A Caprine Model of a Novel Amputation Paradigm for Bi-directional Neural Control of a Bionic Limb

T. R. Clites, M. J. Carty, H. M. Herr, in Plastic Surgery Research Council, (2017), p. 119.


No significant changes have been made to limb amputation surgical paradigms since the Civil War era. Traditional approaches are plagued by poor nerve treatment, which leads to neuromas and phantom pain, and complicates neural communication with advanced limb prostheses. In this study we present a caprine model of the Linked Residual Musculature Peripheral Nerve Interface (LRM-PNI), a surgical approach designed to reduce phantom pain and improve bi-directional neural control of a bionic limb. The key advancement in this architecture is the surgical coaptation of natively-innervated agonist-antagonist muscle pairs within the residuum. The benefits of this approach are two-fold. First, preservation of the mechanical coupling between agonist contraction and antagonist stretch allows physiologically-relevant muscle state feedback from a prosthesis through mechanical activation of native mechanoreceptors within these linked muscles. Second, by preserving functionality of these native mechanoreceptors, we limit the presence of non-meaningful phantom sensation, including phantom pain. We hypothesize that these advancements will allow for afferent proprioceptive sensation of a limb prosthesis through native neural pathways, which is crucial in both reflexive and volitional lower extremity control during gait.

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