Touch Bionics Debuts i-LIMB Hand
A state-of-the-art myoelectric hand was unveiled at the ISPO Congress in Vancouver, Canada, by Touch Bionics. The i-LIMB Hand is the first prosthetic hand with five individually powered fingers, and the related product ProDigits is the first bionic partial hand prosthesis. 

The prosthetic hand uses myoelectrics, which means it utilizes electrical signals from muscles in the patient’s residual limb to open and close its fingers. Patients report that the grip is more natural and easy to control than on previous myoelectric models.

“With my other myoelectric hand, I would really have to concentrate on how much pressure I was putting on [a Styrofoam] cup. The i-LIMB hand does things naturally. I can just grab the cup like a regular person,” says Sgt. Juan Arrendo, a Texas patient who was fitted with the new technology.

Touch Bionics has been working with U.S. clinical partners, including Advanced Arm Dynamics, Benchmark Orthotics and Prosthetics, Hanger Prosthetics and Orthotics, LIVINGSKIN and Scott Sabolich Prosthetics and Research, to fit patients with its new devices, which are now widely available for sale.

Touch Bionics is also working with ARTech Laboratories and LIVINGSKIN to create a life-like cosmetic covering for the hand for patients who desire it, as an alternative to the present semi-transparent covering, called i-LIMB Skin.

“We have always existed to change the lives of patients with severe injuries and disabilities, and it is thrilling to feel that we are now able to accomplish that goal,” says Touch Bionics CEO Stuart Mead.

For more information, visit www.touchbionics.com.

Blood Test Predicts Amputation Results
A new test for the percentage of hemoglobin A1c (HbA1c) in the blood can predict whether a partial foot amputation will succeed in diabetics with foot ulcers, or whether a more disabling below-knee amputation will be required, according to a study presented in July at the American Orthopaedic Foot and Ankle Society’s annual meeting in Seattle. 

Diabetics know that good blood-sugar levels can reduce the risk of amputations, and the HbA1c test provides better information on their blood-sugar control. Unlike fingerstick tests that diabetics perform daily to monitor specific blood-sugar value at a certain time, the HbA1c test provides a more long-term assessment of how well sugar levels have been controlled over several months. An HbA1c value between 3 and 6 percent is considered normal. 

Researchers at St. Paul’s Hospital in Vancouver compared data from 21 patients with a failed partial foot amputation and 21 similar subjects with a successful amputation. A variety of factors were evaluated, including age, sex, smoking habits, pulse in the foot and Hb1Ac levels. The only factor that predicted whether the amputation would fail or succeed was the HbA1c value. 

For more information, visit www.paktribune.com.

2007 OPC Report Now Available
The results are in from the 2007 OPC Report! This year, 204 companies reported their financial information for this special comparative survey of O&P industry performance, up from 164 companies the last time AOPA did the survey in 2005.

Businesses who participated in the survey will receive their free individualized report in the mail shortly, comparing their facility with companies in the same region and nationwide. Others can purchase the report online at www.aopanet.org.

Some points that emerged from this year’s preliminary data include:

• Businesses experienced an average 5.4% sales growth in 2006.
• On average, profit leaders employed four fewer people than the 17.4 average reported by all respondents.
• The percentage of disallowed sales and contractual adjustments was 14.7% on average for all respondents, but only 1.5% for the profit leaders.
• Return on net worth was 120.1% for profit leaders, compared to 37.2% for all respondents.

For more information on the OPC Report, visit www.aopanet.org.

Demand for Prostheses Growing in Iraq
The number of amputees in Iraq is rapidly growing, according to a recent article in the Guardian Unlimited. The Red Crescent Society and the director general for health services in Mosul estimate that the current requirement for prosthetic limbs is up to 3000 a year.

The nature of the war in Iraq means that injuries from car bombs and suicide bomber explosions are rampant, in addition to collateral injuries from U.S. airstrikes. These injuries result in a high percentage of amputations. 

Although the article did not cite exact statistics on the number of Iraqi amputations, it did say that 6 percent of U.S. soldiers wounded in Iraq require an amputation, as opposed to the 3 percent typical in past conflicts. 

“[Below-knee amputations are] probably the number-one operation performed,” says Lt. Col. Wayne Mosley, an orthopedic surgeon at the military hospital in Mosul that treats U.S. soldiers, Iraqi civilians and Iraqi security forces. 

Prostheses available in the region for injured Iraqis are mostly outdated models based on 1970s designs. The Marla Fund, a charity named for the memory of U.S. aid worker Marla Ruzicka, is proposing funding to build a $500,000 factory in Mosul to meet the demand for modern prostheses. 

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

A More Dexterous Hand—Even a Monkey Can Do It
Scientists at Johns Hopkins University in Baltimore have been able to demonstrate that neural activity recorded from a monkey’s brain can be interpreted by a robotic hand. According to a recent article in MIT’s Technology Review, this increased the hand’s dexterity to the point where it could play several notes on a piano. 

“If you can tap into the brain, you can record from the brain itself the intent of hand and finger movement,” said Nitish Thakor, a neuroengineer at Johns Hopkins who is working on the project.

To develop a neural interface, researchers recorded brain-cell activity from monkeys as they moved their fingers in different ways. They then created algorithms to decode these brain signals by identifying the specific activity patterns linked to particular movements. When the decoding system was connected to a robotic hand and fed these new neural-activity patterns, the fingers on the hand performed the intended movement 95 percent of the time, according to the researchers. 

These initial tests were performed “off-line,” meaning that brain activity was recorded and then fed into the system at a later time, but a live demonstration in which monkeys are implanted with recording electrodes that are hooked up directly to a virtual prosthetic arm are currently in development. Scientists will then be able to determine how well these monkeys can use their brain activity to control the virtual hand in real time. 

While most prosthetic hands are limited to a clawlike grasping motion, scientists hope this more-sophisticated hand would be capable of finer levels of control. While they are excited by the preliminary results, they still have a long way to go before they can mimic the true dexterity of the hand.

For more information, visit www.technologyreview.com.

Mummy’s Prosthetic Toe Might Be First
A mummy found seven years ago in a tomb in Egypt was recently announced to have an artificial toe, which may be the first known functional prosthesis, according to the Web site LiveScience.com. 

The prosthetic toe is on display at “Hidden Treasures of the Egyptian Museum,” a new exhibit at the Cairo museum, where many artifacts previously in storage are being shown for the first time. 

The toe was made of wood and leather, between 1069 and 664 B.C. The mummy, a 50- to 60-year-old woman, may have lost her big toe due to complications from diabetes, archaeologists suggested.

This prosthesis predates the bronze Roman Capua Leg, formerly known as the first functioning prosthesis. The leg dated from about 300 B.C. and used to be kept in the Royal College of Surgeons, where it was destroyed by the bombing of London during World War II.

Another mummy toe was discovered in the nineteenth century—it was named the Greville Chester Great Toe, after the man who acquired it for the British Museum—but that toe was likely cosmetic rather than functional, since it had no joints. The Cairo toe is jointed in three places and is much sturdier than the linen-and-plaster Chester toe.

Researchers are signing up volunteers who are missing their big toe to try out replicas of the mummy toe and see how well it might have worked in ancient Egypt, and to determine whether it might provide useful concepts for today.

For more information, visit www.livescience.com.

Brain Chip Could Control Prosthetic Limbs
A chip may one day be implanted into the brain that could give people the ability to control prosthetic limbs, stop epileptic seizures and even treat diseases, according to researchers at the University of Florida’s Neuroprosthetics Research Group. 

“It’s becoming a reality,” said Justin Sanchez, director of the program. “We’re designing electronics that we can interface with biological systems and we can use that to help people.”

This “neuroprosthetic” chip is being developed thanks to a $2.5 million grant from the National Institutes of Health. It would be implanted directly into a patient’s brain tissue, where it could gather data from brainwaves, decode them and stimulate other parts of the brain, according to the researchers. Researchers have been able to decode brain activity for years using electroencephalography (EEG), which involves placing a sensor-wired net over the head to measure brain activity through the scalp. 

Similar devices are currently being studied in rats, while people are getting an intermediary form of the technology with tests being conducted on electrodes placed on the surface of their brain. 

The research group hopes to have a prototype ready that could be tested on people within four years. 

For more information, visit www.uf.edu.

ACA Holds Youth Camp
In July, the Amputee Coalition of America (ACA) held its annual summer youth camp in Warm Springs, Ga. for young people between the ages of 10 and 16 who are living with limb difference or limb loss. 

Activities such as canoeing, swimming, basketball, wheelchair rugby, golf and tennis were offered during the five-day camp. Campers also got to participate in physical and team-building exercises, while getting the opportunity to speak with peer and adult amputee mentors. 

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

Oscar Pistorius to Undergo Biometric Analysis
Bilateral amputee sprinter Oscar Pistorius plans to work with the German Sport University in Cologne to do a full biometrical analysis of his movement using carbon-fiber running blades, reports the Sports Illustrated Web site.

Pistorius has encountered resistance from the International Association of Athletics Federations (IAAF) in his quest to become the first amputee in the Olympics. The IAAF is concerned that his prosthetic running legs may provide an unfair advantage in racing.

As a first step in its data-gathering, the IAAF made a video of Pistorius’s race on July 13 against able-bodied athletes. 

Pistorius will work with Prof. Peter Bruggemann for several days in October, and the subsequent data analysis will take about three weeks.

“By aligning experts from prosthetics and biomechanics, I believe we will be able to put this issue to rest one way or the other,” says Pistorius.

For more information, visit sportsillustrated.cnn.com.

LCodeSearch.com Launched at Convention
Those confused by coding now have some valuable help. AOPA debuted its new coding resource, LCodeSearch.com, at its National Assembly in Las Vegas. 

This online resource was designed so that O&P practitioners can easily match the products they need for a particular patient’s treatment with a list of corresponding L codes, and manufacturers can make sure their products are seen by the people who need them. Visitors to the Web site can search by L code, manufacturer name, part of anatomy, or product brand name.

In order to give the best coding advice, L code recommendations entered by companies will be reviewed by the AOPA Coding and Reimbursement Committee prior to publication. SADMERC coding decisions have authority over the AOPA Committee as well as the manufacturer, if they should disagree. 

Product entry will also be limited to AOPA supplier members in the initial stages, while the ability to search the Web site LCodeSearch.com will only be available to AOPA members.

To check out this new research, visit LCodeSearch.com.

People in the News

Paddy Rossbach, president and CEO of the Amputee Coalition of America (ACA) since 2002, will retire early next year. During her tenure, Rossbach helped implement the Action Plan for People with Limb Loss, a national campaign that has resulted in seven states passing legislation requiring health insurers to provide adequate prosthetic coverage; 28 additional states have legislation in the works, according to the ACA.

Michael Chapman has joined AOPA and is working on special projects in the membership and marketing departments. He holds a bachelor’s degree in political science and has interned on Capitol Hill for the past four summers.

Erin Kennedy has joined AOPA and is working on special projects in the meetings and conventions department.

AOPA announced several annual awards at the 2007 AOPA National Assembly:

Charles Dankmeyer, CPO, received the 2007 Lifetime Achievement Award, given to an individual who has made significant contributions to the field of orthotics and prosthetics.

Liz Hillen, Lynn A. DeCola and Jayne C. Drummey were the recipients of the 2007 Dan McKeever Scholarships, which provide grants to individuals who are pursuing an education in orthotics and prosthetics.

Michael E. Hamontree was awarded the Ralph R. “Ronney” Snell, CPO, FAAOP, Legislative Advocacy Award, which recognizes an individual who has made a valuable contribution toward advancing the legislative and regulatory goals of O&P by motivating Congress and other decision makers to take action on behalf of O&P.

AOPA also featured two of the Thranhardt Lecture winners during its National Assembly.

Robert Gailey, PT, presented a lecture on “Power Knee Gait Training: Learning to Employ Artificial Intelligence.”

Ian Engelman, CPO, presented a lecture on “AFO Biomechanics—Drop and Slap Foot.”

Launched by a gift from J.E. Hanger, the prestigious Thranhardt Lectures consist of the top two clinical abstracts chosen from an open application pool by the clinical sessions work group to present at this year’s Assembly. Each winner received a $500 honorarium.

Rick Sevier, ROPA, C.Ped., L.Ped., and Theresa McLeod, CMF, COF, have been appointed to the board of directors of the Board for Orthotist/Prosthetist Certification (BOC) and are serving one-year terms.

Ryan Dougherty has joined Coastal Prosthetics & Orthotics of Norfolk, Va. as a resident prosthetist.

Jennifer Fayter joins Comfort Products of Croydon, Penn. as the new company sales manager. In the past, Fayter has worked for O&P Business News and the Orthotic & Prosthetic Assistance Fund (OPAF), where she currently serves on the advisory board. One of her projects at Comfort Products will be to work with Bauerfeind to bring their modular components to the United States.

Kara Davis has received the Outstanding O&P Student Award from Eastern Michigan University (EMU). Davis earned her bachelor’s degree at the University of Michigan before enrolling in O&P graduate program at EMU.

Troy Davis, CO, of Fillauer LLC, celebrates 50 years of service with the company. Davis joined Fillauer in 1957 and received his certification in 1972. Davis has served in a variety of roles including shop superintendent, custom orthotic fabrication supervisor, and senior clinical practitioner.

Kathleen P. Bloch is the new vice president and chief financial officer of Langer Inc., the Deer Park, N.Y.-based provider of medical products targeting the long-term care, orthopedic, orthotic and prosthetic markets.

Mike Vaughn is the new product manager at the headquarters of PEL Supply in Cleveland, Ohio. He will be responsible for evaluation of new and existing products, as well as suppliers and acquisition pricing. Vaughn has been with PEL since 2000.

Amanda Vidovic has been promoted to marketing associate for PEL Supply, based in Cleveland. Since joining PEL in 2004, Vidovic has worked in accounts payable and customer service.

Dennis K. Williams, CP, of Allied Orthotics & Prosthetics of Mt. Laurel, N.J. and member of OPAF’s board, recently led Team Allied to the Extremity Games in Orlando, Fl. for the second year in a row.

Max Cleland will serve as a senior policy adviser to Tissue Regeneration Technologies LLC, a medical technology company based in Woodstock, Ga. Cleland, a triple amputee from his service in Vietnam, served as a Democratic senator from Georgia from 1996 to 2002. Cleland will be based in Atlanta.

Businesses in the News

Acor Orthopaedic has consolidated their warehouse and shipping departments back to their corporate headquarters in Cleveland, Ohio. The new warehouse became fully operational in July.

Bridgepoint Medical LLC of Lexington, Ky. has acquired Reynolds Prosthetics & Orthotics Inc. (RPO), and retained John Reynolds, CPO, as owner-operator. The two RPO locations in Maryville and Oak Ridge, Tenn. will retain their current name. Bridgepoint Medical now operates a total of four locations in Kentucky and Tennessee.

Eastern Michigan University has received full accreditation from the Commission on Accreditation of Allied Health Education Programs (CAAHEP) for its post-graduate programs in orthotics and prosthetics. EMU plans to increase enrollment, and expanded to 18 the number of openings for its next class, beginning in September 2007.

Ohio Willow Wood, located in Mt. Sterling, Ohio, is expanding their relationship with Cascade Orthopedic Supply to include central fabrication services. Cascade will become the new west coast central fabrication source for users of Ohio Willow Wood’s OMEGA® Tracer® System.

OPP of Arkansas held their fifth annual educational fair at the Peabody Hotel in Little Rock, Ark. July 6-7. This year, 120 practitioners and technicians attended.

PrimeCare O&P Network held their ninth annual PrimeFare East symposium June 29-30 in Nashville, Tenn. Attendance totaled 150 practitioners, technicians, and administrative personnel.

ReAble Therapeutics Inc., an Austin-based medical device maker, acquired DJO Inc., a Vista, California-based orthopedic sports medicine company, for $1.18 billion. The deal is expected to close in the fourth quarter of 2007.