气候变化领域集成服务门户(CCPortal): Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation

CCPortal

DOI	10.1073/pnas.2019555118
	Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation
	Srinivasan S.S.; Gutierrez-Arango S.; Teng A.C.-E.; Israel E.; Song H.; Bailey Z.K.; Carty M.J.; Freed L.E.; Herr H.M.
发表日期	2021
ISSN	00278424
卷号	118 期号:9
英文摘要	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. © This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).
英文关键词	Amputation; Neural engineering; Physiology; Prosthetics; Sensory feedback
语种	英语
来源期刊	Proceedings of the National Academy of Sciences of the United States of America
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/180474
作者单位	MIT Center for Extreme Bionics, Biomechatronics Group, Massachusetts Institute of Technology, Cambridge, MA 02139, United States; Harvard-MIT Program in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA 02139, United States; Harvard Medical School, Boston, MA 02114, United States; Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, United States; Department of Mechanical Engineering, United States Air Force Academy, Colorado Springs, CO 80920, United States; Division of Plastics and Reconstructive Surgery, Brigham and Women's Hospital, Boston, MA 02114, United States
推荐引用方式 GB/T 7714	Srinivasan S.S.,Gutierrez-Arango S.,Teng A.C.-E.,et al. Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation[J],2021,118(9).
APA	Srinivasan S.S..,Gutierrez-Arango S..,Teng A.C.-E..,Israel E..,Song H..,...&Herr H.M..(2021).Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation.Proceedings of the National Academy of Sciences of the United States of America,118(9).
MLA	Srinivasan S.S.,et al."Neural interfacing architecture enables enhanced motor control and residual limb functionality postamputation".Proceedings of the National Academy of Sciences of the United States of America 118.9(2021).