical and orthopedic operation - carried out in the USA for the first time in 2001 - which transfers the main nerves of the upper limb to muscles that have lost their original function.
The method used by Kuiken allows for more intuitive control by the patient who continues to imagine the movement of the arm as he always has, but automatically activating the muscle once again connected to the nerves. "For example, in patients with shoulder disarticulation, nerves are transferred to the pectoralis major muscle, or in individuals with above-the-elbow amputations reinnervation occurs in the biceps and triceps," explained the TMR pioneer in his keynote to students and researchers UCBM. The reinnervated muscles are then exploited as 'biological amplifiers' of the nerve signals which originally controlled the amputated area.
In fact, the patient does not lose the functioning of the nervous system with the amputation, which continues to send command signals. After TMR, these will then activate the reinnervated muscles and transfer them as myoelectric signals to the prosthesis, with simultaneous and more patient-intuitive control. "The brain will think about moving the arm while the chest will move and operate the bionic arm," said Prof. Kuiken. "That's why it's intuitive."
