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New Clinical Research Will Test Brain’s Ability to Adapt to Advanced Bionic Limbs

The research, led by Limbitless Solutions, Wolfson Children’s Hospital of Jacksonville and Nemours Children’s Health, Jacksonville, aims to improve prosthetic mastery in children born without limbs.

Anew, first-of-its-kind clinical trial will examine how the brain adapts to advanced, bionic arms in children born without a limb, with the ultimate goal of improving children’s control of their prosthetic.

The work, which starts this spring, will be led byÌý, a nonprofit, direct support organization at the º£½ÇÖ±²¥,ÌýÌýandÌý. The joint effort brings together expertise from pediatric research, neuroradiology, and bionics.

Approximately four babies in every 10,000 are born missing a limb, according to the U.S. Centers for Disease Control and Prevention. Prosthetics can be a supportive tool for children to perform everyday activities, but little is known about how the brain responds to the addition of an artificial limb.

“Limited research has been conducted on how the brain’s motor cortex structure changes from congenitalÌýlimb loss and subsequentÌýuse of a prosthetic,â€� saysÌýAlbert Manero, ’12 ’14MS ’16PhD, executive director and co-founder of Limbitless Solutions.

The four-month clinical trial will examine if Limbitless’ prosthetic — paired with itsÌýÌý— will impact the motor control center of the brain. Researchers will closely monitor any changes in the signals the brain sends to the muscle groups that direct the bionics’ movement.

They will do this using advanced functional magnetic resonance imaging techniques before and after prosthetic use and training. Additionally, researchers will use a method known as tractography — where MRI scans visualize the nerve pathways — to identify new or more robust pathways resulting from the training.

The study is unique because it combines advanced imaging techniques with novel prosthetics and video-game-based training to evaluate motor cortex engagement.

“It may provide new insight to how the brain’s motor cortex adapts to learning how to use our organic, or robotic, limbs,� Manero says.

Manero will lead the researchÌýstudy on the Limbitless side as the investigator along with other UCF staff and faculty. Chetan Shah,Ìýchair of radiology at Nemours Children’s Health, Jacksonville, Florida, and based at Wolfson Children’s Hospital of Jacksonville, will lead the imaging work.

“This research will help us see how the brain responds to the child’s newly acquired ability to use a prosthetic hand,� Dr. Shah says. “This is a novel way of using existing brain circuits to use an artificial limb, and most importantly, this is a life-changing device for a child both mentally and physically. We are extremely enthusiastic about this research.�

Limbitless Solutions, which Manero co-founded as a graduate student at UCF along withÌýJohnÌýSparkman ’13 ’15MSÌýandÌýDominique Courbin ’18, specializes in developing advanced, muscle-based biosensing technology, such as bionic limbs, to empower children and adults in the limb-different community.

The customized prosthetics they create are 3D printed and can be paired with a parent’s smart phone. The devices even charge like a cell phone, via USB type C.

The exteriors of the devices are artistically designed and customized, with input from each participant. Existing muscles in the residual part of a limb are used to control their function, which is triggered by a person’s own muscle flex.

In 2016, Limbitless and faculty membersÌýMatt DombrowskiÌý’08²Ñ¹ó´¡ÌýwithÌýUCF’s School of Visual Arts and DesignÌýandÌýPeter SmithÌý’05MS ’12PhDÌýwithÌýUCF’s Nicholson School of Communication and MediaÌýcreatedÌývideo games to train children’s muscles in anticipation of receiving bionic arms. These video games will be leveraged in the trial to support training for the use of the prosthetic limb.

Limbitless Solutions believes no person with a limb difference should be financially burdened to have a bionic arm and plans to provide prosthetics and training systems for the study free of charge.

To learn more about the program and to submit an application to receive information about the study, families are asked to apply here:Ìý. The study is for children ages 9 to 12, and a maximum of five patients will be enrolled in the pilot study.

About Limbitless Solutions

Limbitless Solutions is a nonprofit and direct support organization at UCF dedicated to empowering children and adults in the limb difference community. Through personalized, creative, and expressive bionics – provided without financial burden – the team uses innovative technology and interdisciplinary collaboration to develop muscle-based biosensing technology (multi-gesture bionic arms, a hands-free wheelchair control device and interactive video game training).

Undergraduate students from various academic perspectives engage in project-based learning, professional development and research experiences where students put academics into practice in an environment focused on making a difference, as well as professional and technical development.

Previous clinical trials of Limbitless Solutions technology have included examining theÌýfunctionality of the bionic arms and their effect on quality of life, theÌýeffectiveness of video-game-based training, and theÌýability of a hands-free wheelchair control device to improve independent mobility and quality of life.

Manero received hisÌýdoctoral degreeÌýin mechanical engineering and hisÌý³¾²¹²õ³Ù±ð°ù’sÌýandÌý²ú²¹³¦³ó±ð±ô´Ç°ù’sÌýdegrees in aerospace engineering from UCF. He joined UCF’s Office ofÌýResearchÌýin 2017, and holds courtesy research appointments in UCF’sÌýMechanical and Aerospace Engineering DepartmentÌýin theÌýCollege of Engineering and Computer Science, Mayo Clinic’s Neurology department, and Veterans Affairs Orlando Healthcare System. He is also a member of UCF’sÌýBiionixÌýresearch cluster.

About Wolfson Children’s Hospital of Jacksonville

Wolfson Children’s HospitalÌýin Jacksonville, Florida, is a part ofÌýBaptist Health, Northeast Florida’s most comprehensive health system serving every stage of life. Wolfson Children’s is the only children’s hospital in Northeast Florida and serves as the pediatric referral center for North Florida, South Georgia and beyond. Staffed 24/7 by pediatric nurses and other healthcare professionals specially trained to work with children, the 216-bed, patient- and family-centered hospital features the latest pediatric medical technology in a welcoming, child-friendly environment. At Wolfson Children’s, nationally recognized pediatric specialists representing nearly every medical and surgical specialty work with pediatricians to provide care for children of all ages with congenital heart conditions, cancer, neurological disorders, diabetes and endocrinology disorders, orthopedic conditions, behavioral health conditions, traumatic injuries, and more. Wolfson Children’s pediatric institutional partners includeÌýNemours Children’s Specialty Care, Jacksonville,ÌýUPMC Children’s Hospital of Pittsburgh, theÌýº£½ÇÖ±²¥ of Florida College of Medicine — JacksonvilleÌýandÌýMayo Clinic Florida. A Magnet-designated hospital since 2010, Wolfson Children’s Hospital has been named among theÌýU.S. News & World ReportÌý50 Best Children’s Hospitals year after year, and in 2021, was selected as one of only eight children’s hospitals in the country as a Leapfrog Top Children’s Hospital, a recognition of patient quality and safety.

Principal Investigator

CEO Limbitless Solutions
Albert.Manero@ucf.edu