IN THE NEWS
Task Force to Study Private-Sector Limb Loss Prevention over the past five years. The organization also has shown a reduction in the cost of pharmaceuticals by 48 percent, lab studies by 32 percent, and inpatient bed days by 44 percent. The potential for savings in the private healthcare system is significant. “We agree that the VA system offers much promise if translated to the private sector health-care system,” says Terrence Sheehan, MD, Amputee Coalition medical director and chief medical officer at Adventist Rehabilitation Hospital in Rockville, Maryland. “The next step is to create a demonstration project to test these limb-saving and costsaving measures. If we can save one person from having an amputation, that is a savings of $500,000—imagine the savings to our health-care system if we could achieve the approximately 50 percent reduction that the VA has realized.” The group ’s number one priority is to conduct a demonstration project in a civilian hospital, emulating the system of care in the VA. Task force members will collaborate on funding, resources, and research. A full white paper will be available this summer.
Researchers Aim To Improve Neural Control of Prostheses Researchers at Sandia National Laboratories are using off-the-shelf equipment to investigate methods to improve amputees’ control over prostheses with direct help from their own nervous systems. Organic materials chemist Shawn Dirk and robotics engineer Steve Buerger are leading the group in creating biocompatible interface scaffolds with the goal of improving prostheses with flexible nerve-to-nerve or nerve-to-muscle interfaces through which transected nerves can grow, putting small groups of nerve fibers in close contact to electrode sites connected to separate, implanted electronics. Sandia’s researchers have found that interfaces can monitor nerve signals or provide inputs that let amputees control prosthetic devices by direct neural signals, the same way they would control parts of their own bodies. The research focuses on biomaterials and peripheral nerves at the interface site. The idea is to match material properties to nerve fibers with flexible, conductive materials that are biocompatible, so they can integrate with nerve bundles. The researchers are looking at flexible conducting electrode materials using thin evaporated metal or patterned multiwalled carbon nanotubes. The work is in its early stages.
O&P Almanac APRIL 2012
Organic materials chemist Shawn Dirk focuses a projector during work on neural interfaces.
Robotics engineer Steve Buerger displays implantable and wearable neural interface electronics.
Photos: Sandia National Laboratories, Randy Montoya
Several U.S. health-care leaders met in February in Potomac, Maryland, at the Amputee Coalition Limb Loss Summit to review the Department of Veterans Affairs (VA) System of Care Preservation-Amputation Care and Treatment (PACT) program, which has shown compelling outcomes in limb loss prevention. The group, which included prosthetists, physicians, nurses, psychologists, and health-care policy leaders from the Centers for Disease Control and Prevention (CDC), the VA, the Agency for Healthcare Research and Quality, the National Institute on Disability and Rehabilitation Research, and civilian hospitals and health-care systems, examined elements of the VA program to develop a plan for limb loss prevention for the private sector health-care system. The VA’s initiative, which began in 1992, has demonstrated a dramatic reduction in rates of foot ulcers from diabetes and peripheral vascular disease, which are the leading causes of amputation. For example, the Veterans Affairs Medical Center in Nashville has demonstrated a 40 percent decrease in the number of lower-limb amputations
American Orthotic & Prosthetic Association (AOPA) - April 2012 Issue - O&P Almanac