Re-Engaging Spinal Reflexes: Toward Multisensory Feedback Integration in Neuroprosthetic Control

Neuroprosthetic devices have evolved significantly over the last two decades. Modern Electromyography (EMG) prostheses and neural EMG prostheses can fully decode the user's intention for basic motor tasks. Bidirectional research has revealed exciting advances, with intraneural stimulation and bionic encoding of tactile and proprioceptive inputs. Thus, even without visual feedback, they can modulate force and other properties of the object they interact with. Clinical trials of neuromusculoskeletal prostheses have shown feasibility for long-term use. This paper applies these ideas: feedback should not be limited to processing artificial sensory signals at the controller level; it should be returned to the spinal reflex pathway to engage intrinsic circuits in low-latency correction, perturbation, and postural stabilization. These frameworks can be illustrated by case studies of intraneural tactile feedback and tendon vibration to understand how users of the prosthesis can restore stability, efficiency, and implement reflex arcs with artificial receptors. Taken together, these findings suggest that the prosthesis can be viewed as an embodied extension of the nervous system rather than a robotic device separated from the body. If neuroprostheses include multimodal sensory feedback and revert to spinal cord level reflexes, these implantable devices have the potential to produce natural motor coordination that remains clinically feasible for daily functioning.