Targeted muscle reinnervation (TMR)
A surgical technique that aims to redirect the nerves remaining after amputation to nearby muscles; it may contribute to muscle signals becoming more distinct and to supporting prosthesis control.
What is targeted muscle reinnervation (TMR)?
Targeted muscle reinnervation (TMR) is a technique that aims to surgically redirect nerves that have lost their function after upper limb amputation to nearby muscles. The redirected nerves stimulate the relevant muscle and may contribute to the generation of electrical signals that can be measured from the surface when the muscle contracts.
This technique is not a brand or product, but a clinical approach performed by a surgical team where considered appropriate. Suitability is assessed by specialist physicians, taking into account the person's condition, amputation level and goals.
How does it work?
After amputation, some of the nerves that carry movement commands no longer have a corresponding target in the limb. In targeted muscle reinnervation, these nerves are transferred to selected nearby muscles, with the aim that they come to stimulate these muscles over time.
The surface signals generated when the muscles contract may be used as a control source in suitable prosthetic systems. In this way, the aim is to support the link between the intention to move and prosthesis control.
Intended contributions
The headings below introduce the general goals of the technique; results differ individually depending on the person and the clinical assessment.
More distinct muscle signals
The aim is for the signals taken from the muscles stimulated by the redirected nerves to become more distinguishable.
Support for prosthesis control
The more distinct signals may be used as a control source in suitable prosthetic systems.
Alignment with movement intention
The aim is to support the link between natural movement commands and prosthesis use.
Individual assessment
Suitability and the expected contributions are assessed jointly by the surgical and prosthetic team according to the person's condition.
Relationship to prosthesis control
The signals provided by targeted muscle reinnervation can be measured through electrodes placed on the arm residual limb. By evaluating these signals, the adjustment of a suitable prosthetic system to the individual can be planned.
The position of the electrodes and the system settings are determined individually so that the muscle signals can be used as effectively as possible, and are adapted during the fitting process.
Rehabilitation and adjustment process
After surgery, it takes time for the nerves to adapt to their new muscles. During this period, exercising the muscles and learning the signals are supported through physiotherapy and guided exercises.
The planning and progress of the process are carried out individually through the joint work of the surgical team, the prosthetic practitioner and physiotherapists.
- Monitoring the recovery period
- Practicing muscle signals through exercises
- Gradual prosthesis fitting and adjustment of settings
Related topics
Types of arm prostheses
You can find information about the general types of upper limb prostheses and their areas of use.
Learn more
Myoelectric arm prostheses
You can find information about the operating principle of prosthetic hands controlled by muscle signals.
Frequently asked questions
Is targeted muscle reinnervation a product?
No. It is not a brand or product, but a clinical technique performed by a specialist surgical team where considered appropriate.
Can it be performed on everyone?
Suitability is assessed individually by specialist physicians, taking into account amputation level, nerve and muscle condition, general health and personal goals.
Is it required for prosthesis use?
No. It is not the only method for prosthesis use; the control and prosthetic solutions suitable for the person are determined together with a clinical assessment.
Assessing your process together
Targeted muscle reinnervation and prosthesis control are an individual process and are planned with a specialist physician's assessment. You can contact us for information.
ContactThis content is for informational purposes; consult your physician for diagnosis and treatment. Surgical techniques and prosthetic fittings are carried out at authorized healthcare institutions and our licensed center addresses in line with a specialist physician's prescription/medical report.