Targeted Muscle Reinnervation Book - Rehabilitation Institute of Chicago

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RIC Center for Bionic Medicine

TMR research was pioneered at the Center for Bionic Medicine (CBM). The CBM combines science, engineering, and clinical skill to improve function and life quality for persons with limb loss.

Targeted Muscle Reinnervation:
A Neural Interface for Artificial Limbs

Kuiken Targeted Muscle Reinnervation book coverTargeted Muscle Reinnervation:
A Neural Interface for Artificial
Limbs
(CRC Press, 2013) can
be purchased at the CRC
Press website
or on Amazon.

Developed by Todd A. Kuiken, MD, PhD, at the Rehabilitation Institute of Chicago, and Gregory A. Dumanian, MD, at Northwestern Memorial Hospital, Targeted Muscle Reinnervation (TMR) is an innovative surgical procedure that provides easier, more intuitive prosthesis control for individuals with arm amputations.

During TMR, nerves in an amputee’s residual arm are transferred to target muscles that no longer perform a useful function because of the amputation. These nerves, which previously controlled the elbow, wrist, and hand of the missing arm, grow into (or reinnervate) the target muscle. The target muscles act as biological amplifiers of control signals from these nerves, generating electrical signals that can be used to control a prosthesis.

TMR makes prosthesis control more intuitive by creating additional control sites, and control signals intended for the missing elbow, wrist, or hand can be used to control those same movements in the prosthesis.

TMR is now a standard surgical procedure and has been performed worldwide on more than 100 patients, including many military veterans at the San Antonio Military Medical Center and Walter Reed National Military Medical Center.

Edited and written by experts in the field, Targeted Muscle Reinnervation: A Neural Interface for Artificial Limbs (CRC Press, 2013) is the definitive guide to TMR, detailing the scientific basis for the procedure and the principles of prosthetic fitting and occupational therapy for TMR patients. The functional outcomes for the first people to undergo this procedure are described, and the possible role of TMR in the prevention and treatment of end-neuromas and in providing sensory feedback to prosthesis users is discussed.

Learn more about TMR by watching Dr. Todd Kuiken’s TED Talk—“A prosthetic arm that ‘feels'”—and listening to an accompanying feature recently produced by NPR.

Click on the sections below to explore TMR in more detail.

Introduction

Scientific Basis

Surgical Techniques

Neuroma Prevention

Physiatrist's Vewpoint

Prosthetic Fitting

Occupational Therapy

Sensory Reinnervation

Outcomes

Future Directions

Development of this website was supported by the National Library of Medicine of the National Institutes of Health, Award Number G13LM011221. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.