The Agonist-antagonist Myoneural Interface.

Tech Orthop

MIT Center for Extreme Bionics, Biomechatronics Group, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.

Published: December 2021

Scientist and technologist have long sought to advance limb prostheses that connect directly to the peripheral nervous system, enabling a person with amputation to volitionally control synthetic actuators that move, stiffen and power the prosthesis, as well as to experience natural afferent sensations from the prosthesis. Recently, the agonist-antagonist myoneural interface (AMI) was developed, a mechanoneural transduction architecture and neural interface system designed to provide persons with amputation improved muscle-tendon proprioception and neuroprosthetic control. In this paper, we provide an overview of the AMI, including its conceptual framing and pre-clinical science, surgical techniques for its construction, and clinical efficacy related to pain mitigation, phantom limb range of motion, fascicle dynamics, central brain proprioceptive sensorimotor preservation, and prosthetic controllability. Following this broad overview, we end with a discussion of current limitations of the AMI and potential resolutions to such challenges.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630671PMC
http://dx.doi.org/10.1097/bto.0000000000000552DOI Listing

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  • * The AMI surgery involves grafting the soleus muscle and reconnecting nerves to enhance motor function and proprioception in rats.
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  • After the surgery, the muscles can get weak because they’re not used much, but electrical muscle stimulation (EMS) can help keep the muscles strong.
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Background: The agonist-antagonist myoneural interface (AMI) technique at the time of transtibial amputation involves the use of agonist-antagonist muscle pairs to restore natural contraction-stretch relationships and to improve proprioceptive feedback when utilizing a prosthetic limb.

Description: Utilizing the standard incision for a long posterior myofasciocutaneous flap, the lateral and medial aspects of the limb are dissected, identifying and preserving the superficial peroneal and saphenous nerve, respectively. The tendons of the tibialis anterior and peroneus longus are transected distally to allow adequate length for the AMI constructs.

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