{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:56:52Z","timestamp":1792151812779,"version":"4.4.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Marie Sk\u0142odowska-Curie Actions"},{"DOI":"10.13039\/100019180","name":"European Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019180","id-type":"DOI","asserted-by":"publisher"}]},{"name":"\u00d6ssur and Ottobock Research Trust Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Myoelectric control paradigms have the potential to enable continuous volitional control of bionic limbs in various movement conditions. Although individuals with below knee amputations and an agonist\u2013antagonist muscle interface (AMI) were proven to display a greater degree of continuous volitional control in bionic ankle-foot systems with respect to conventional socket-suspended prosthetic users, it remains unclear how myoelectric interfaces could translate to non-AMI prosthetic users with bone-anchored prostheses (BAP). This preliminary study proposes a human\u2013machine interface (HMI) based on a neuromechanical model to enable volitional, continuous myoelectric control of a bionic leg in AMI and BAP users, walking across various speeds and ground inclinations. Differently from state of the art solutions, the proposed HMI is based on a digital twin of the intact leg, synthesizing the user\u2019s phantom limb musculoskeletal function as controlled by muscle activations measured from the residuum. When embedded in a real-time framework, it enabled the participants to achieve volitional modulation of prosthesis peak plantar-dorsiflexion torques timing and amplitude during overground walking at three speeds (between 1.6 and 3.96 km\/h), with case studies provided during calf-raises (30, 45, and 60 bpm) and ramp ascent walking (3 and 5% incline). Before prosthesis control tests, the participants underwent a 2-day gait training session. Results showed that all three subjects learned how to alter initial muscle activation patterns so that an average of 87% of peak activation timing fell within target ranges. The proposed neuromechanical modeling technology opens new avenues toward generalizable HMIs for the volitional control of active prostheses beyond set conditions and amputation types.<\/jats:p>","DOI":"10.1093\/pnasnexus\/pgaf413","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T15:19:00Z","timestamp":1767626340000},"source":"Crossref","is-referenced-by-count":1,"title":["Continuous volitional control of a bionic leg supports diverse walking patterns in both agonist\u2013antagonist muscle interface and bone-anchored prosthesis users"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3411-8440","authenticated-orcid":false,"given":"Federica","family":"Damonte","sequence":"first","affiliation":[{"name":"Department of Biomechanical Engineering, University of Twente , Enschede 7522 LW ,","place":["The Netherlands"]},{"name":"Global Research, Ottobock SE & Co. KGaA , Duderstadt D-37115, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-5683","authenticated-orcid":false,"given":"Lucas","family":"Avanci Gaudio","sequence":"additional","affiliation":[{"name":"Department of Biomechanical Engineering, University of Twente , Enschede 7522 LW ,","place":["The Netherlands"]},{"name":"Global Research, Ottobock SE & Co. KGaA , Duderstadt D-37115, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3448-7393","authenticated-orcid":false,"given":"Jose","family":"Gonzalez-Vargas","sequence":"additional","affiliation":[{"name":"Global Research, Ottobock SE & Co. KGaA , Duderstadt D-37115, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6951-776X","authenticated-orcid":false,"given":"Guillaume","family":"Durandau","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, McGill University , Montreal , QC, Canada H3A 0C3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Ernst","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Hannover Medical School , Hannover OE-6320 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan S","family":"Rietman","sequence":"additional","affiliation":[{"name":"Department of Biomechanical Engineering, University of Twente , Enschede 7522 LW ,","place":["The Netherlands"]},{"name":"Roessingh Research and Development , Revalidatiecentrum Roessingh, Enschede 7522 AH ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6158-6901","authenticated-orcid":false,"given":"Ruud","family":"Leijendekkers","sequence":"additional","affiliation":[{"name":"Radboudumc Department of Rehabilitation, , Nijmegen 6525 GA ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7926-3262","authenticated-orcid":false,"given":"Herman","family":"van der Kooij","sequence":"additional","affiliation":[{"name":"Department of Biomechanical Engineering, University of Twente , Enschede 7522 LW ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0930-6535","authenticated-orcid":false,"given":"Massimo","family":"Sartori","sequence":"additional","affiliation":[{"name":"Department of Biomechanical Engineering, University of Twente , Enschede 7522 LW ,","place":["The 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