A Robust Neuromuscular Interface to Restore Lost Function in People with Amputations.

Upper limb loss can negatively impact an individual's ability to perform daily tasks as well as mental health and well-being. Currently available prosthetic control interfaces provide limited prosthetic finger dexterity compared to the complex functions that multi-articulating robotic hands are capable of actuating. A significant barrier is the ability to reliably sense efferent motor action potentials from peripheral nerves when a patient's muscles are lost or damaged due to amputation and injury. In an early-feasibility clinical trial, we implanted four patients with intramuscular electrodes in Regenerative Peripheral Nerve Interfaces (RPNIs). In all patients, the electrodes recorded large-amplitude and stable control signals from RPNIs with a median Signal-to-Noise Ratio (SNR) of 40.6 throughout their study participation. No serious adverse events occurred related to the electrode implantation or the devices themselves. Furthermore, implanting RPNIs provided valuable information to create an algorithm to predict movements previously mediated by lost muscles. These results indicate RPNI-electrode implantation is a repeatable and viable technique to record nerve signals for prosthetic control.