Researcher: Hugh Herr

A prosthesis driven by the nervous system helps people with amputation walk naturally

Anne Trafton |

State-of-the-art prosthetic limbs can help people with amputations achieve a natural walking gait, but they don’t give the user full neural control over the limb. Instead, they rely on robotic sensors and controllers that move the limb using predefined gait algorithms.

Using a new type of surgical intervention and neuroprosthetic interface, MIT researchers, in collaboration with colleagues from Brigham and Women’s Hospital, have shown that a natural walking gait is achievable using a prosthetic leg fully driven by the body’s own nervous system. The surgical amputation procedure reconnects muscles in the residual limb, which allows patients to receive “proprioceptive” feedback about where their prosthetic limb is in space.

In a study of seven patients who had this surgery, the MIT team found that they were able to walk faster, avoid obstacles, and climb stairs much more naturally than people with a traditional amputation.

“This is the first prosthetic study in history that shows a leg prosthesis under full neural modulation, where a biomimetic gait emerges. No one has been able to show this level of brain control that produces a natural gait, where the human’s nervous system is controlling the movement, not a robotic control algorithm,” says Hugh Herr, a professor of media arts and sciences, co-director of the K. Lisa Yang Center for Bionics at MIT, an associate member of MIT’s McGovern Institute for Brain Research, and the senior author of the new study.

Patients also experienced less pain and less muscle atrophy following this surgery, which is known as the agonist-antagonist myoneural interface (AMI). So far, about 60 patients around the world have received this type of surgery, which can also be done for people with arm amputations.

Hyungeun Song, a postdoc in MIT’s Media Lab, is the lead author of the paper, which appears today in Nature Medicine.

Sensory feedback

Most limb movement is controlled by pairs of muscles that take turns stretching and contracting. During a traditional below-the-knee amputation, the interactions of these paired muscles are disrupted. This makes it very difficult for the nervous system to sense the position of a muscle and how fast it’s contracting — sensory information that is critical for the brain to decide how to move the limb.

People with this kind of amputation may have trouble controlling their prosthetic limb because they can’t accurately sense where the limb is in space. Instead, they rely on robotic controllers built into the prosthetic limb. These limbs also include sensors that can detect and adjust to slopes and obstacles.

To try to help people achieve a natural gait under full nervous system control, Herr and his colleagues began developing the AMI surgery several years ago. Instead of severing natural agonist-antagonist muscle interactions, they connect the two ends of the muscles so that they still dynamically communicate with each other within the residual limb. This surgery can be done during a primary amputation, or the muscles can be reconnected after the initial amputation as part of a revision procedure.

“With the AMI amputation procedure, to the greatest extent possible, we attempt to connect native agonists to native antagonists in a physiological way so that after amputation, a person can move their full phantom limb with physiologic levels of proprioception and range of movement,” Herr says.

In a 2021 study, Herr’s lab found that patients who had this surgery were able to more precisely control the muscles of their amputated limb, and that those muscles produced electrical signals similar to those from their intact limb.

After those encouraging results, the researchers set out to explore whether those electrical signals could generate commands for a prosthetic limb and at the same time give the user feedback about the limb’s position in space. The person wearing the prosthetic limb could then use that proprioceptive feedback to volitionally adjust their gait as needed.

In the new Nature Medicine study, the MIT team found this sensory feedback did indeed translate into a smooth, near-natural ability to walk and navigate obstacles.

“Because of the AMI neuroprosthetic interface, we were able to boost that neural signaling, preserving as much as we could. This was able to restore a person’s neural capability to continuously and directly control the full gait, across different walking speeds, stairs, slopes, even going over obstacles,” Song says.

A natural gait

For this study, the researchers compared seven people who had the AMI surgery with seven who had traditional below-the-knee amputations. All of the subjects used the same type of bionic limb: a prosthesis with a powered ankle as well as electrodes that can sense electromyography (EMG) signals from the tibialis anterior the gastrocnemius muscles. These signals are fed into a robotic controller that helps the prosthesis calculate how much to bend the ankle, how much torque to apply, or how much power to deliver.

The researchers tested the subjects in several different situations: level-ground walking across a 10-meter pathway, walking up a slope, walking down a ramp, walking up and down stairs, and walking on a level surface while avoiding obstacles.

In all of these tasks, the people with the AMI neuroprosthetic interface were able to walk faster — at about the same rate as people without amputations — and navigate around obstacles more easily. They also showed more natural movements, such as pointing the toes of the prosthesis upward while going up stairs or stepping over an obstacle, and they were better able to coordinate the movements of their prosthetic limb and their intact limb. They were also able to push off the ground with the same amount of force as someone without an amputation.

“With the AMI cohort, we saw natural biomimetic behaviors emerge,” Herr says. “The cohort that didn’t have the AMI, they were able to walk, but the prosthetic movements weren’t natural, and their movements were generally slower.”

These natural behaviors emerged even though the amount of sensory feedback provided by the AMI was less than 20 percent of what would normally be received in people without an amputation.

“One of the main findings here is that a small increase in neural feedback from your amputated limb can restore significant bionic neural controllability, to a point where you allow people to directly neurally control the speed of walking, adapt to different terrain, and avoid obstacles,” Song says.

“This work represents yet another step in us demonstrating what is possible in terms of restoring function in patients who suffer from severe limb injury. It is through collaborative efforts such as this that we are able to make transformational progress in patient care,” says Matthew Carty, a surgeon at Brigham and Women’s Hospital and associate professor at Harvard Medical School, who is also an author of the paper.

Enabling neural control by the person using the limb is a step toward Herr’s lab’s goal of “rebuilding human bodies,” rather than having people rely on ever more sophisticated robotic controllers and sensors — tools that are powerful but do not feel like part of the user’s body.

“The problem with that long-term approach is that the user would never feel embodied with their prosthesis. They would never view the prosthesis as part of their body, part of self,” Herr says. “The approach we’re taking is trying to comprehensively connect the brain of the human to the electromechanics.”

The research was funded by the MIT K. Lisa Yang Center for Bionics and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

MIT scientists learn how to control muscles with light

Anne Trafton |

For people with paralysis or amputation, neuroprosthetic systems that artificially stimulate muscle contraction with electrical current can help them regain limb function. However, despite many years of research, this type of prosthesis is not widely used because it leads to rapid muscle fatigue and poor control.

McGovern Institute Associate Investigator Hugh Herr. Photo: Jimmy Day / MIT Media Lab

MIT researchers have developed a new approach that they hope could someday offer better muscle control with less fatigue. Instead of using electricity to stimulate muscles, they used light. In a study in mice, the researchers showed that this optogenetic technique offers more precise muscle control, along with a dramatic decrease in fatigue.

“It turns out that by using light, through optogenetics, one can control muscle more naturally. In terms of clinical application, this type of interface could have very broad utility,” says Hugh Herr, a professor of media arts and sciences, co-director of the K. Lisa Yang Center for Bionics at MIT, and an associate member of MIT’s McGovern Institute for Brain Research.

Optogenetics is a method based on genetically engineering cells to express light-sensitive proteins, which allows researchers to control activity of those cells by exposing them to light. This approach is currently not feasible in humans, but Herr, MIT graduate student Guillermo Herrera-Arcos, and their colleagues at the K. Lisa Yang Center for Bionics are now working on ways to deliver light-sensitive proteins safely and effectively into human tissue.

Herr is the senior author of the study, which appears today in Science Robotics. Herrera-Arcos is the lead author of the paper.

Optogenetic control

For decades, researchers have been exploring the use of functional electrical stimulation (FES) to control muscles in the body. This method involves implanting electrodes that stimulate nerve fibers, causing a muscle to contract. However, this stimulation tends to activate the entire muscle at once, which is not the way that the human body naturally controls muscle contraction.

“Humans have this incredible control fidelity that is achieved by a natural recruitment of the muscle, where small motor units, then moderate-sized, then large motor units are recruited, in that order, as signal strength is increased,” Herr says. “With FES, when you artificially blast the muscle with electricity, the largest units are recruited first. So, as you increase signal, you get no force at the beginning, and then suddenly you get too much force.”

This large force not only makes it harder to achieve fine muscle control, it also wears out the muscle quickly, within five or 10 minutes.

The MIT team wanted to see if they could replace that entire interface with something different. Instead of electrodes, they decided to try controlling muscle contraction using optical molecular machines via optogenetics.

Two scientists in the lab.
“This could lead to a minimally invasive strategy that would change the game in terms of clinical care for persons suffering from limb pathology,” Hugh Herr says, pictured on left next to Herrera-Arcos.

Using mice as an animal model, the researchers compared the amount of muscle force they could generate using the traditional FES approach with forces generated by their optogenetic method. For the optogenetic studies, they used mice that had already been genetically engineered to express a light-sensitive protein called channelrhodopsin-2. They implanted a small light source near the tibial nerve, which controls muscles of the lower leg.

The researchers measured muscle force as they gradually increased the amount of light stimulation, and found that, unlike FES stimulation, optogenetic control produced a steady, gradual increase in contraction of the muscle.

“As we change the optical stimulation that we deliver to the nerve, we can proportionally, in an almost linear way, control the force of the muscle. This is similar to how the signals from our brain control our muscles. Because of this, it becomes easier to control the muscle compared with electrical stimulation,” Herrera-Arcos says.

Fatigue resistance

Using data from those experiments, the researchers created a mathematical model of optogenetic muscle control. This model relates the amount of light going into the system to the output of the muscle (how much force is generated).

This mathematical model allowed the researchers to design a closed-loop controller. In this type of system, the controller delivers a stimulatory signal, and after the muscle contracts, a sensor can detect how much force the muscle is exerting. This information is sent back to the controller, which calculates if, and how much, the light stimulation needs to be adjusted to reach the desired force.

Using this type of control, the researchers found that muscles could be stimulated for more than an hour before fatiguing, while muscles became fatigued after only 15 minutes using FES stimulation.

One hurdle the researchers are now working to overcome is how to safely deliver light-sensitive proteins into human tissue. Several years ago, Herr’s lab reported that in rats, these proteins can trigger an immune response that inactivates the proteins and could also lead to muscle atrophy and cell death.

“A key objective of the K. Lisa Yang Center for Bionics is to solve that problem,” Herr says. “A multipronged effort is underway to design new light-sensitive proteins, and strategies to deliver them, without triggering an immune response.”

As additional steps toward reaching human patients, Herr’s lab is also working on new sensors that can be used to measure muscle force and length, as well as new ways to implant the light source. If successful, the researchers hope their strategy could benefit people who have experienced strokes, limb amputation, and spinal cord injuries, as well as others who have impaired ability to control their limbs.

“This could lead to a minimally invasive strategy that would change the game in terms of clinical care for persons suffering from limb pathology,” Herr says.

The research was funded by the K. Lisa Yang Center for Bionics at MIT.

Beyond the brain

by Jennifer Michalowski |

This story also appears in the Spring 2024 issue of BrainScan.

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Like many people, graduate student Guillermo Herrera-Arcos found himself working from home in the spring of 2020. Surrounded by equipment he’d hastily borrowed from the lab, he began testing electrical components he would need to control muscles in a new way. If it worked, he and colleagues in Hugh Herr’s lab might have found a promising strategy for restoring movement when signals from the brain fail to reach the muscles, such as after a spinal cord injury or stroke.

Man holds a fiber that is illuminated with blue light at its tip.
Guillermo Herrera-Arcos, a graduate student in Hugh Herr’s lab, is developing an optical technology with the potential to restore movement in people with spinal cord injury or stroke. Photo: Steph Stevens

Herrera-Arcos and Herr’s work is one way McGovern neuroscientists are working at the interface of brain and machine. Such work aims to enable better ways of understanding and treating injury and disease, offering scientists tools to manipulate neural signaling as well as to replace its function when it is lost.

Restoring movement

The system Herrera-Arcos and Herr were developing wouldn’t be the first to bypass the brain to move muscles. Neuroprosthetic devices that use electricity to stimulate muscle-activating motor neurons are sometimes used during rehabilitation from an injury, helping patients maintain muscle mass when they can’t use their muscles on their own. But existing neuroprostheses lack the precision of the body’s natural movement system. They send all-or-nothing signals that quickly tire muscles out.

TWo men looking at a computer screen, one points to the image on the screen.
Hugh Herr (left) and graduate student Guillermo Herrera-Arco at work in the lab. Photo: Steph Stevens

Researchers attribute that fatigue to an unnatural recruitment of neurons and muscle fibers. Electrical signals go straight to the largest, most powerful components of the system, even when smaller units could do the job. “You turn up the stimulus and you get no force, and then suddenly, you get too much force. And then fatigue, a lack of controllability, and so on,” Herr explains. The nervous system, in contrast, calls first on small motor units and recruits larger ones only when needed to generate more force.

Optical solution

In hopes of recreating this strategic pattern of muscle activation, Herr and Herrera-Arcos turned to a technique pioneered by McGovern Investigator Edward Boyden that has become common research: controlling neural activity with light. To put neurons under their control, researchers equip them with light-sensitive proteins. The cells can then be switched on or off within milliseconds using an optic fiber.

When a return to the lab enabled Herr and Herrera-Arcos to test their idea, they were thrilled with the results. Using light to switch on motor neurons and stimulate a single muscle in mice, they recreated the nervous system’s natural muscle activation pattern. Consequently, fatigue did not set in nearly as quickly as it would with an electrically-activated system. Herrera-Arcos says he set out to measure the force generated by the muscle and how long it took to fatigue, and he had to keep extending his experiments: After an hour of light stimulation, it was still going strong.

To optimize the force generated by the system, the researchers used feedback from the muscle to modulate the intensity of the neuron-activating light. Their success suggests this type of closed-loop system could enable fatigue-resistant neuroprostheses for muscle control.

“The field has been struggling for many decades with the challenge of how to control living muscle tissue,” Herr says. “So the idea that this could be solved is very, very exciting.”

There’s work to be done to translate what the team has learned into practical neuroprosthetics for people who need them. To use light to stimulate human motor neurons, light-sensitive proteins will need to be delivered to those cells. Figuring out how to do that safely is a high priority at the K. Lisa Yang Center for Bionics, which Herr co-directs with Boyden, and might lead to better ways of obtaining tactile and proprioceptive feedback from prosthetic limbs, as well as to control muscles for the restoration of natural movements after spinal cord injury. “It would be a game changer for a number of conditions,” Herr says.

Gut-brain connection

While Herr’s team works where the nervous system meets the muscle, researchers in Polina Anikeeva’s lab are exploring the brain’s relationship with an often-overlooked part of the nervous system — the hundreds of millions of neurons in the gut.

“Classically, when we think of brain function in neuroscience, it is always studied in the framework of how the brain interacts with the surrounding environment and how it integrates different stimuli,” says Atharva Sahasrabudhe, a graduate student in the group. “But the brain does not function in a vacuum. It’s constantly getting and integrating signals from the peripheral organs.”

Man smiles at camera while holding up tiny devices.
Atharva Sahasrabudhe holds some of the fiber technology he developed in the Anikeeva lab. Photo: Steph Stevens

The nervous system has a particularly pronounced presence in the gut. Neurons embedded within the walls of the gastrointestinal (GI) tract monitor local conditions and relay information to the brain. This mind-body connection may help explain the GI symptoms associated with some brain-related conditions, including Parkinson’s disease, mood disorders, and autism. Researchers have yet to untangle whether GI symptoms help drive these conditions, are a consequence of them, or are coincidental. Either way, Anikeeva says, “if there is a GI connection, maybe we can tap into this connection to improve the quality of life of affected individuals.”

Flexible fibers

At the K. Lisa Yang Brain-Body Center that Anikeeva directs, studying how the gut communicates with the brain is a high priority. But most of neuroscientists’ tools are designed specifically to investigate the brain. To explore new territory, Sahasrabudhe devised a device that is compatible with the long and twisty GI tract of a mouse.

The new tool is a slender, flexible fiber equipped with light emitters for activating subsets of cells and tiny channels for delivering nutrients or drugs. To access neurons dispersed throughout the GI tract, its wirelessly controlled components are embedded along its length. A more rigid probe at one end of the device is designed to monitor and manipulate neural activity in the brain, so researchers can follow the nervous system’s swift communications across the gut-brain axis.

Scientists on Anikeeva’s team are deploying the device to investigate how gut-brain communications contribute to several conditions. Postdoctoral researcher Sharmelee Selvaraji is focused on Parkinson’s disease. Like many scientists, she wonders whether the neurodegenerative movement disorder might actually start in the gut. There’s a molecular link: the misshapen protein that sickens brain cells in patients with Parkinson’s disease has been found aggregating in the gut, too. And the constipation and other GI problems that are common complaints for people with Parkinson’s disease usually start decades before the onset of motor symptoms. She hopes that by investigating gut-brain communications in a mouse model of the disease, she will uncover important clues about its origins and progression.

“We’re trying to observe the effects of Parkinson’s in the gut, and then eventually, we may be able to intervene at an earlier stage to slow down the disease progression, or even cure it,” says Selvaraji.

Meanwhile, colleagues in the lab are exploring related questions about gut-brain communications in mouse models of autism, anxiety disorders, and addiction. Others continue to focus on technology development, adding new capabilities to the gut-brain probe or applying similar engineering principles to new problems.

“We are realizing that the brain is very much connected to the rest of the body,” Anikeeva says. “There is now a lot of effort in the lab to create technology suitable for a variety of really interesting organs that will help us study brain-body connections.”

Francesca Riccio-Ackerman works to improve access to prosthetics

by Kara Baskin |

This story originally appeared in the Spring 2023 issue of Spectrum.

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In Sierra Leone, war and illness have left up to 40,000 people requiring orthotics and prosthetics services, but there is a profound lack of access to specialized care, says Francesca Riccio-Ackerman, a biomedical engineer and PhD student studying health equity and health systems. There is just one fully certified prosthetist available for the thousands of patients in the African nation who are living with amputation, she notes. The ideal number is one for every 250, according to the World Health Organization and the International Society of Orthotics and Prosthetics.

The data point is significant for Riccio-Ackerman, who conducts research in the MIT Media Lab’s Biomechatronics Group and in the K. Lisa Yang Center for Bionics, both of which aim to improve translation of assistive technologies to people with disabilities. “We’re really focused on improving and augmenting human mobility,” she says. For Riccio-Ackerman, part of the quest to improve human mobility means ensuring that the people who need access to prosthetic care can get it—for the duration of their lives.

“We’re really focused on improving and augmenting human mobility,” says Riccio-Ackerman.

In September 2021, the Yang Center provided funding for Riccio-Ackerman to travel to Sierra Leone, where she witnessed the lingering physical effects of a brutal decade-long civil war that ended in 2002. Prosthetic and orthotic care in the country, where a vast number of patients are also disabled by untreated polio or diabetes, has become more elusive, she says, as global media attention on the war’s aftermath has subsided. “People with amputation need low-level, consistent care for years. There really needs to be a long-term investment in improving this.”

Through the Yang Center and supported by a fellowship from the new MIT Morningside Academy for Design, Riccio-Ackerman is designing and building a sustainable care and delivery model in Sierra Leone that aims to multiply the production of prosthetic limbs and strengthen the country’s prosthetic sector. “[We’re working] to improve access to orthotic and prosthetic services,” she says.

She is also helping to establish a supply chain for prosthetic limb and orthotic brace parts and equipping clinics with machines and infrastructure to serve more patients. In January 2023, her team launched a four-year collaboration with the Sierra Leone Ministry of Health and Sanitation. One of the goals of the joint effort is to enable Sierra Leoneans to obtain professional prosthetics training, so they can care for their own community without leaving home.

From engineering to economics

Riccio-Ackerman was drawn to issues around human mobility after witnessing her aunt suffer from rheumatoid arthritis. “My aunt was young, but she looked like she was 80 or 90. She was sick, in pain, in a wheelchair— a young spirit in an old body,” she says.

As a biomedical engineering undergraduate student at Florida International University, Riccio-Ackerman worked on clinical trials for neural-enabled myoelectric arms controlled by nerves in the body. She says that the technology was thrilling yet heartbreaking. She would often have to explain to patients who participated in testing that they couldn’t take the devices home and that they may never be covered by insurance.

Riccio-Ackerman began asking questions: “What factors determine who gets an amputation? Why are we making devices that are so expensive and inaccessible?” This sense of injustice inspired her to pivot away from device design and toward a master’s degree in health economics and policy at the SDA Bocconi School of Management in Milan.

She began work as a research specialist with Hugh Herr SM ’93, professor of arts and sciences at the MIT Media Lab and codirector of the Yang Center, helping to study communities that were medically neglected in prosthetic care. “I knew that the devices weren’t getting to the people who need them, and I didn’t know if the best way to solve it was through engineering,” Riccio-Ackerman explains.

While Riccio-Ackerman’s PhD should be finished within three years, she’s only at the beginning of her health care equity work. “We’re forging ahead in Sierra Leone and thinking about translating our strategy and methodologies to other communities around the globe that could benefit,” she says. “We hope to be able to do this in many, many countries in the future.”

Bionics researchers develop technologies to ease pain and transcend human limitations

by Leda Zimmerman |

This story originally appeared in the Spring 2023 issue of Spectrum.

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In early December 2022, a middle-aged woman from California arrived at Boston’s Brigham and Women’s Hospital for the amputation of her right leg below the knee following an accident. This was no ordinary procedure. At the end of her remaining leg, surgeons attached a titanium fixture through which they threaded eight thin, electrically conductive wires. These flexible leads, implanted on her leg muscles, would, in the coming months, connect to a robotic, battery-powered prosthetic ankle and foot.

The goal of this unprecedented surgery, driven by MIT researchers from the K. Lisa Yang Center for Bionics at MIT, was the restoration of near-natural function to the patient, enabling her to sense and control the position and motion of her ankle and foot—even with her eyes closed.

In the K. Lisa Yang Center for Bionics, codirector Hugh Herr SM ’93 and graduate student Christopher Shallal are working to return mobility to people disabled by disease or physical trauma. Photo: Tony Luong

“The brain knows exactly how to control the limb, and it doesn’t matter whether it is flesh and bone or made of titanium, silicon, and carbon composite,” says Hugh Herr SM ’93, professor of media arts and sciences, head of the MIT Media Lab’s Biomechatronics Group, codirector of the Yang Center, and an associate member of MIT’s McGovern Institute for Brain Research.

For Herr, in attendance during that long day, the surgery represented a critical milestone in a decades-long mission to develop technologies returning mobility to people disabled by disease or physical trauma. His research combines a dizzying range of disciplines—electrical, mechanical, tissue, and biomedical engineering, as well as neuroscience and robotics—and has yielded pathbreaking results. Herr’s more than 100 patents include a computer-controlled knee and powered ankle-foot prosthesis and have enabled thousands of people around the world to live more on their own terms, including Herr.

Surmounting catastrophe

For much of Herr’s life, “go” meant “up.”

“Starting when I was eight, I developed an extraordinary passion, an absolute obsession, for climbing; it’s all I thought about in life,” says Herr. He aspired “to be the best climber in the world,” a goal he nearly achieved in his teenage years, enthralled by the “purity” of ascending mountains ropeless and solo in record times, by “a vertical dance, a balance between physicality and mind control.”

McGovern Institute Associate Investigator Hugh Herr. Photo: Jimmy Day / MIT Media Lab

At 17, Herr became disoriented while climbing New Hampshire’s Mt. Washington during a blizzard. Days in the cold permanently damaged his legs, which had to be amputated below his knees. His rescue cost another man’s life, and Herr was despondent, disappointed in himself, and fearful for his future.

Then, following months of rehabilitation, he felt compelled to test himself. His first weekend home, when he couldn’t walk without canes and crutches, he headed back to the mountains. “I hobbled to the base of this vertical cliff and started ascending,” he recalls. “It brought me joy to realize that I was still me, the same person.”

But he also recognized that as a person with amputated limbs, he faced severe disadvantages. “Society doesn’t look kindly on people with unusual bodies; we are viewed as crippled and weak, and that did not sit well with me.” Unable to tolerate both the new physical and social constraints on his life, Herr determined to view his disability not as a loss but as an opportunity. “I think the rage was the catapult that led me to do something that was without precedent,” he says.

Lifelike limb

On hand in the surgical theater in December was a member of Herr’s Biomechatronics Group for whom the bionic limb procedure also held special resonance. Christopher Shallal, a second-year graduate student in the Harvard-MIT Health Sciences and Technology program who received bilateral lower limb amputations at birth, worked alongside surgeon Matthew Carty testing the electric leads before implantation in the patient. Shallal found this, his first direct involvement with a reconstruction surgery, deeply fulfilling.

“Ever since I was a kid, I’ve wanted to do medicine plus engineering,” says Shallal. “I’m really excited to work on this bionic limb reconstruction, which will probably be one of the most advanced systems yet in terms of neural interfacing and control, with a far greater range of motion possible.”

Hugh and Shallal are working on a next-generation, biomimetic limb with implanted sensors that can relay signals between the external prosthesis and muscles in the remaining limb. Photo: Tony Luong

Like other Herr lab designs, the new prosthesis features onboard, battery-powered propulsion, microprocessors, and tunable actuators. But this next-generation, biomimetic limb represents a major leap forward, replacing electrodes sited on a patient’s skin, subject to sweat and other environmental threats, with implanted sensors that can relay signals between the external prosthesis and muscles in the remaining limb.

This system takes advantage of a breakthrough technique invented several years ago by the Herr lab called CMI (for cutaneous mechanoneural interface), which constructs muscle-skin-nerve bundles at the amputation site. Muscle actuators controlled by computers on board the external prosthesis apply forces on skin cells implanted within the amputated residuum when a person with amputation touches an object with their prosthesis.

With CMI and electric leads connecting the prosthesis to these muscle actuators within the residual limb, the researchers hypothesize that a person with an amputation will be able to “feel” their prosthetic leg step onto the ground. This sensory capability is the holy grail for persons with major limb loss. After recovery from her surgery, the woman from California will be wearing Herr’s latest state-of-the-art prosthetic system in the lab.

‘Tinkering’ with the body

Not all artificial limbs emulate those that humans are born with. “You can make them however you want, swapping them in and out depending on what you want to do, and they can take you anywhere,” Herr says. Committed to extreme climbing even after his accident, Herr came up with special limbs that became a commercial hit early in his career. His designs made it possible for someone with amputated legs to run and dance.

But he also knew the day-to-day discomfort of navigating on flatter earth with most prostheses. He won his first patent during his senior year of college for a fluid-controlled socket attachment designed to reduce the pain of walking. Growing up in a Mennonite family skilled in handcrafting things they needed, and in a larger community that was disdainful of technology, Herr says he had “difficulty trusting machines.” Yet by the time he began his master’s program at MIT, intent on liberating persons with limb amputation to live more fully in the world, he had embraced the tools of science and engineering as the means to this end.

“I want to be in the business of designing not more and more powerful tools but designing new bodies,” says Hugh Herr.

For Shallal, Herr was an early icon, and his inventions and climbing exploits served as inspiration. “I’d known about Hugh since middle school; he was famous among those with amputations,” he says. “As a kid, I liked tinkering with things, and I kind of saw my body as a canvas, a place where I could explore different boundaries and expand possibilities for myself and others with amputations.” In school, Shallal sometimes encountered resistance to his prostheses. “People would say I couldn’t do certain things, like running and playing different sports, and I found these barriers frustrating,” he says. “I did things in my own way and didn’t want people to pity me.”

In fact, Shallal felt he could do some things better than his peers. In high school, he used a 3-D printer to make a mobile phone charger case he could plug into his prosthesis. “As a kid, I would wear long pants to hide my legs, but as the technology got cooler, I started wearing shorts,” he says. “I got comfortable and liked kind of showing off my legs.”

Global impact

December’s surgery was the first phase in the bionic limb project. Shallal will be following up with the patient over many months, ensuring that the connections between her limb and implanted sensors function and provide appropriate sensorimotor data for the built-in processor. Research on this and other patients to determine the impact of these limbs on gait and ease of managing slopes, for instance, will form the basis for Shallal’s dissertation.

“After graduation, I’d be really interested in translating technology out of the lab, maybe doing a startup related to neural interfacing technology,” he says. “I watched Inspector Gadget on television when I was a kid. Making the tool you need at the time you need it to fix problems would be my dream.”

Herr will be overseeing Shallal’s work, as well as a suite of research efforts propelled by other graduate students, postdocs, and research scientists that together promise to strengthen the technology behind this generation of biomimetic prostheses.

One example: devising an innovative method for measuring muscle length and velocity with tiny implanted magnets. In work published in November 2022, researchers including Herr; project lead Cameron Taylor SM ’16, PhD ’20, a research associate in the Biomechatronics Group; and Brown University partners demonstrated that this new tool, magnetomicrometry, yields the kind of high-resolution data necessary for even more precise bionic limb control. The Herr lab awaits FDA approval on human implantation of the magnetic beads.

These intertwined initiatives are central to the ambitious mission of the K. Lisa Yang Center for Bionics, established with a $24 million gift from Yang in 2021 to tackle transformative bionic interventions to address an extensive range of human limitations.

Herr is committed to making the broadest possible impact with his technologies. “Shoes and braces hurt, so my group is developing the science of comfort—designing mechanical parts that attach to the body and transfer loads without causing pain.” These inventions may prove useful not just to people living with amputation but to patients suffering from arthritis or other diseases affecting muscles, joints, and bones, whether in lower limbs or arms and hands.

The Yang Center aims to make prosthetic and orthotic devices more accessible globally, so Herr’s group is ramping up services in Sierra Leone, where civil war left tens of thousands missing limbs after devastating machete attacks. “We’re educating clinicians, helping with supply chain infrastructure, introducing novel assistive technology, and developing mobile delivery platforms,” he says.

In the end, says Herr, “I want to be in the business of designing not more and more powerful tools but designing new bodies.” Herr uses himself as an example: “I walk on two very powerful robots, but they’re not linked to my skeleton, or to my brain, so when I walk it feels like I’m on powerful machines that are not me. What I want is such a marriage between human physiology and electromechanics that a person feels at one with the synthetic, designed content of their body.” and control, with a far greater range of motion possible.”

New collaboration aims to strengthen orthotic and prosthetic care in Sierra Leone

by Alexandra Kahn | MIT Media Lab |

MIT’s K. Lisa Yang Center for Bionics has entered into a collaboration with the Government of Sierra Leone to strengthen the capabilities and services of that country’s orthotic and prosthetic (O&P) sector. Tens of thousands of people in Sierra Leone are in need of orthotic braces and artificial limbs, but access to such specialized medical care in this African nation is limited.

The agreement, reached between MIT, the Center for Bionics, and Sierra Leone’s Ministry of Health and Sanitation (MoHS), provides a detailed memorandum of understanding and intentions that will begin as a four-year program.  The collaborators aim to strengthen Sierra Leone’s O&P sector through six key objectives: data collection and clinic operations, education, supply chain, infrastructure, new technologies and mobile delivery of services.

Project Objectives

  1. Data Collection and Clinic Operations: collect comprehensive data on epidemiology, need, utilization, and access for O&P services across the country
  2. Education: create an inclusive education and training program for the people of Sierra Leone, to enable sustainable and independent operation of O&P services
  3. Supply Chain: establish supply chains for prosthetic and orthotic components, parts, and materials for fabrication of devices
  4. Infrastructure: prepare infrastructure (e.g., physical space, sufficient water, power and internet) to support increased production and services
  5. New Technologies: develop and translate innovative technologies with potential to improve O&P clinic operations and management, patient mobility, and the design or fabrication of devices
  6. Mobile Delivery: support outreach services and mobile delivery of care for patients in rural and difficult-to-reach areas

Working together, MIT’s bionics center and Sierra Leone’s MoHS aim to sustainably double the production and distribution of O&P services at Sierra Leone’s National Rehabilitation Centre and Bo Clinics over the next four years.

The team of MIT scientists who will be implementing this novel collaboration is led by Hugh Herr, MIT Professor of Media Arts and Sciences. Herr, himself a double amputee, serves as co-director of the K. Lisa Yang Center for Bionics, and heads the renowned Biomechatronics research group at the MIT Media Lab.

“From educational services, to supply chain, to new technology, this important MOU with the government of Sierra Leone will enable the Center to develop a broad, integrative approach to the orthotic and prosthetic sector within Sierra Leone, strengthening services and restoring much needed care to its citizens,” notes Professor Herr.

Sierra Leone’s Honorable Minister of Health Dr. Austin Demby also states: “As the Ministry of Health and Sanitation continues to galvanize efforts towards the attainment of Universal Health Coverage through the life stages approach, this collaboration will foster access, innovation and capacity building in the Orthotic and Prosthetic division. The ministry is pleased to work with and learn from MIT over the next four years in building resilient health systems, especially for vulnerable groups.”

“Our team at MIT brings together expertise across disciplines from global health systems to engineering and design,” added Francesca Riccio-Ackerman, the graduate student lead for the MIT Sierra Leone project. “This allows us to craft an innovative strategy with Sierra Leone’s Ministry of Health and Sanitation. Together we aim to improve available orthotic and prosthetic care for people with disabilities.”

The K. Lisa Yang Center for Bionics at the Massachusetts Institute of Technology pioneers transformational bionic interventions across a broad range of conditions affecting the body and mind. Based on fundamental scientific principles, the Center seeks to develop neural and mechanical interfaces for human-machine communications; integrate these interfaces into novel bionic platforms; perform clinical trials to accelerate the deployment of bionic products by the private sector; and leverage novel and durable, but affordable, materials and manufacturing processes to ensure equitable access to the latest bionic technology by all impacted individuals, especially those in developing countries. 

Sierra Leone’s Ministry of Health and Sanitation is responsible for health service delivery across the country, as well as regulation of the health sector to meet the health needs of its citizenry. 

For more information about this project, please visit: https://mitmedialab.info/prosforallproj2

 

The ways we move

by Jennifer Michalowski |

This story originally appeared in the Winter 2023 issue of BrainScan.
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Many people barely consider how their bodies move — at least not until movement becomes more difficult due to injury or disease. But the McGovern scientists who are working to understand human movement and restore it after it has been lost know that the way we move is an engineering marvel.
Muscles, bones, brain, and nerves work together to navigate and interact with an ever-changing environment, making constant but often imperceptible adjustments to carry out our goals. It’s an efficient and highly adaptable system, and the way it’s put together is not at all intuitive, says Hugh Herr, a new associate investigator at the Institute.

That’s why Herr, who also co-directs MIT’s new K. Lisa Yang Center for Bionics, looks to biology to guide the development of artificial limbs that aim to give people the same agency, control, and comfort of natural limbs. McGovern Associate Investigator Nidhi Seethapathi, who like Herr joined the Institute in September, is also interested in understanding human movement in all its complexity. She is coming at the problem from a different direction, using computational modeling to predict how and why we move the way we do.

Moving through change

The computational models that Seethapathi builds in her lab aim to predict how humans will move under different conditions. If a person is placed in an unfamiliar environment and asked to navigate a course under time pressure, what path will they take? How will they move their limbs, and what forces will they exert? How will their movements change as they become more comfortable on the terrain?

McGovern Associate Investigator Nidhi Seethapathi with lab members (from left to right) Inseung Kang, Nikasha Patel, Antoine De Comite, Eric Wang, and Crista Falk. Photo: Steph Stevens

Seethapathi uses the principles of robotics to build models that answer these questions, then tests them by placing real people in the same scenarios and monitoring their movements. So far, that has mostly meant inviting study subjects to her lab, but as she expands her models to predict more complex movements, she will begin monitoring people’s activity in the real world, over longer time periods than laboratory experiments typically allow.

Seethapathi’s hope is that her findings will inform the way doctors, therapists, and engineers help patients regain control over their movements after an injury or stroke, or learn to live with movement disorders like Parkinson’s disease. To make a real difference, she stresses, it’s important to bring studies of human movement out of the lab, where subjects are often limited to simple tasks like walking on a treadmill, into more natural settings. “When we’re talking about doing physical therapy, neuromotor rehabilitation, robotic exoskeletons — any way of helping people move better — we want to do it in the real world, for everyday, complex tasks,” she says.

When we’re talking about helping people move better — we want to do it in the real world, for everyday, complex tasks,” says Seethapathi.

Seethapathi’s work is already revealing how the brain directs movement in the face of competing priorities. For example, she has found that when people are given a time constraint for traveling a particular distance, they walk faster than their usual, comfortable pace — so much so that they often expend more energy than necessary and arrive at their destination a bit early. Her models suggest that people pick up their pace more than they need to because humans’ internal estimations of time are imprecise.

Her team is also learning how movements change as a person becomes familiar with an environment or task. She says people find an efficient way to move through a lot of practice. “If you’re walking in a straight line for a very long time, then you seem to pick the movement that is optimal for that long-distance walk,” she explains. But in the real world, things are always changing — both in the body and in the environment. So Seethapathi models how people behave when they must move in a new way or navigate a new environment. “In these kinds of conditions, people eventually wind up on an energy-optimal solution,” she says. “But initially, they pick something that prevents them from falling down.”

To capture the complexity of human movement, Seethapathi and her team are devising new tools that will let them monitor people’s movements outside the lab. They are also drawing on data from other fields, from architecture to physical therapy, and even from studies of other animals. “If I have general principles, they should be able to tell me how modifications in the body or in how the brain is connected to the body would lead to different movements,” she says. “I’m really excited about generalizing these principles across timescales and species.”

Building new bodies

In Herr’s lab, a deepening understanding of human movement is helping drive the development of increasingly sophisticated artificial limbs and other wearable robots. The team designs devices that interface directly with a user’s nervous system, so they are not only guided by the brain’s motor control systems, but also send information back to the brain.

Herr, a double amputee with two artificial legs of his own, says prosthetic devices are getting better at replicating natural movements, guided by signals from the brain. Mimicking the design and neural signals found in biology can even give those devices much of the extraordinary adaptability of natural human movement. As an example, Herr notes that his legs effortlessly navigate varied terrain. “There’s adaptive, stabilizing features, and the machine doesn’t have to detect every pothole and pebble and banana peel on the ground, because the morphology and the nervous system control is so inherently adaptive,” he says.

McGovern Associate Investigator Hugh Herr at work in the K. Lisa Yang Center for Bionics at MIT. Photo: Jimmy Day/Media Lab

But, he notes, the field of bionics is in its infancy, and there’s lots of room for improvement. “It’s only a matter of time before a robotic knee, for example, can be as good as the biological knee or better,” he says. “But the problem is the human attached to that knee won’t feel it’s their knee until they can feel it, and until their central nervous system has complete agency over that knee,” he says. “So if you want to actually build new bodies and not just more and more powerful tools for humans, you have to link to the brain bidirectionally.”

Herr’s team has found that surgically restoring natural connections between pairs of muscles that normally work in opposition to move a limb, such as the arm’s biceps and triceps, gives the central nervous system signals about how that limb is moving, even when a natural limb is gone. The idea takes a cue from the work of McGovern Emeritus Investigator Emilio Bizzi, who found that the coordinated activation of groups of muscles by the nervous system, called muscle synergies, is important for motor control.

“It’s only a matter of time before a robotic knee can be as good as the biological knee or better,” says Herr.

“When a person thinks and moves their phantom limb, those muscle pairings move dynamically, so they feel, in a natural way, the limb moving — even though the limb is not there,” Herr explains. He adds that when those proprioceptive signals communicate instead how an artificial limb is moving, a person experiences “great agency and ownership” of that limb. Now, his group is working to develop sensors that detect and relay information usually processed by sensory neurons in the skin, so prosthetic devices can also perceive pressure and touch.

At the same time, they’re working to improve the mechanical interface between wearable robots and the body to optimize comfort and fit — whether that’s by using detailed anatomical imaging to guide the design of an individual’s device or by engineering devices that integrate directly with a person’s skeleton. There’s no “average” human, Herr says, and effective technologies must meet individual needs, not just for fit, but also for function. At that same time, he says it’s important to plan for cost-effective, mass production, because the need for these technologies is so great.

“The amount of human suffering caused by the lack of technology to address disability is really beyond comprehension,” he says. He expects tremendous progress in the growing field of bionics in the coming decades, but he’s impatient. “I think in 50 years, when scientists look back to this era, it’ll be laughable,” he says. “I’m always anxiously wanting to be in the future.”

Magnetic sensors track muscle length

Anne Trafton |

Using a simple set of magnets, MIT researchers have come up with a sophisticated way to monitor muscle movements, which they hope will make it easier for people with amputations to control their prosthetic limbs.

In a new pair of papers, the researchers demonstrated the accuracy and safety of their magnet-based system, which can track the length of muscles during movement. The studies, performed in animals, offer hope that this strategy could be used to help people with prosthetic devices control them in a way that more closely mimics natural limb movement.

“These recent results demonstrate that this tool can be used outside the lab to track muscle movement during natural activity, and they also suggest that the magnetic implants are stable and biocompatible and that they don’t cause discomfort,” says Cameron Taylor, an MIT research scientist and co-lead author of both papers.

McGovern Institute Associate Investigator Hugh Herr. Photo: Jimmy Day / MIT Media Lab

In one of the studies, the researchers showed that they could accurately measure the lengths of turkeys’ calf muscles as the birds ran, jumped, and performed other natural movements. In the other study, they showed that the small magnetic beads used for the measurements do not cause inflammation or other adverse effects when implanted in muscle.

“I am very excited for the clinical potential of this new technology to improve the control and efficacy of bionic limbs for persons with limb-loss,” says Hugh Herr, a professor of media arts and sciences, co-director of the K. Lisa Yang Center for Bionics at MIT, and an associate member of MIT’s McGovern Institute for Brain Research.

Herr is a senior author of both papers, which appear today in the journal Frontiers in Bioengineering and Biotechnology. Thomas Roberts, a professor of ecology, evolution, and organismal biology at Brown University, is a senior author of the measurement study.

Tracking movement

Currently, powered prosthetic limbs are usually controlled using an approach known as surface electromyography (EMG). Electrodes attached to the surface of the skin or surgically implanted in the residual muscle of the amputated limb measure electrical signals from a person’s muscles, which are fed into the prosthesis to help it move the way the person wearing the limb intends.

However, that approach does not take into account any information about the muscle length or velocity, which could help to make the prosthetic movements more accurate.

Several years ago, the MIT team began working on a novel way to perform those kinds of muscle measurements, using an approach that they call magnetomicrometry. This strategy takes advantage of the permanent magnetic fields surrounding small beads implanted in a muscle. Using a credit-card-sized, compass-like sensor attached to the outside of the body, their system can track the distances between the two magnets. When a muscle contracts, the magnets move closer together, and when it flexes, they move further apart.

The new muscle measuring approach takes advantage of the magnetic attraction between two small beads implanted in a muscle. Using a small sensor attached to the outside of the body, the system can track the distances between the two magnets as the muscle contracts and flexes. Image: Hugh Herr

In a study published last year, the researchers showed that this system could be used to accurately measure small ankle movements when the beads were implanted in the calf muscles of turkeys. In one of the new studies, the researchers set out to see if the system could make accurate measurements during more natural movements in a nonlaboratory setting.

To do that, they created an obstacle course of ramps for the turkeys to climb and boxes for them to jump on and off of. The researchers used their magnetic sensor to track muscle movements during these activities, and found that the system could calculate muscle lengths in less than a millisecond.

They also compared their data to measurements taken using a more traditional approach known as fluoromicrometry, a type of X-ray technology that requires much larger equipment than magnetomicrometry. The magnetomicrometry measurements varied from those generated by fluoromicrometry by less than a millimeter, on average.

“We’re able to provide the muscle-length tracking functionality of the room-sized X-ray equipment using a much smaller, portable package, and we’re able to collect the data continuously instead of being limited to the 10-second bursts that fluoromicrometry is limited to,” Taylor says.

Seong Ho Yeon, an MIT graduate student, is also a co-lead author of the measurement study. Other authors include MIT Research Support Associate Ellen Clarrissimeaux and former Brown University postdoc Mary Kate O’Donnell.

Biocompatibility

In the second paper, the researchers focused on the biocompatibility of the implants. They found that the magnets did not generate tissue scarring, inflammation, or other harmful effects. They also showed that the implanted magnets did not alter the turkeys’ gaits, suggesting they did not produce discomfort. William Clark, a postdoc at Brown, is the co-lead author of the biocompatibility study.

The researchers also showed that the implants remained stable for eight months, the length of the study, and did not migrate toward each other, as long as they were implanted at least 3 centimeters apart. The researchers envision that the beads, which consist of a magnetic core coated with gold and a polymer called Parylene, could remain in tissue indefinitely once implanted.

“Magnets don’t require an external power source, and after implanting them into the muscle, they can maintain the full strength of their magnetic field throughout the lifetime of the patient,” Taylor says.

The researchers are now planning to seek FDA approval to test the system in people with prosthetic limbs. They hope to use the sensor to control prostheses similar to the way surface EMG is used now: Measurements regarding the length of muscles will be fed into the control system of a prosthesis to help guide it to the position that the wearer intends.

“The place where this technology fills a need is in communicating those muscle lengths and velocities to a wearable robot, so that the robot can perform in a way that works in tandem with the human,” Taylor says. “We hope that magnetomicrometry will enable a person to control a wearable robot with the same comfort level and the same ease as someone would control their own limb.”

In addition to prosthetic limbs, those wearable robots could include robotic exoskeletons, which are worn outside the body to help people move their legs or arms more easily.

The research was funded by the Salah Foundation, the K. Lisa Yang Center for Bionics at MIT, the MIT Media Lab Consortia, the National Institutes of Health, and the National Science Foundation.

Hugh Herr

Revolutionizing Bionics

Hugh Herr creates bionic limbs that emulate the function of natural limbs. In 2011, TIME magazine named him the “Leader of the Bionic Age” for his revolutionary work in the emerging field of biomechatronics, an emerging field that marries human physiology with electromechanics.

Herr, who lost both of his legs below the knee to a climbing accident in 1982, has dedicated his career to the creation of technologies that push the possibilities of prosthetics. As co-director of the K. Lisa Yang Center for Bionics, Herr seeks to develop neural and mechanical interfaces for human-machine communications; integrate these interfaces into novel bionic platforms; perform clinical trials to accelerate the deployment of bionic products by the private sector; and leverage novel and durable, but affordable, materials and manufacturing processes to ensure equitable access of the latest bionic technology to all impacted individuals, especially to those in developing countries.

Herr’s story has been told in the National Geographic film, Ascent: The Story of Hugh Herr as well as the PBS documentary, Augmented.

Augmented: The journey of Hugh Herr

by Julie Pryor |

Augmented is a Nova PBS documentary that premiered in February 2022, featuring Hugh Herr, the co-director of the K. Lisa Yang Center for Bionics at MIT.

Follow the dramatic personal journey of Hugh Herr, a biophysicist working to create brain-controlled robotic limbs. At age 17, Herr’s legs were amputated after a climbing accident. Frustrated by the crude prosthetic limbs he was given, Herr set out to remedy their design, leading him to a career as an inventor of innovative prosthetic devices. Now, Herr is teaming up with an injured climber and a surgeon at a leading Boston hospital to test a new approach to surgical amputation that allows prosthetic limbs to move and feel like the real thing. Herr’s journey is a powerful tale of innovation and the inspiring story of a personal tragedy transformed into a life-long quest to help others.

Read more at PBS.org.