Occupational therapy protocol for amputees with targeted muscle reinnervation.

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.

[1]  V. Mathiowetz,et al.  Adult norms for the Box and Block Test of manual dexterity. , 1985, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[2]  A G Fisher,et al.  The assessment of IADL motor skills: an application of many-faceted Rasch analysis. , 1993, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[3]  Christopher Lake,et al.  Effects of Prosthetic Training on Upper‐Extremity Prosthesis Use , 1997 .

[4]  Robert D. Lipschutz,et al.  The use of targeted muscle reinnervation for improved myoelectric prosthesis control in a bilateral shoulder disarticulation amputee , 2004, Prosthetics and orthotics international.

[5]  R. H. Meier,et al.  Functional Restoration of Adults and Children with Upper Extremity Amputation , 2004 .

[6]  Smith Dg,et al.  Atlas Of Amputations and Limb Deficiencies : Surgical, Prosthetic, and Rehabilitation Principles , 2004 .

[7]  Smith Dg,et al.  Atlas of Amputations and Limb Deficiencies, Third Edition: Surgical, Prosthetic and Rehabilitation Principles , 2004 .

[8]  Robert D. Lipschutz,et al.  Improved Myoelectric Prosthesis Control Accomplished Using Multiple Nerve Transfers , 2006, Plastic and reconstructive surgery.

[9]  Todd A. Kuiken,et al.  Shoulder Disarticulation Externally Powered Prosthetic Fitting Following Targeted Muscle Reinnervation for Improved Myoelectric Control , 2006 .

[10]  Robert D. Lipschutz,et al.  Targeted reinnervation for enhanced prosthetic arm function in a woman with a proximal amputation: a case study , 2007, The Lancet.

[11]  千敬 髙島,et al.  呼吸器疾患におけるAssessment of Motor and Process Skillsの応用 , 2007 .

[12]  T. Kuiken,et al.  Control of a six degree of freedom prosthetic arm after targeted muscle reinnervation surgery. , 2008, Archives of physical medicine and rehabilitation.

[13]  T. Kuiken,et al.  Improved Myoelectric Prosthesis Control Using Targeted Reinnervation Surgery: A Case Series , 2008, IEEE Transactions on Neural Systems and Rehabilitation Engineering.