title: Control of a six degree of freedom prosthetic arm after targeted muscle reinnervation surgery.
abstract: OBJECTIVE
  To fit and evaluate the control of a complex prosthesis for a shoulder disarticulation-level amputee with targeted muscle reinnervation.
  
  
  METHODS
  One participant who had targeted muscle reinnervation surgery was fitted with an advanced prosthesis and his use of this device was compared with the device that he used in the home setting.
  
  
  METHODS
  The experiments were completed within a laboratory setting.
  
  
  METHODS
  The first recipient of targeted muscle reinnervation: a bilateral shoulder disarticulation-level amputee.
  
  
  METHODS
  Two years after surgery, the subject was fitted with a 6 degree of freedom (DOF) prosthesis (shoulder flexion, humeral rotation, elbow flexion, wrist rotation, wrist flexion, and hand control). Control of this device was compared with that of his commercially available 3-DOF system (elbow, wrist rotation, and powered hook terminal device).
  
  
  METHODS
  In order to assess performance, movement analysis and timed movement tasks were executed.
  
  
  RESULTS
  The subject was able to independently operate all 6 arm functions with good control. He could simultaneously operate 2 DOF of several different joint combinations with relative ease. He operated up to 4 DOF simultaneously, but with poor control. Work space was markedly increased and some timed tasks were faster with the 6-DOF system.
  
  
  CONCLUSIONS
  This proof-of-concept study shows that advances in control of shoulder disarticulation-level prostheses can improve the quality of movement. Additional control sources may spur the development of more advanced and complex componentry for these amputees.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. lamiller@northwestern.edu
authors.forename: Laura A
authors.initials: LA
authors.lastname: Miller
authors.forename: Robert D
authors.initials: RD
authors.lastname: Lipschutz
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Stubblefield
authors.forename: Blair A
authors.initials: BA
authors.lastname: Lock
authors.forename: He
authors.initials: H
authors.lastname: Huang
authors.forename: T Walley
authors.initials: TW
authors.lastname: Williams
authors.forename: Richard F
authors.initials: RF
authors.lastname: Weir
authors.forename: Todd A
authors.initials: TA
authors.lastname: Kuiken
mesh_terms: D001186:Artificial Limbs; D004567:Electrodes, Implanted; D004576:Electromyography; D006801:Humans; D008297:Male; D008328:Man-Machine Systems; D008875:Middle Aged; D016067:Nerve Transfer; D010369:Pectoralis Muscles / Q000294:innervation; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012782:Shoulder / Q000294:innervation; D034941:Upper Extremity / Q000294:innervation