Walter Reed Gait Lab to Expand
Walter Reed Army Medical Center’s gait laboratory in Washington, D.C. will soon be able to gather data on patients’ running gait, once it expands to a new space in the facility’s Amputee Care Center, which is currently under construction.

The current gait lab, which gathers data on the movement of veteran amputees, is about 20 feet long, 6 feet wide and 7 feet high. During tests, patients have several reflective markers attached to their bodies. Special cameras record a three-dimensional image of the patient’s motions while walking with a prosthesis. The cameras have light-emitting diodes (LEDs), which flash 20 times per second to record the angle and position of each joint. Two plates in the floor record the force with which the patient’s feet hit the ground.

The resulting data can be compared to the motion of a non-amputee or to the patient’s able-bodied side, and helps the patient’s recovery team determine if the patient needs a different prosthetic alignment, new type of equipment or alterations in physical therapy.

The new gait lab will be much larger and will be able to gather data on running with a prosthesis. It will also give patients the opportunity to practice with virtual-reality systems that approximate the experience of balancing in a boat or subway car. 

Not only does the lab data help individual patients, but it may assist manufacturers in developing improved prosthetic models. The lab’s physical therapist, Barri Schnall, states that Walter Reed’s patients express a desire to have one prosthesis they can use for both walking and running, without having to change one leg for another.

“When we give feedback to the prosthetic companies, they can use the data that we have … to help achieve the goal of providing a universal type of prosthesis,” Schnall says.

For more information, visit www.army.mil.

Blood Thinner Helps to Save Frostbitten Digits
Tissue plasminogen activator, or tPA, may be able to prevent frostbitten fingers and toes from being amputated, according to a study published in the June issue of the journal Archives of Surgery and reported on by the Los Angeles Times. 

Doctors at the University of Utah’s health center in Salt Lake City found that six patients who received the tPA drug kept 90 percent of their affected digits, while 12 patients treated before the center began using tPA retained only 59 percent of their frostbitten fingers and toes. 

Frostbite occurs when ice crystals form on body tissues, killing the tissue. When tissue dies, the affected areas must often be amputated.

There is a middle zone between the dead and the living tissue that may or may not survive. When that tissue thaws, slow blood flow in the damaged blood vessels can cause clots to form. If the clots are bad enough to block circulation, the tissue dies.

According to the study, tPA breaks down such clots and allows blood to flow to the intermediate zone.
“What it does is salvage stuff that’s in jeopardy,” said Dr. Amalia Cochran, one of the study’s authors. “It’s really an addition to what we currently do for frostbite.”

tPA must be used within 24 hours of initial frostbite to be effective, and it cannot be used for trauma patients or those with blood-clotting disorders.

The health center would like to see more centers do similar studies, to give weight to their conclusions about the usefulness of early treatment with tPA.

New Device for Clubfoot
A doctor at Washington University’s School of Medicine in St. Louis has designed a new brace used to correct clubfoot, a birth defect in which the foot is turned in toward the body. While other treatments do exist, parents were shown to comply better with this brace and use it for the prescribed time.

Traditional treatment for clubfoot is known as the Ponseti method. It involves weekly casting and manipulation of the clubfoot soon after birth. Patients must also wear a nighttime brace with a fixed metal bar that can lead to skin blistering and restriction of leg movement. Consequently, parents are known to not put the brace on their child for the full prescribed period.

Matthew B. Dobbs, MD, designed the “Dobbs brace,” which has shown better compliance and fewer complications than the traditional brace used to treat the condition, according to a study published in the Journal of Pediatric Orthopaedics.

Dobbs and his team tested the brace on 28 patients who had already received non-surgical treatment for their clubfeet. After following up, they found the brace was at least as effective as the Ponseti method and resulted in better compliance by parents.

For more information, visit mednews.wustl.edu.

La Trobe University Revises O&P Curriculum
La Trobe University in Melbourne, Australia is revising its O&P curriculum to include mandatory health classes and bachelor’s and master’s degree programs. The university’s Faculty of Health Sciences (FHS) initiated the change.

Under the new program, students will be able to obtain a bachelor’s degree after three years of full-time study, and a master’s degree after four years of full-time study. There are also plans for a two-year graduate track to allow students who have already completed a bachelor’s degree to obtain a master’s in O&P.

The FHS will implement the new curriculum in 2009. Final planning of changes to the new O&P program is to be completed by the end of this year.

Handy Zipper Makes Life Easier for Amputee
A 62-year-old former Marine who lost his leg due to vascular disease has designed “zipper-leg trousers” to help amputees remove their prosthetic limbs without having to completely remove their clothing, as reported by the Army Times.

Charles Collins designed the pants with a zipper on the inseam. In addition to making it easier to take his prosthetic leg on and off, Collins said it has made it easier to drive.

“I couldn’t even drive because my leg was crammed. This puts pressure on the stump,” he was quoted as saying.

Collins uses a tailor to add special one-way zippers in colors designed to match the pants.

The design has not been mass-produced, but Collins has a book of plans he hopes to one day give to a manufacturing company so that zipper-leg trousers can be available to all amputees.

For more information, visit www.armytimes.com.

IAAF Follows Pistorius’ Efforts
Oscar Pistorius, the bilateral amputee sprinter featured in last month’s “Five Questions For” feature, will now be permitted to run against able-bodied athletes in international competition. The International Association of Athletics Federations (IAAF) will keep an eye on his races while researchers assess whether his carbon-fiber racing legs give him an advantage over able-bodied athletes.

Pistorius, the world-record holder for disabled sprint times, hopes to make it to the Beijing Olympics. According to the British newspaper Daily Mail, his best 400 meter time is 46.65 seconds, slower than the 46.3 needed to qualify and three seconds behind the Olympic record set by Jeremy Wariner. Pistorius will be trying, between now and July 2008, to meet the Olympic qualifying standard and become the first amputee in the Games.

The IAAF has not yet reversed its position on the Olympics for Pistorius. They expect to make a decision after more information- gathering and after viewing Pistorius in competition.

In July, Pistorius’ debut competition against elite able-bodied athletes was soured when he placed last in the 400 meter race under heavy rain and then was disqualified for running out of his lane. His time at that race was 47.65 seconds.

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

Robotic Device Helps Stroke Patients
A new robotic device called the Myomo e100 NeuroRobotic System is helping stroke patients and others with partially paralyzed limbs regain movement in their arms. Worn as an arm brace, it works by sensing weak electrical activity in patients’ arm muscles and providing just enough assistance so they can complete simple exercises, according to a recent article in the New York Times.

“[The device] is designed to improve and facilitate movement through a feedback-based, closed-loop system that both amplifies and rewards a patient with motion,” according to a statement released by the company. 

Graduate students at MIT began developing the technology in 2002. They conducted a small study of the device with Spaulding Rehabilitation Hospital in Massachusetts, the results of which are published in the April issue of The American Journal of Physical Medicine and Rehabilitation.

During the trials, patients had electrodes that sensed electrical activity placed on their biceps and triceps. When a patient attempted to extend his or her arm, the robotic brace would go into action and stretch the arm.

The device has been approved by the Food and Drug Administration and is expected to reach the market shortly.

For more information, visit www.myomo.com.

Cyclist Completes U.S. Portion of Trek
Dan Sheret, the amputee who is currently cycling around the world to raise awareness of amputee and land mine issues, will soon finish his trek across the United States and begin the international portion of his athletic journey.

Since June 1, Sheret has cycled from Washington, D.C. to the ACA annual convention in Atlanta, Ga., and across Georgia, Tennessee and Kentucky. At press time, he was cycling across Kansas, and he plans to finish up in San Francisco, Calif.

Sheret’s “AbilityTrek 2007” will raise funds for Clear Path International, which aids land mine and bomb survivors, and for the Basra, Iraq Prosthetics Project, which works for civilian land mine amputees in Iraq.

For more information and to view Sheret’s itinerary, visit www.abilitytrek.org.

People in the News

Wendy Beattie, CPO, FAAOP, is the new president of the American Academy of Orthotists & Prosthetists for the 2007–2008 membership year. Beattie is director of clinical education for Becker Orthopedic in Waterford, Mich. and is the director of the company’s residency program.

Bruce McClellan, CPO, LPO, FISPO, is a new at-large board member of the American Academy of Orthotists & Prosthetists. McClellan is the president and owner of Prosthetic-Orthotic Associates of Texas.

Nicole Parent-Weiss, CO, OTR, FAAOP, is a new at-large board member of the American Academy of Orthotists & Prosthetists. Parent-Weiss is an Acute Care team leader at the University of Michigan Orthotics & Prosthetics Center in Ann Arbor, Mich.

Steven Rybicki has joined AOPA and is working on special projects for marketing, membership and meetings.

Gregory M. Safko is the new president of the Board for Orthotist/Prosthetist Certification (BOC) and is overseeing the organization’s five certification programs and its facility accreditation program. Previously, Safko served as deputy secretary of Maryland’s Department of Labor, Licensing and Regulation. Safko succeeds Dr. Donald O. Fedder, who served as BOC’s executive director for nearly 20 years before retiring last July.

Michelle Poeppelmann, CO; Michelle Curran, C.Ped; and Eric Watt have joined OrPro and are working at the company’s Dayton and Springfield, Ohio offices.

George Reed is a new customer service representative for PEL Supply, based in Cleveland. Reed joined PEL in 2003 as a warehouse employee.

Correction: in our July 2007 issue, we incorrectly listed the address and degree for Glenn Wilson, the new manager and practitioner at Hanger Prosthetics and Orthotics in Great Falls, Mont. Wilson earned his associate’s degree in prosthetics from the British Columbia Institute of Technology.

Businesses in the News

The American Academy of Orthotists and Prosthetists, through a grant from the Department of Education, has produced a career video for prospective orthotists and prosthetists. The video is available on YouTube at www.youtube.com/watch?v=cbM9pPuht34.

American Prosthetic Components Inc. in Green Bay, Wis. will receive $250,000 in Technology Zone tax credits from the state. The credits will help the company create 51 new jobs and expand its facility.

The Denny’s restaurant chain has contributed $15,000 to the Amputee Coalition of America Youth Camp. The annual Youth Camp in Warm Springs, Ga. involves young amputees in fitness activities, team-building and opportunities to work with mentors. Other sponsors include Otto Bock HealthCare, Ohio Willow Wood and the Orthotics and Prosthetics Assistance Fund (OPAF).

Hanger Orthopedic Group Inc. of Bethesda, Md. has acquired the assets of Paris O&P, a multi-site provider of orthotic and prosthetic services with locations in Paris, Greenville, and Sulphur Springs, Texas, and Hugo, Okla.

Prosthetic Laboratories has opened its tenth location in Sioux Falls, S.D. The company is based in Rochester, Minn.

Sound Limbs Orthotics and Prosthetics of Lewiston, Maine and Tallahassee Orthopedic Clinic’s division of orthotics and prosthetics were recently accredited by ABC. Both were recognized for achievement in the areas of organizational management, professional staffing qualifications and responsibilities, patient care management, quality assurance and facility and safety management, according to ABC.
   
SPS, a subsidiary of Hanger Orthopedic Group Inc., has acquired SureFit LLC, which makes therapeutic footwear for diabetic patients. SureFit is based in Coral Springs, Fla.

In Memoriam

Gene C. Jones, former president of AOPA from 1983–1984, passed away July 18 in the Walnut Creek/Concord, Calif. area. Jones was CFO of Hittenberger Corp. and was instrumental in establishing the California O&P Association (COPA). Jones served as COPA’s Legislative Committee chairman for over 20 years.

Lawrence R. Lange, CPO, FAAOP, passed away on July 15. Lange was a dedicated volunteer for the ABC certification and accreditation programs for many years. He served the examination programs as a committee member, item writer, examiner, and exam chairman. He also served as a facility surveyor for the facility accreditation program. Lange published on the topic of partial foot prosthetics and was a resource to the prosthetics profession at large in the design of the cosmetic partial foot system. Lange was also the editor of the Journal of the American Orthotic & Prosthetic Association from 1984 to 1986.

He is survived by his wife Judianne and two children.

Walter H. Mahnke, CPO, passed away on June 30, shortly before his 91st birthday. Mahnke became certified in O&P in 1951 after working in his father’s O&P facility in Duluth, Minn. In 1975, he founded Mahnke’s Orthotics-Prosthetics in Ft. Lauderdale, Fla. and went on to own and operate two additional branches with his partner James Newberry in the Fort Lauderdale area until his retirement in 1988.

He is survived by his children Marilyn, Jerald, Robert, Bonnie, Barbara and George, along with 11 grandchildren and 16 great-grandchildren. His wife of nearly 40 years, Violet, died in January.