Logo for the Journal of Rehab R and D

Volume 46 Number 4, 2009
   Pages 481 — 488

Abstract – Occupational therapy protocol for amputees with targeted muscle reinnervation

Kathy A. Stubblefield, OTR/L;1* Laura A. Miller, PhD, CP;1-2 Robert D. Lipschutz, BSME, CP;1 Todd A. Kuiken, MD, PhD1-3
1Neural Engineering Center for Artificial Limbs, Rehabilitation Institute of Chicago, Chicago, IL; 2Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL; 3Department of Biomedical Engineering, Robert R. McCormick School of Engineering and Applied Science, Northwestern University, Evanston, IL

Abstract — Abstract-Targeted muscle reinnervation (TMR) is a surgical intervention to improve the control of myoelectric prostheses in high-level upper-limb amputation. This article briefly describes the procedure and presents the protocol for postoperative, preprosthetic care. We also recommend a guide to patient training using standard-of-care prosthetic devices controlled by up to four intuitive, independent, and isolated myoelectric signals. We discuss the advantages of this new control paradigm and methods for optimizing clinical outcomes for patients with high-level upper-limb amputations. This material is based on more than 6 years of experience treating patients with TMR in a research setting. Detailed results of this research are reported elsewhere.

Key words: amputation, myoelectric control, nerve transfer, occupational therapy, preprosthetic training, prosthetic training, rehabilitation, simultaneous control, targeted muscle reinnervation, upper limb.

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