Features

Provides a practical guide to implementing TMR for all members of a multidisciplinary rehabilitation team
Discusses how TMR can improve the function and quality of life for individuals with amputations
Explores the potential for providing sensory feedback to amputees
Examines the surgical and functional outcomes of actual TMR patients
Offers training videos of TMR surgical and rehabilitation procedures as well as information about new research developments on a complementary website
Summary

Implement TMR with Your Patients and Improve Their Quality of Life

Developed by Dr. Todd A. Kuiken and Dr. Gregory A. Dumanian, targeted muscle reinnervation (TMR) is a new approach to accessing motor control signals from peripheral nerves after amputation and providing sensory feedback to prosthesis users. This practical approach has many advantages over other neural-machine interfaces for the improved control of artificial limbs. Targeted Muscle Reinnervation: A Neural Interface for Artificial Limbs provides a template for the clinical implementation of TMR and a resource for further research in this new area of science.

After describing the basic scientific concepts and key principles underlying TMR, the book presents surgical approaches to transhumeral and shoulder disarticulation amputations. It explores the possible role of TMR in the prevention and treatment of end-neuromas and details the principles of rehabilitation, prosthetic fitting, and occupational therapy for TMR patients. The book also describes transfer sensation and discusses the surgical and functional outcomes of the first several TMR patients. It concludes with emerging research on using TMR to further improve the function and quality of life for people with limb loss.

With contributions from renowned leaders in the field, including Drs. Kuiken and Dumanian, this book is a useful guide to implementing TMR in patients with high-level upper limb amputations. It also supplies the foundation to enable improvements in TMR techniques and advances in prosthetic technology.

Table of Contents

Introduction to Targeted Reinnervation, Todd A. Kuiken

The Scientific Basis of Targeted Muscle Reinnervation, Todd A. Kuiken
Principles of Targeted Muscle Reinnervation
Optimization of the EMG Signal

Surgical Techniques for Targeted Muscle Reinnervation, Gregory A. Dumanian and Jason M. Souza
Fundamentals of Targeted Musscle Reinnervation Surgery
Targeted Muscle Reinnervation for the Transhumeral Amputee
Targeted Muscle Reinnervation for the Shoulder Disarticulation Amputee
Targeted Sensory Reinnervation

Targeted Muscle Reinnervation as a Strategy for Neuroma Prevention, Jason H. Ko, Peter S. Kim, and Douglas G. Smith
Neuroma Pathophysiology
Treatment of Neuromas
TMR as a Strategy for Neuroma Prevention

Rehabilitation of the Targeted Muscle Reinnervation Patient, Todd A. Kuiken
Presurgical Evaluation
Patient and Team Education
Potential Surgical Complications

Prosthetic Fitting before and after Targeted Muscle Reinnervation, Laura A. Miller and Robert D. Lipschutz
Presurgical Considerations
Postsurgical Reinnervation (Interim) Period
Post-Reinnervation Fitting

Occupational Therapy for the Targeted Muscle Reinnervation Patient, Kathy A. Stubblefield and Todd A. Kuiken
Presurgical Program
Postsurgical Program

Targeted Sensory Reinnervation, Paul D. Marasco
Sensory Perception and Feedback in Prostheses
Transfer Sensation in Targeted Reinnervation Amputees
Application of Transfer Sensation for Sensory Feedback

Surgical and Functional Outcomes of Targeted Muscle Reinnervation, Laura A. Miller, Kathy A. Stubblefield, Robert D. Lipschutz, Blair A. Lock, Jason M. Souza, Gregory A. Dumanian, and Todd A. Kuiken
Surgical Goals
Assessment of Functional Outcomes at RIC

Future Research Directions, Levi J. Hargrove and Blair A. Lock
Improvements in Control Algorithms
Extension of TMR to Transradial and Lower Limb Amputations
Advanced Prosthetic Systems

Index

References appear at the end of each chapter.