Toward higher-performance bionic limbs for wider clinical use.

Thorvaldur Ingvarsson, Oskar C Aszmann, Richard F Ff Weir, Dustin Tyler, Agnes Sturma, Thomas Stieglitz, Silvestro Micera, Todd Kuiken, Kristleifur Kristjánsson, Hilmar Bragi Janusson, Dario Farina, He Helen Huang, Klaus-Peter Hoffmann, Levi J Hargrove, Bernhard Graimann, Hans Dietl, Anthony M J Bull, Rickard Brånemark, Ivan Vujaklija

Journal: Nature biomedical engineering 2023;7(4):473-485

PMID: 34059810

Abstract

Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged towards the creation of a new generation of high-performance bionic limbs. These technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs.

© 2021. Springer Nature Limited.

Address: Department of Bioengineering, Imperial College London, London, UK. [email protected].; Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland.; Center for Extreme Bionics, Biomechatronics Group, MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA.; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.; Department of Bioengineering, Imperial College London, London, UK.; Ottobock Products SE & Co. KGaA, Vienna, Austria.; Ottobock SE & Co. KGaA, Duderstadt, Germany.; Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA.; Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, USA.; Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA.; Department of Medical Engineering & Neuroprosthetics, Fraunhofer-Institut für Biomedizinische Technik, Sulzbach, Germany.; NCSU/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA.; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.; Department of Research and Development, Össur Iceland, Reykjavík, Iceland.; Faculty of Medicine, University of Iceland, Reykjavík, Iceland.; School of Engineering and Natural Sciences, University of Iceland, Reykjavík, Iceland.; The Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pontedera, Italy.; Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pontedera, Italy.; Bertarelli Foundation Chair in Translational NeuroEngineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland.; Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, BrainLinks-BrainTools Center and Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany.; Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria.; Case School of Engineering, Case Western Reserve University, Cleveland, OH, USA.; Louis Stokes Veterans Affairs Medical Centre, Cleveland, OH, USA.; Biomechatronics Development Laboratory, Bioengineering Department, University of Colorado Denver and VA Eastern Colorado Healthcare System, Aurora, CO, USA.

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