Motor unit characteristics after selective nerve transfers

Book chapter, 2021

Selective nerve transfers are used in biological and bionic extremity reconstruction to restore and improve extremity function. Here, peripheral nerves are rerouted to various target muscles, and thereby the structural composition of motor units is surgically altered. Previous studies have shown a high success rate of successful reinnervation of above 90% after these nerve transfers. In targeted muscle reinnervation, nerve transfers are applied to reroute amputated nerves to more proximal muscles in the stump and thereby increase the number of prosthetic control signals. Because donor nerves physiologically supply multiple muscles but are transferred to a single target muscle, the innervation ratio between donor and recipient is substantially altered. This changes the characteristics of the motor unit of the target muscles that we extensively investigated in a novel nerve transfer animal model. In this chapter, we illustrate this model, the effect of nerve transfers on motor unit physiology, as well as the implications on improving the interface between man and machine in prosthetic extremity reconstruction. In addition, first results on the effect of targeted muscle reinnervation on human motor unit physiology are described.