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[size=18]من خلال جراحة جديدة تسمى Target Muscle Reinnervation TMR اصبح للذين فقدوا اطرافهم من اللعب بسهولة مع اطفالهم من جديد , حيث سوف تسمح للمرضى بتحريك اكثر من مفصل فى نفس الوقت على عكس الاطراف الصناعية المتوفرة حاليا والتى تسمح بتريك مفصل واحد.
وتعتمد هذه الجراحة الحديثة على إعادة توصيل الالياف العهصبية التى تم بترها بعضلات الصدر .
والان ليكم المقال:
Through a new surgery known as targeted muscle reinnervation (TRM), patients who have lost their limbs may soon be able to pinch someone or play baseball more easily with their children. Though prosthetic limbs are available, they may limit a patient in their movements and tasks. The new surgery would allow patients to move multiple joints at the same time, whereas current prosthetic limbs limit patients to only moving one joint at a time.
The new surgery involves reconnecting nerve fibers that had been amputated to muscles in the chest. The nerve impulses generated would then control the movement of a special motorized prosthetic arm. The majority of prosthetic arms are currently directed by body movement, where a harness is attached to the shoulder. The harness captures movement from the shoulder and transfers it through a cable to the joints in the arm and hand. However, this is where the limitation currently lies, with only one joint being able to be moved at a time. Because nerves are also lost with amputation, the TMR procedure has been developed to try and restore the loss of nerve impulses. Through TMR surgery, nerve function is restored to the remaining nerves in the arm and the chest or upper-arm muscles. Once the nerve function is restored a patient’s muscles are again able to send electrical signals to joints in their prosthetic arm and hand.
TMR surgery was tested during a U.S. study conducted by the Rehabilitation Institute of Chicago (RIC) from January 2007 to January 2008, and was published in the February 11 issue of the Journal of American Medical Association. The study was conducted to determine the effectiveness of the surgery when used with motorized arms, and to determine if the reinnervated muscles can produce consistent and accurate electrical signals to control a patient’s artificial arm in “real time”. The study was to determine if a patient who had the surgery and used a motorized arm would be able to think what they wanted to do with their motorized arm, and it would respond almost instantaneously and correctly, as would their own arm.
The study evaluated five amputees who had undergone TMR surgery and compared them to five participants who did not have amputations. The ten participants performed several arm movements and researchers evaluated their ability to control the virtual prosthetic arm. Though the non-amputees were quicker than those who had undergone TMR surgery, the amputees gave the non-amputees a run for their money. For instance, the average time for elbow and wrist movements of extending the elbow, with turning, flexing and extending the wrist was .22 seconds for TMR surgery participants and .16 for the non-amputee group. The average time it took for hand grasps were 1.54 seconds for the TMR group and 1.26 seconds for the control group. According to Dr. Todd Kuiken, lead researcher with Chicago’s Rehabilitation Institute, “The prosthetic arms tested in this study performed very well as early prototypes. Further improvements are needed and have been planned, including reducing the size and weight and increasing the robustness of these advanced prostheses.”
This is such an exciting advancement. Patients who have lost a limb may soon have an option that will allow them more advanced movements of their prosthetic arms. According to the study authors, “the use of pattern-recognition control is an exciting advancement for patients with arm amputations.” The researchers feel the surgery will allow for more use of neural information from patients to control more natural movements of prostheses. Amanda Kitts, one of the patients who underwent TMR surgery after loosing her limb in 2006 who also participated in the study said, “I was amazed at the level of hand function and how fast I was able to control the arm and hand.” She was able to pick up a penny and a checker rolling across a table. Amanda received an advanced prostheses developed by John Hopkins University Applied Physics Lab and Deka Research, Inc[/size
].The new surgery involves reconnecting nerve fibers that had been amputated to muscles in the chest. The nerve impulses generated would then control the movement of a special motorized prosthetic arm. The majority of prosthetic arms are currently directed by body movement, where a harness is attached to the shoulder. The harness captures movement from the shoulder and transfers it through a cable to the joints in the arm and hand. However, this is where the limitation currently lies, with only one joint being able to be moved at a time. Because nerves are also lost with amputation, the TMR procedure has been developed to try and restore the loss of nerve impulses. Through TMR surgery, nerve function is restored to the remaining nerves in the arm and the chest or upper-arm muscles. Once the nerve function is restored a patient’s muscles are again able to send electrical signals to joints in their prosthetic arm and hand.
TMR surgery was tested during a U.S. study conducted by the Rehabilitation Institute of Chicago (RIC) from January 2007 to January 2008, and was published in the February 11 issue of the Journal of American Medical Association. The study was conducted to determine the effectiveness of the surgery when used with motorized arms, and to determine if the reinnervated muscles can produce consistent and accurate electrical signals to control a patient’s artificial arm in “real time”. The study was to determine if a patient who had the surgery and used a motorized arm would be able to think what they wanted to do with their motorized arm, and it would respond almost instantaneously and correctly, as would their own arm.
The study evaluated five amputees who had undergone TMR surgery and compared them to five participants who did not have amputations. The ten participants performed several arm movements and researchers evaluated their ability to control the virtual prosthetic arm. Though the non-amputees were quicker than those who had undergone TMR surgery, the amputees gave the non-amputees a run for their money. For instance, the average time for elbow and wrist movements of extending the elbow, with turning, flexing and extending the wrist was .22 seconds for TMR surgery participants and .16 for the non-amputee group. The average time it took for hand grasps were 1.54 seconds for the TMR group and 1.26 seconds for the control group. According to Dr. Todd Kuiken, lead researcher with Chicago’s Rehabilitation Institute, “The prosthetic arms tested in this study performed very well as early prototypes. Further improvements are needed and have been planned, including reducing the size and weight and increasing the robustness of these advanced prostheses.”
This is such an exciting advancement. Patients who have lost a limb may soon have an option that will allow them more advanced movements of their prosthetic arms. According to the study authors, “the use of pattern-recognition control is an exciting advancement for patients with arm amputations.” The researchers feel the surgery will allow for more use of neural information from patients to control more natural movements of prostheses. Amanda Kitts, one of the patients who underwent TMR surgery after loosing her limb in 2006 who also participated in the study said, “I was amazed at the level of hand function and how fast I was able to control the arm and hand.” She was able to pick up a penny and a checker rolling across a table. Amanda received an advanced prostheses developed by John Hopkins University Applied Physics Lab and Deka Research, Inc[/size
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