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categories: ["bodies", "cybernetics"]categories: ["bodies", "cybernetics"]tags: ["prosthetics", "amputation", "emg", "assistive technology", "rehabilitation", "sensory feedback"]tags: ["prosthetics", "amputation", "emg", "assistive technology", "rehabilitation", "sensory feedback"]summary: "Externally powered artificial limbs controlled by electrical activity recorded from the wearer's residual muscles, the dominant design for powered upper-limb prostheses."summary: "Externally powered artificial limbs controlled by electrical activity recorded from the wearer's residual muscles, the dominant design for powered upper-limb prostheses."updated: "2026-07-27"updated: "2026-10-29"humanEvidence: "Routine clinical care in human amputees since the 1960s; a randomized trial supports targeted muscle reinnervation for neuroma pain rather than for control, and osseointegrated implanted-electrode arms have been used at home by a small number of patients."humanEvidence: "Routine clinical care in human amputees since the 1960s; a randomized trial supports targeted muscle reinnervation for neuroma pain rather than for control, and osseointegrated implanted-electrode arms have been used at home by a small number of patients."access: "Commercially available and fitted through prosthetics clinics in high-income countries; advanced hands run to tens of thousands of dollars before socket and therapy, and reimbursement varies sharply between health systems."access: "Commercially available and fitted through prosthetics clinics in high-income countries; advanced hands run to tens of thousands of dollars before socket and therapy, and reimbursement varies sharply between health systems."reversibility: "partly-reversible"reversibility: "partly-reversible"lines 34–42 → 34–4219 unchanged lines not shown
**Myoelectric prosthetics** are artificial limbs driven by motors and controlled by the electrical**Myoelectric prosthetics** are artificial limbs driven by motors and controlled by the electricalactivity of the wearer's own remaining muscles. Surface electrodes in the socket pick upactivity of the wearer's own remaining muscles. Surface electrodes in the socket pick upelectromyographic signals a few hundred microvolts in amplitude, the prosthesis converts theirelectromyographic signals a few hundred microvolts in amplitude, the prosthesis converts theirenvelope into motor commands, and the user learns to produce the required contractions. Theenvelope into motor commands, and the user learns to produce the required contractions. The approachapproach dominates powered upper-limb prosthetics, and its persistent problem is not the hand — moderndominates powered upper-limb prosthetics. Modern hands are mechanically excellent, and thehands are mechanically excellent — but the narrow, noisy control channel available to drive it.approach's persistent problem is the narrow, noisy control channel available to drive them. ## How it works## How it works lines 110–120 → 110–12067 unchanged lines not shown
```timeline```timeline[[ { "year": "1948–1960s", "title": "First myoelectric arms", "text": "Reinhold Reiter demonstrates myoelectric control in Munich; Soviet and Viennese groups field the first clinical devices, and the 'Russian hand' is exhibited internationally." }, { "year": "1948-1960s", "title": "First myoelectric arms", "text": "Reinhold Reiter demonstrates myoelectric control in Munich; Soviet and Viennese groups field the first clinical devices, and the 'Russian hand' is exhibited internationally." }, { "year": "1960s–1980s", "title": "Clinical adoption", "text": "Two-site proportional control becomes standard; thalidomide-related limb difference in Europe drives paediatric fitting programmes." }, { "year": "1960s-1980s", "title": "Clinical adoption", "text": "Two-site proportional control becomes standard; thalidomide-related limb difference in Europe drives paediatric fitting programmes." }, { "year": "2002–2009", "title": "Targeted muscle reinnervation", "text": "Nerve transfers create new intuitive control sites; a case series demonstrates real-time control of multifunction arms." }, { "year": "2002-2009", "title": "Targeted muscle reinnervation", "text": "Nerve transfers create new intuitive control sites; a case series demonstrates real-time control of multifunction arms." }, { "year": "2007–2015", "title": "Multi-articulating hands", "text": "Independently actuated fingers reach the market, offering many grip patterns but no corresponding increase in control channels." }, { "year": "2007-2015", "title": "Multi-articulating hands", "text": "Independently actuated fingers reach the market, offering many grip patterns but no corresponding increase in control channels." }, { "year": "2013–2020", "title": "Pattern recognition and implanted electrodes", "text": "Commercial pattern-recognition controllers are released; osseointegrated systems with implanted electrodes and nerve stimulation are used long-term outside the laboratory." }, { "year": "2013-2020", "title": "Pattern recognition and implanted electrodes", "text": "Commercial pattern-recognition controllers are released; osseointegrated systems with implanted electrodes and nerve stimulation are used long-term outside the laboratory." }, { "year": "2024", "title": "Restored proprioception in gait", "text": "Amputees with surgically reconstructed agonist-antagonist muscle pairs achieve near-normal walking biomechanics under continuous neural control of a powered ankle." } { "year": "2024", "title": "Restored proprioception in gait", "text": "Amputees with surgically reconstructed agonist-antagonist muscle pairs achieve near-normal walking biomechanics under continuous neural control of a powered ankle." }]]``````lines 127–138 → 127–1376 unchanged lines not shown
studies: weight, lack of sensory feedback, insufficient durability, discomfort, slow donning, poorstudies: weight, lack of sensory feedback, insufficient durability, discomfort, slow donning, poorreliability in wet or dusty conditions, and cost of repair.reliability in wet or dusty conditions, and cost of repair. Body-powered prostheses — a harness across the shoulders operating a split hook through a cable — areBody-powered prostheses, in which a harness across the shoulders operates a split hook through alighter, cheaper by an order of magnitude, essentially unbreakable, and give the user crude forcecable, are lighter, cheaper by an order of magnitude, essentially unbreakable, and give the userfeedback through cable tension, a form of proprioception no commercial myoelectric hand provides.crude force feedback through cable tension, a form of proprioception no commercial myoelectric handMany experienced amputees prefer them for work and keep a myoelectric hand for social settings. Anyprovides. Many experienced amputees prefer them for work and keep a myoelectric hand for socialhonest account of the field has to record that the most advanced device is not always the one peoplesettings. The most advanced device is therefore not always the one people choose.choose. > [!stat] The mismatch> [!stat] The mismatch> A multi-articulating hand offers a dozen or more programmed grips. Standard two-site control> A multi-articulating hand offers a dozen or more programmed grips. Standard two-site controllines 141–149 → 140–1482 unchanged lines not shown
Cost compounds the problem. Advanced hands run to tens of thousands of dollars before the socket,Cost compounds the problem. Advanced hands run to tens of thousands of dollars before the socket,fitting, and therapy that determine whether the device works, and reimbursement varies sharplyfitting, and therapy that determine whether the device works, and reimbursement varies sharplybetween health systems and between civilian and veteran populations within the same country. Mostbetween health systems and between civilian and veteran populations within the same country. Most ofof the world's amputees, concentrated in low- and middle-income countries and in populationsthe world's amputees, concentrated in low- and middle-income countries and in populations affectedaffected by conflict and diabetes, have no realistic access to any powered device — the patternby conflict and diabetes, have no realistic access to any powered device, an instance of the patterndescribed under [[access-and-inequality]]. Low-cost 3D-printed powered hands have narrowed the gapdescribed under [[access-and-inequality]]. Low-cost 3D-printed powered hands have narrowed the gapfor some paediatric users without closing it.for some paediatric users without closing it. lines 154–171 → 153–1704 unchanged lines not shown
adds control dimensions. Sensory feedback remains the largest functional gap: without it, usersadds control dimensions. Sensory feedback remains the largest functional gap: without it, userswatch their hand continuously and cannot modulate grip force by feel, which makes handling fragilewatch their hand continuously and cannot modulate grip force by feel, which makes handling fragileobjects slow and error-prone. Implanted nerve stimulation restores graded touch in researchobjects slow and error-prone. Implanted nerve stimulation restores graded touch in researchsettings, but no commercial upper-limb prosthesis provides it as of 2026. The contrast with thesettings, but no commercial upper-limb prosthesis provides it as of 2026. The [[cochlear-implant]][[cochlear-implant]], which has delivered an artificial sensory code to hundreds of thousands ofhas delivered an artificial sensory code to hundreds of thousands of people for decades, but hearingpeople for decades, is instructive: hearing tolerates a crude code, whereas touch used for motortolerates a crude code, whereas touch used for motor control needs timing and force information thecontrol needs timing and force information the current interfaces cannot supply.current interfaces cannot supply. Prosthetic limbs also do not restore the limb. They restore a subset of its functions to a personProsthetic limbs also do not restore the limb. They restore a subset of its functions to a personwho must actively operate them, which is why users describe fatigue as a reason for abandonment andwho must actively operate them, which is why users describe fatigue as a reason for abandonment andwhy the field's ethical literature resists framing amputation as a solved problem — a pointwhy the field's ethical literature resists framing amputation as a solved problem, a point developeddeveloped under [[disability-rights-and-enhancement]]. A minority of users take the opposite viewunder [[disability-rights-and-enhancement]]. A minority of users take the opposite view and treatand treat the prosthesis as a platform to be customized rather than a substitute for a lost hand,the prosthesis as a platform to be customized rather than a substitute for a lost hand, the positionthe position argued under [[morphological-freedom]], and interchangeable tool attachments andargued under [[morphological-freedom]], and interchangeable tool attachments and non-anthropomorphicnon-anthropomorphic end effectors follow naturally from it.end effectors follow naturally from it. ## Outlook## Outlook lines 174–181 → 173–1802 unchanged lines not shown
electronics, combined with implanted rather than surface recording. Bidirectional systems thatelectronics, combined with implanted rather than surface recording. Bidirectional systems thatcombine implanted stimulation for touch with skeletal attachment are the plausible next clinicalcombine implanted stimulation for touch with skeletal attachment are the plausible next clinicalproduct, following the pattern of [[neuroprosthetics]] generally, where writing information in lagsproduct, following the pattern of [[neuroprosthetics]] generally, where writing information in lagsreading it out. Adding channels the body does not already have — vibration, temperature, or gripreading it out. Adding channels the body does not already have, such as vibration, temperature, orforce mapped onto an unrelated nerve — shades into [[sensory-augmentation]], and users ofgrip force mapped onto an unrelated nerve, shades into [[sensory-augmentation]], and users oftouch-restoring systems have reported that the mapping need not be anatomically faithful to betouch-restoring systems have reported that the mapping need not be anatomically faithful to beusable.usable. removed, struck through added, underlinedLine numbers count the serialised markdown of each revision, frontmatter included.
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