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Targeted muscle reinnveration, usually referred to as "TMR" is a complicated surgical procedure for high level arm amputees that takes nerves previously dedicated to hand, wrist or elbow motion, and rewires them into adjacent muscles, dramatically amplifying the nerve signals with the goal of providing users with "thought control" of their myoelectric prosthesis.

Current myoelectric prostheses for above-elbow and shoulder disarticulation levels provide up to three degrees of freedom:

Flexing and extending the elbow
Turning the wrist in or out
Opening and closing the hand or electronic terminal device
These motions are typically controlled one at a time by electrical signals from one or two muscle sites (known as "EMG sites") in the residual limb or upper shoulder area.

TMR surgery creates additional EMG sites that are controlled with distinct and intuitive muscle contractions, some of which can occur simultaneously and with less mental effort. When combined with occupational therapy, the result is a high level of intuitive control, which can significantly enhance the functional use of the prosthesis.

This enhanced functionality is even more important now that prosthetic researchers and manufacturers are investing tremendous effort into creating additional degrees of freedom in prosthetic systems, which will require additional EMG sites to fully realize their increasing complexity and capability.
(https://www.armdynamics.com/research-and-technology/prosthetic-technology)

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Targeted Muscle Reinnervation (TMR)

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