This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The control of prostheses for patients with shoulder disarticulations and transhumeral amputations is significantly more difficult than that of prostheses for more distal amputations. Amputees have significant difficulties coordinating the separate functions of prosthetic shoulder, elbow, wrist, and hand components. The user must lock one joint at a particular position in space before subsequently moving a different joint. Use of the devices seldom becomes intuitive for the amputee. Peripheral nerves still carry information from the brain, despite having no function after the amputation of the upper extremity. Our strategy is to surgically link the amputated nerve stumps of the arm to otherwise functionless residual muscles of the chest and upper arm using standard techniques of peripheral nerve surgery and muscle flap surgery. Muscle segments which receive these novel nerve transfers then act as bio-amplifiers of the electric signals of the peripheral nervous system. The muscle contractions elicited under voluntary control of the patient are detectable by surface EMG electrodes, and can be used to signal a myoelectric prosthesis. This surgery creates a useful brain-machine interface which is smooth, intuitive, and for the first time allows the simultaneous control of multiple prosthesis joints.
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