Kalff M N, Hoursch V, Kirsten N, Pardo L A, Kasprzak K, Egger M, Schmidt S N, Sehmisch S, Ernst J
Medizinische Hochschule Hannover, Klinik für Unfallchirurgie, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
Universitätsmedizin Göttingen, Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Göttingen, Deutschland.
Unfallchirurgie (Heidelb). 2025 Apr;128(4):256-263. doi: 10.1007/s00113-025-01536-3. Epub 2025 Mar 6.
The agonist-antagonist myoneural interface (AMI) is an innovative approach to restoring proprioception and achieving more intuitive motor control following limb loss. This cutting-edge technique replicates the natural biomechanical relationship between agonist and antagonist muscles, enabling bidirectional communication between a prosthesis and the user's peripheral nervous system. Through the transposition of neurovascularly pedicled agonist-antagonist muscle pairs, which are reconnected via an adapted tendon suture and positioned within a gliding mechanism, AMI generates proprioceptive feedback during movement. Changes in tension within these muscle pairs produce signals that are transmitted to the central nervous system via afferent nerve pathways, enabling users to perceive the joint position of the limb that was originally governed by the muscle pair. This enhanced sensory input significantly facilitates control of the prosthesis. The AMI appears to enable an integration of the prosthesis into the body's existing neural networks and improve motor control of the prosthesis and the sensory discrimination. Compared to traditional surgical techniques (myodesis or myoplasty) with a purely mechanical transposition of residual stump muscles, AMI reduces the cognitive burden during the use of the prosthesis and delivers a more natural sense of movement, fostering a profound sense of embodiment. In summary, AMI represents a significant leap forward in human-machine integration. By enhancing both the functionality and user experience of prosthetic devices, it provides a very promising transformative solution for sustainable improvement of the quality of life for individuals living with limb loss.
激动剂 - 拮抗剂肌神经接口（AMI）是一种创新方法，用于在肢体缺失后恢复本体感觉并实现更直观的运动控制。这项前沿技术复制了激动剂和拮抗剂肌肉之间的自然生物力学关系，使假肢与使用者的外周神经系统之间能够进行双向通信。通过将带神经血管蒂的激动剂 - 拮抗剂肌肉对进行移位，这些肌肉对通过改良的肌腱缝合重新连接并放置在滑动机制内，AMI在运动过程中产生本体感觉反馈。这些肌肉对中的张力变化产生的信号通过传入神经通路传输到中枢神经系统，使用户能够感知原本由该肌肉对控制的肢体的关节位置。这种增强的感觉输入显著促进了假肢的控制。AMI似乎能够将假肢整合到身体现有的神经网络中，并改善假肢的运动控制和感觉辨别能力。与传统的手术技术（肌固定术或肌成形术）相比，传统技术只是对残端肌肉进行纯粹的机械移位，AMI减轻了使用假肢时的认知负担，并带来更自然的运动感觉，培养了一种深刻的身体存在感。总之，AMI代表了人机整合方面的重大飞跃。通过增强假肢设备的功能和用户体验，它为持续改善肢体缺失者的生活质量提供了一个非常有前景的变革性解决方案。
