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The latest on rehabilitation for amputees

Posted on 24th May 2017

Technological advances in the field of rehabilitation are exciting, astonishing and incredible for amputees who have suffered life changing injuries. I was reminded of this when I attended the annual #Dorset Orthopaedic #TotalRehabilitation Conference at the Billesley Manor Hotel recently.

Targeted Muscle Reinervation

The conference opened with an informative discussion of Targeted Muscle Reinervation (TMR); how it works and the role it has to play in upper limb amputation rehabilitation.

Mr Norbert Kang FRCS, Consultant Plastic and Hand Surgeon explained that TMR is a surgical procedure used to improve the control of the upper limb prosthesis. Residual nerves from the amputated limb are transferred to reinnervate new muscle targets that have otherwise lost their function. These reinnervated muscles then serve as biological amplifiers of the amputated nerve motor signals, allowing for more intuitive control of advanced prosthetic arms.

This was demonstrated by Alex Paterson, also known as #Captain Armless. Alex’s life changed forever when at the age of 17 he lost control of his motorbike and flew headlong into a tree. It was the kind of accident that most people don’t survive but Alex did. He sadly lost his left arm but is living testament that there is life beyond limb loss.

Alex lived with intractable pain for 38 years but following pioneering TMR he reported that he is now pain free and has been able to throw away his painkillers. We saw Alex being connected to a computer using a contact array of pins, where new “innervated” muscles are being taught to communicate with the brain and prosthetics will be built that can sync with the newly activate muscle tissue. This will enable Alex to use his prosthesis in the same way an able bodied person uses their limbs.

Alex said “This pioneering treatment could be the chance I and other amputees have been waiting for to live fuller, happier lives”.

Implants

Mr Munjed Al Muderis, Consultant Orthopaedic Surgeon informed the audience of the story so far with Osseointegration which was initially discovered by Professor Branemark in 1952. Osseointegration is the process in which a titanium implant is surgically implanted into a bone which eliminates the need for traditional socket based prosthetics. Osseoperception occurs as the prosthetic is anchored directly into the bone which would transmit sensory signals, resulting in patients recovering a certain level of feeling. The adaptor is fixed to a control device and is connected to the exterior of the prosthetic limb. Putting on and taking off the limb can be done in less than 10 seconds. We were told osseointegration surgery aims to provide amputees with greater mobility, comfort and quality of life.

Stephen Cruse gave a highly motivational and inspiring talk of his journey following a devastating car crash that claimed both his lower legs during a working holiday in Australia. He had 10 operations and spent 7 weeks in hospital, where staff introduced him to other amputees. Stephen explained that after discussing his situation with other amputees instead of thinking “this is the end of my life” he thought “this is a whole new lifestyle and a whole new start”. Following successful osseointegration Stephen is able to walk, run, cycle, climb mountains and live a normal life.

Leg mobility system

We were then introduced to Matthew Hughs and Wolfgang Kierdorf who demonstrated wearing the revolutionising C- Brace, the world first in leg mobility system for people with #SpinalCordInjury.

The C- Brace, a custom electronic leg brace is a computer controlled knee ankle foot orthosis (KAFO) that provides an entirely new approach to walking for individuals who have lower-limb mobility issues due to partial paralysis, incomplete spinal cord injury, post-polio syndrome, quadriceps weakness and post stroke. It enables the user to walk with more ease and less concentration as well as helping natural movement to occur.

Wolfgang explained that with this revolutionary device he is now able to walk on all types of terrain without worrying about falling or stumbling. He can walk with more ease and less concentration

Bionic technologies

The conference illustrated cutting edge treatments and advances in bionic technology which are going a long way to bringing an end to physical disability.

There is news of the Bionic hand that “sees” objects and instantly decides what kind of grip is needed to pick them up. A prosthetic hand with a built in camera similar to Luke Skywalker’s bionic hand in the Star Wars films is being trialled in the NHS. Biomedical engineer Dr Kianoush Nazarpour was recently quoted as saying “using computer vision, we have developed a bionic hand…just like a real hand, the user can reach out and pick up a cup or a biscuit with nothing more than a glance in the right direction”.

These are truly amazing and exciting times for amputees giving hope with modern advances in surgery, rehabilitation, prosthetic design the amputation of a limb no longer has to be a barrier to total independence.

I will continue to closely monitor developments in bionic technology as I have a great interest in medical advancements that could help my clients who have undergone amputations to regain their independence and show them that there is #LifeBeyondLimbLoss.

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