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Journal Review: Neuromuscular implants: Interfacing with skeletal muscle for improved clinical translation of prosthetic limbs
Journal Review: Neuromuscular implants: Interfacing with skeletal muscle for improved clinical translation of prosthetic limbs
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Abstract
After an amputation, advanced prosthetic limbs can be used to interface with the nervous system and restore motor function. Despite numerous breakthroughs in the field, many of the recent research advancements have not been widely integrated into clinical practice. This review highlights recent innovations in neuromuscular implants—specifically those that interface with skeletal muscle—which could improve the clinical translation of prosthetic technologies. Skeletal muscle provides a physiologic gateway to harness and amplify signals from the nervous system. Recent surgical advancements in muscle reinnervation surgeries leverage the “bio-amplification” capabilities of muscle, enabling more intuitive control over a greater number of degrees of freedom in prosthetic limbs than previously achieved. We anticipate that state-of-the-art implantable neuromuscular interfaces that integrate well with skeletal muscle and novel surgical interventions will provide a long-term solution for controlling
advanced prostheses. Flexible electrodes are expected to play a crucial role in reducing foreign body responses and improving the longevity of the interface. Additionally, innovations in device miniaturization and ongoing exploration of shape memory polymers could simplify surgical procedures for implanting such interfaces. Once implanted, wireless strategies for powering and transferring data from the interface can eliminate bulky external wires, reduce infection risk, and enhance day-to-day usability. By outlining the current limitations of neuromuscular interfaces along with potential future directions, this review aims to guide continued research efforts and future collaborations between engineers and specialists in the field of neuromuscular and musculoskeletal medicine.

Objectives: The objectives of this activity are to enable the reader to: 1) Understand how targeted muscle reinnervation, regenerative peripheral nerve interfaces, and vascular denervated muscle targets play roles in the use of prosthetic limbs; 2) Understand the clinical implications of the various electrodes used for targeted muscle reinnervation; 3) Understand the clinical uses, strengths, and limitations of wireless transmission for creating useful prosthetic limbs. 


ACCREDITATION STATEMENT
The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


CREDIT DESIGNATION
The AANEM is accredited by the American Council for Continuing Medical Education (ACCME) to providing continuing education for physicians. AANEM designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 1/4/2027.

DISCLOSURE INFORMATION
The authors had no financial conflicts of interest.


FORMAT
PDF
Authors
Kiara N. Quinn BS; Yucheng Tian MSE; Ryan Budde BS; Pedro P. Irazoqui PhD; Sami Tuffaha MD; Nitish V. Thakor PhD
Summary
Availability: On-Demand
Expires on Jan 04, 2027
Cost: Member: $0.00
Non-Member: $25.00
Credit Offered:
1 CME Credit
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