Oscar Pistorius Ruled Ineligible for Olympic Competition
On January 14, the International Association of Athletics Federations (IAAF) released the results of its biomechanical tests on Oscar Pistorius, the South African Paralympic champion and bilateral amputee. The IAAF declared that Pistorius’ “Cheetah” prosthetic racing legs gave him a clear advantage over able-bodied sprinters, and that he would not be permitted to race in (or attempt to qualify for) the Olympic Games, according to The Washington Post.

The IAAF asserted in a press release that its findings showed 25 percent less energy expenditure by Pistorius, when running on his blade-like prostheses, compared with five able-bodied runners as control subjects, and a threefold increase in energy return using blades versus the human ankle joint. The tests took place on November 12 and 13, 2007, at the German Sport University in Cologne, by a team of more than 10 scientists.

Pistorius, who has yet to meet Olympic qualifying times, had hoped the testing would prove he did not have an unfair advantage, so that he would have a chance to compete in Beijing. He plans to appeal the ruling.
Athletics South Africa has announced it is required to apply the IAAF ruling to athletics in that country, where Pistorius finished second last year in the 400 meters against able-bodied competition at the South African National Championships.

“That’s a huge blow,” said Peet Van Zyl, Pistorius’ manager. “At this stage it looks like he is out of any able-bodied event.”

Ossur, the manufacturer of the Cheetah leg, also contends that the prosthetic blades do not provide an advantage over the human leg.

For more information, visit www.washingtonpost.com or www.iaaf.org.

New Jersey Passes O&P Parity Law
Supporters of orthotic and prosthetic parity celebrated a victory in January. On the last day of its session, the New Jersey state legislature passed a bill mandating comprehensive coverage for orthotic and prosthetic care.

Senate Bill 502, sponsored by Sen. Nia Gill, requires health insurance plans to offer coverage for O&P care without caps or co-pays that restrict access to prescribed devices.

In 2004, Assemblymen Vincent Prieto, Brian P. Stack and Neil Cohen sponsored such a bill, but it never got off the ground. In 2006, it was reintroduced and had to go through several steps to reach its goal, culminating in its passage by the state Assembly and Senate at the end of 2007. New Jersey Gov. Jon Corzine signed the bill into law January 13, 2008.

The Amputee Coalition of America (ACA), which has worked hard lobbying for parity laws, hopes that New Jersey’s progress will help create momentum for ACA’s campaign for a national parity law as well as protections on the state level.

“For less than a couple dollars per year, amputees in New Jersey will get the care they need to get back to work and live independent, productive lives,” said Morgan Sheets, ACA’s national advocacy director.

Other states with parity laws include California, Colorado, New Hampshire, Maine, Massachusetts, Oregon and Rhode Island.

For more information, visit www.amputee-coalition.org.

Reinnervation Brings Back a Sense of Touch
According to the Guardian Unlimited, a side benefit of the targeted muscle reinnervation technique (see “Reaching Toward a Better Arm,” December 2007 O&P Almanac) is emerging as researchers discover that a sense of hot, cold or pressure on the skin over the reinnervated area is perceived by the patient as a sense of hot, cold or pressure in the amputated limb.

Claudia Mitchell, a patient at the Rehabilitation Institute of Chicago, which is working with the Defense Advanced Research Projects Agency (DARPA), found that before her TMR surgery, her “phantom hand” often felt cold. But four months after surgery, putting a hot water bottle on a patch of skin on her chest warmed the phantom limb. Mitchell can also feel a sense of touch in her amputated hand when she grasps an object with her prosthetic hand.

Along with Jesse Sullivan, another upper-limb amputee, Mitchell took part in tests where doctors mapped out spots on the patients’ chests where they should press to create a sense of touch in particular areas of the missing hand. Some points created pressure on the wrist, palm, or back of the missing hand, and other points created a tingling sensation over a larger area of the limb.

Paul Marasco, a sensory neurophysiologist at the clinic, says that “down the road one of the ideas is that we put multiple devices on the chest representing individual fingers—that’s where we’d like to end up.”

For more information, visit www.guardian.co.uk.

Dermal Thermometer Boon to Diabetics
Individuals with diabetes who monitor the temperature of the skin on the bottom of their feet may be able to prevent ulcers and therefore amputations, according to an article in Medical News Today.

Because so many diabetics suffer neuropathy (loss of sensation in their extremities), they often fail to notice anything is wrong with their feet until ulcers form. Once one does, treatment costs approximately $14,000 just in the first year.

The TempTouch™ thermometer measures the temperature on the skin.

Patients hold the thermometer to the bottom of their feet before they start their day. If the temperature is higher in one place than others, it could signify that an infection is brewing. Patients who notice these hot spots can then stay off their feet to prevent ulcers from forming.

Patients using the thermometers in a recent clinical trial were three times less likely to develop ulcers than those in a control group.

For more information, visit www.medicalnewstoday.com.

Emirati Student Invents Inexpensive Myoelectric Hand
A biomedical engineering student in the United Arab Emirates has developed an inexpensive prosthetic hand that uses the body’s own electricity, reports The Nation.

The Myoelectric Hand Prosthesis can be made for about $134. Comparable devices, available from Europe, cost about $8,168.

Abdul Hafidh Al Zubaidi, the inventor, said that he was inspired by friends who have lost limbs in auto accidents. He wants to mass-produce the devices and make them available to poor amputees.

The hand detects signals from remaining arm muscles to allow users to grip with the device. Using this myoelectricity removes the need for an external control or power source.

Al Zubaidi plans to continue his research to develop a hand that is sensitive to temperature.   
 
For more information, visit archive.gulfnews.com/nation.

Bone Marrow Cells Being Investigated as Therapy
Not all stem cells come from embryos. All of us carry them around with us in our bone marrow; they are used by the body to repair injuries. New research is being done into how to coax the stem cells into making these repairs when the breakdown of blood vessels makes it difficult for them to do so, according to the Post and Courier of Charleston, S.C.

Critical limb ischemia, a serious artery blockage related to such conditions as diabetes and smoking, is being treated by the experimental therapy at six medical centers around the country.

The trial procedure uses bone marrow extracted from a patient’s pelvis. The stem cells from the marrow are concentrated with a centrifuge and injected into a limb with poor circulation. Doctors hope that the concentrate will respond to the lack of oxygen and build new blood vessels.

Similar treatments have been used abroad for five years; almost 70 percent of those limbs have been saved.

For more information, visit www.charleston.net.

Small Plastic Beads Used to Heal Chronic Wounds
A study conducted in Tel Aviv could change the way wounds are healed worldwide. According to London’s Daily Mail, the therapy, called Polyheal, uses minute plastic beads to stimulate healing cells in chronic wounds, some as much as several years old.

The polystyrene beads, known as microspheres and too small to be seen with the naked eye, are combined with a water-based solution. An electric current is run through the solution, and then it is applied to the wound and wrapped with gauze.

The charged microspheres cause the body to release several different types of cells for healing wounds, including fibroblasts, which help create granulation tissue. This is the tissue that fills in a wound after the initial scabbing. The microspheres also make it easier for the wound to heal by providing additional surface area for the healing cells to attach to.

Ten patients participated in the study. All had chronic leg ulcers for three to four years. After eight weeks of the therapy, three patients’ ulcers healed entirely and six others saw their ulcers reduced by 30-50 percent. Eight reported a significant reduction in pain within a week of starting the therapy.

Israel’s Soroka University Medical Center will conduct a new study this year with 60 patients.

For more information, visit www.polyheal.co.il.

Nanotechnology May Create Sensitive Prosthetic Skin
The map of nerve endings researchers hope to achieve in TMR studies could ideally be matched with a new form of synthetic skin being worked on by NASA, the Oak Ridge National Laboratory (ORNL) in Tennessee, and the National Institute of Aerospace (NIA) in Hampton, Va., in association with DARPA. The agencies are conducting research into using carbon nanotubes combined with a certain polymer to make a skin for prosthetic hands which can sense heat, cold and pressure.

The material would have piezoelectric properties, causing it to generate electricity in response to pressure. It would use temperature sensors embedded under the polymer layer, with carbon nanotubes conducting heat from the polymer surface to the sensors. The challenge will be how to connect the signal from the synthetic skin to the reinnervated areas on the patient’s chest.

According to IEEE Spectrum Online, a technology Web site, the researchers aim to create a sample patch of the synthetic skin by the end of 2009.

For more information, visit www.spectrum.ieee.org.

Canadian Soldier Inspired by Success of U.S. Amputees
Master Cpl. Paul Franklin, a Canadian soldier, lost both legs in Afghanistan. He is able to walk with two canes, but has seen how much better amputee soldiers in the U.S. have fared. This inspired him to start a new physical therapy program at the University of Alberta’s Steadward Centre in Edmonton, according to The Canadian Press.

Franklin visited Walter Reed Army Medical Center and observed that the attitude toward rehabilitation there was completely different from what he had experienced. While soldiers recovering at Walter Reed meet with a physiotherapist on the first day of their treatment, amputees in Canada often do not begin physical therapy at all until their injuries are fully healed.

Franklin observed that when physical therapy was started early in the healing process, the patients regained their abilities more quickly and more completely. He developed the Freedom Through Sport program at the Steadward Centre for people with all types of disabilities.

The program focuses new attention on getting patients involved in physiotherapy early in the healing process. It also gives them the camaraderie of sports, as well as a forum for discussing what recovery techniques did or didn’t work.

For more information, visit www.cbc.ca.

Doctors Come Under Closer Scrutiny
The time is coming where you can look up ratings for doctors as you would for hotels or restaurants.

According to an article in Business Insurance, WellPoint, a health insurance company that owns New York’s Empire Blue Cross Blue Shield, is working with Zagat Survey to publish patients’ ratings of their doctors in the areas of trust, communication, availability and office environment, on a 30-point scale. Patient comments will also be included in the listings. The program will be available online to over a million WellPoint members by the end of March 2008, with the date to make it available to all 35 million members yet to be determined.

Physician ranking and assessment programs are being investigated by New York Attorney General Andrew Cuomo, who sent letters to Aetna, CIGNA, UnitedHealth Group Inc. and several other New York-based insurers on the subject.

CIGNA Healthcare worked with Cuomo to develop a model for physician ranking programs. CIGNA plans to expand the program beyond New York by late 2008 or early 2009. WellPoint and Aetna also plan to implement the standards on a nationwide basis, without a specific time frame. Aetna currently surveys patients about physicians in their networks, and posts the results online for members.

For more information, visit www.businessinsurance.com.

People in the News

David Butler received the Service to Other Users Award at the Prosthetic and Orthotic Awards held at Stoke-on-Trent, England in November, 2007. Butler lost both legs and a hand when he was 11, in an accident with an unexploded mortar shell. He holds a full international racing license, is the only disabled driver in the world to do so, and has worked for 30 years to increase the opportunities for disabled drivers to compete in motor sports. He is chairman of the British Motorsport Association for the Disabled and director of the charity Mobilise.

BOC has elected a new member to its Board of Directors, as well as confirming two candidates serving in one-year terms to full three-year appointments.

Newly elected is Jim Hewlett, BOCO, CFO, who has worked in the orthotics industry for 36 years. He also serves on BOC’s exam-item-writing committee and its orthotists’ Video Practical Exam (VPE) review panel.

Theresa McLeod, COF, CMF, was elected to a new full term. McLeod works at Sloan-Kettering Cancer Center in New York City, where she manages the Evelyn H. Lauder Breast Cancer ward.

Rick E. Sevier, C.Ped., BOC Pedorthist, also elected to a new full term,  is an instructor in the O&P program at Oklahoma State University (OSU) at Okmulgee and for CFS Allied Health Education, a distance learning program serving the health care community. He also works with patients on a pro bono basis through OSU’s O&P clinic.

Alexander Lyons, CPO, president of Lyons Prosthetics and Orthotics Inc., announced the second meeting of a roundtable of health professionals in Myrtle Beach, S.C. The purpose of this panel is to increase communication and build trust between various health professionals in the field, improving O&P patient care.

In Memoriam

Dr. Pramod Karan Sethi, inventor of the Jaipur foot, died January 6 in the city of Jaipur in northern India. Sethi, along with colleague Ram Chandra, developed the Jaipur Foot out of rubber, wood and aluminum in 1968. The low-cost prosthesis has been used extensively for land-mine survivors in places such as Afghanistan, Cambodia and Rwanda.

Sethi was born in 1927 in Benares (now Varanasi), India. He graduated from Sarojini Naidu Medical College in Agra in 1949 with his bachelor’s degrees in medicine and surgery, and received his master’s degree in surgery from the school in 1952. In 1958 he created the orthopedics department at Sawai Man Singh College and Hospital in Jaipur, where he began working on his invention.

Singh is survived by his wife of 56 years, Sulochana Patni Sethi, three daughters and a son.

Businesses in the News

Becker Orthopedic has made a donation of KAFO knee joints to Healing Hands for Haiti Foundation Prosthetics and Orthotics in Port au Prince, Haiti. Orthoses are in demand in Haiti and other developing countries, where the incidence of congenital deformities and trauma is higher than in the United States.

Ergoresearch Ltd., based in Montreal, has made a deal to buy Orthoconcept, an orthotic and prosthetic device firm based in Laval, Que. for $2.7 million. Ergoresearch manufactures and sells custom foot orthoses and durable medical equipment.

Pegasus Biologics has received CE mark certification (European Conformity mark, roughly equivalent to FDA approval) for the commercial sale of its Unite™ Biomatrix collagen wound dressing in the European Union. The company is based in Irvine, Calif.

Prince William Orthotics and Prosthetics LLC officially opened its doors on November 5, 2007. The patient care facility covers 2,700 square feet, has an on-site fabrication laboratory and state-of-the-art equipment. Albert J. Garney, CPO, is the sole practitioner.

Scotland-based Touch Bionics has announced its incorporation in the U.S. as Touch Bionics Inc. Operations in the U.S. are currently based in Boston.

The company also officially opened its development and manufacturing facility in Livingston, Scotland in January 2008. The new facility allows Touch Bionics to do its manufacturing in-house, giving the company greater ability to support increased demand for the i-LIMB Hand.

The University of New Mexico Carrie Tingley Hospital has received a three-year accreditation in orthotics and prosthetics from ABC. Carrie Tingley Hospital has been offering orthotic and prosthetic services in New Mexico since 1937 and in Albuquerque since 1981.