Todd Kuiken, MD, PhD

Biography

Dr. Todd A. Kuiken is Director Emeritus of the Center for Bionic Medicine at the Shirley Ryan AbilityLab.  As a physician and biomedical engineer who has spent his entire career working to improve the function of artificial limbs, he is considered an internationally respected leader in the care of people with limb loss.

He received a B.S. degree in biomedical engineering from Duke University (1983), a Ph.D. in biomedical engineering from Northwestern University in Evanston, Illinois (1989) and his M.D. from Northwestern University Medical School (1990).
  
At the Center for Bionic Medicine (CBM), Dr. Kuiken leads a multidisciplinary team of physicians, prosthetists, therapists, neuroscientists, engineers, software developers, graduate students, and post-doctoral researchers. The goal of CBM is to improve function and quality of life for people who have suffered limb loss.  This combination of clinical and research expertise provides a unique environment to translate research data into clinical applications.  

In addition to his work at CBM, Dr. Kuiken is a Professor in the Department of Physical Medicine & Rehabilitation at the Feinberg School of Medicine, Northwestern University. He also has appointments in the Departments of Biomedical Engineering and Surgery.

The primary focus of Dr. Kuiken’s research has been to develop a neural-machine interface to improve the function of artificial limbs.  He is best known for his research in developing a surgical technique called Targeted Muscle Reinnervation (TMR), which is now a standard procedure and has been performed on more than 100 individuals in hospitals worldwide.

With TMR, the residual nerves in an amputated limb are transferred to spare muscle and skin in or near the limb. The nerves grow into this muscle, and then the surface EMG over this muscle can be used as an additional control signal.  For example, if the median nerve reinnervates a small region of surface muscle, then when the patient thinks “close hand,” this muscle will contract and the myoelectric signal can be used to close the powered hand. Since physiologically appropriate neural pathways are used, prosthesis control is more intuitive, easier, and faster.
  
Similarly, sensory nerves can be transferred to the residual nerves so that skin of the chest or arm is reinnervated.  When patients are touched on this reinnervated skin, it feels as if they are being touched in their missing arm or hand.  Transfer sensation can provide a pathway for true sensory feedback of light touch, graded pressure, sharp/dull, and thermal feedback.  Sensors can be placed in the prosthetic hand and the resulting data can be used to control a device that delivers the appropriate sensation to the reinnervated skin.  In this way, prosthetic users can feel what they touch with their prosthesis as if they were touching it with their missing hand.

TMR has led to exciting collaborations and additional research to extract more information out of the reinnervated muscle EMG signals. Pattern Recognition computer algorithms have been added to greatly increase the degrees of freedom that can be intuitively operated.  By decoding these rich EMG signals, Dr. Kuiken’s team has demonstrated the intuitive control of powered shoulders, the elbow, wrist flexion/extension, wrist rotation and even a variety of hand grasp patterns.  Prostheses using pattern recognition are now commercially available.  Most recently, CBM has started to use similar techniques to develop a neural interface for powered prosthetic legs.

More information about the Center for Bionic Medicine (CBM) can be found here:

https://www.sralab.org/cbm

Additionally, further reading about Targeted Muscle Reinnervation (TMR) can be found here:

https://www.sralab.org/cbm/tmr

Education

BS, Biomedical Engineering, Duke University
PhD, Biomedical Engineering, Northwestern University
MD, Northwestern University

Areas of Research / Professional Expertise

Limb loss, biomedical engineering, design of wheelchairs, evaluation of surgical techniques for persons with limb loss, prosthesis design and control

Websites

• Center for Bionic Medicine

Books

Articles

Videos