The future of upper extremity rehabilitation robotics: research and practice

Muscle Nerve, 2020 · DOI: 10.1002/mus.26860 · Published: June 1, 2020

Assistive Technology Neurology Neurorehabilitation

Simple Explanation

The loss of upper limb motor function can significantly alter a person’s way of life, creating physical and emotional burdens. Researchers and clinicians have been developing interfaces to interact directly with the human body’s motor system to restore upper limb control and functionality. Two main types of interfaces have been developed: peripheral nerve interfaces and brain-machine interfaces. These interfaces aim to decode neural information to restore upper limb motor function. Despite advancements, challenges remain in translating these technologies to the clinical market. Future research focuses on improving these interfaces and control strategies to enhance the lives of patients with upper extremity immobility.

Study Duration

Not specified

Participants

Patient populations affected by upper extremity loss and functional deficits

Evidence Level

Review Article

Key Findings

1
Peripheral nerve interfaces and brain-machine interfaces share characteristics that allow for concurrent development.
2
Decoding neural information from both interfaces may lead to novel physiological models for restoring upper limb motor function.
3
Current clinical treatments for upper extremity loss and functional deficits are incapable of restoring full functional capabilities of an intact upper limb.

Research Summary

This review discusses peripheral nerve interfaces and brain-machine interfaces developed over the past 30 years for upper extremity control. It highlights the challenges in transitioning these technologies to the clinical market and suggests that concurrent development of both interfaces, along with neural decoding, may restore upper limb motor function. The review also explores myoelectric interfaces, surgical methods for improving peripheral interfaces, and control methods for both prosthetic and paralyzed limbs, emphasizing the need for portable, implantable, and integrated prosthetic devices.

Practical Implications

Enhanced Prosthetic Control

More invasive interfaces accessing independent control sites can provide more intuitive fine motor control for advanced prostheses.

Improved Rehabilitation

Brain-machine interfaces combined with functional electrical stimulation offer a pathway to regain upper extremity function in individuals with spinal cord injury.

Advanced Surgical Techniques

Surgical techniques like targeted muscle reinnervation and regenerative peripheral nerve interfaces can create new myoelectric sites for prosthesis control and amplify nerve signals.

Study Limitations

1
Limited number of control signals with current myoelectric interfaces.
2
Challenges in recording stable and robust signals from peripheral nerve interfaces, especially intraneural electrodes.
3
Computational complexity and safety regulations hinder the development of portable and fully implantable prosthetic devices.

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