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April 2005

New Robot Technology Indicates Bright Future for Prosthetics
At the recent annual meeting of the American Association for the Advancement of Science (AAAS), three independent research teams unveiled novel, low-energy, bipedal robot models, which displayed human-like gait when walking. The latest advancements in the development of these robots may offer promise for amputees hoping to one day use prosthetics that feel more like a natural limb.

“These innovations are a platform upon which others will build,” said Michael Foster, computer and information science and engineering expert at the National Science Foundation (NSF), and one of the managers who oversaw this research. “This is the foundation for what we may see in robotic control in the future.”

Left to right, Delta, MIT, and Cornell walking robots.

The three research teams involved engineers from Cornell University, Ithaca, NY; the Massachusetts Institute of Technology (MIT), Boston; and Delft University of Technology in the Netherlands. The robots were built according to the concepts of passive-dynamics, a theory that presupposes that the motion of human walking may just be the result of people letting their legs swing as they would on their own, with only a little control and power, resulting in a gait with low control and energy demands. Traditionally, mainstream robots have every movement controlled and powered. The robots revealed at this year’s AAAS meeting are not powered, but offer more options for human-like movement.

“Our goal with this project was to learn more about the coordination of human walking by trying to duplicate it. In doing so with simple models and robots, we have learned some fundamental principles about the energetics and control of walking,” says Steven H. Collins, co-author of the study who worked on the Cornell robot.

The Cornell robot can walk on level ground with the use of as little as one half the power of a standard compact fluorescent bulb. It also incorporates a small amount of motorized propulsion at the ankle, allowing it to push off its back foot. The Delft robot uses a pneumatic push at the hip, and the MIT robot uses electric motors that directly move the ankle. The MIT robot, which has been dubbed “Toddler,” also incorporates a small computer, which enables it to “learn” to walk. All three robots have arms synchronized to swing with the opposite leg for balance.

Though the robot project was done mainly to study the biomechanics and control of human locomotion, its applications could be pertinent in other fields. Collins, for example, is applying the concept learned through creating passive-dynamic walkers to the design of a powered prosthetic foot for amputees. “We hope that the technology will be useful in designing prosthetic devices that make walking more efficient and easier to control for amputees,” says Collins. “In my current work, I am focusing on designing prosthetic feet that reduce energy use based on our new understanding.”

So what’s next for these robot models? Are they ready to be used for prosthetics modeling? According to Collins, some of the technology is already being used for prosthetics, but there is still much to be done.

“As other fields advance, such as neural prosthetics and the like, we should be able to incorporate these technologies with the more mechanics-based technology that we are developing into increasingly functional and human-like prosthetic devices.”

New Stem Cell Engineering Technique Holds Promise for Rehab

Mi-Roung Song, PhD

The progress in stem cell research during the last several years has taken genetic engineering technology off the pages of science fiction and thrust it into reality. The implications of this research for spinal rehabilitation, in particular, could be nothing short of miraculous. That is, if the research Mi-Roung Song, PhD, a research associate in the Gene Expression Laboratory at the Salk Institute for Biological Studies, San Diego, continues its promising results.

Song’s research has focused on guiding adult stem cells to generate neurons within the spinal cord, a technique that is different from the now-traditional stem cell research, in which neurons are generated in a culture dish. Results from animal studies are promising, and if successful, Song’s research could achieve the same results with humans.

Her efforts were recently recognized by the Paralyzed Veterans of America, who awarded Song the 2005 Fritz Krauth Memorial Scholarship for her research in the field of neuroscience. In addition to healing spinal cord injuries, the research could benefit those with other paralyzing ailments such as muscular dystrophy and amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease.

Though the research process has a long and arduous path to go, Song is confident, finding solace in the stem cells themselves. “I have to confess that it is still fascinating to look at stem cells under the microscope. They are beautiful and amazing cells with remarkable potential,” says Song. “Going through this process of trial and error is sometimes frustrating and painful but it is worthwhile because the moment of discovery is so rewarding and priceless. I believe that if we understand how our body is built in nature, we will be able to use our knowledge to benefit humanity.” —Nicolle Harrity

New Recommendations for Medicaid Crisis
Former US Senator Bob Kerrey and former US House Speaker Newt Gingrich, co-chairs of the National Commission for Quality Long-term Care (NCQLTC), announced that the Commission will recommend national goals for improving the quality of long-term care to the National Governors Association. The Commission recognizes that Medicaid is the principal funding source for long-term care in the United States and that Medicaid reform is one of the most urgent issues facing today’s governors. The Commission is seeking to partner with the National Governors Association, the Administration, and Congress to champion reforms that identify workable solutions to both the Medicaid crisis and the growing long-term care crisis. The Commission believes that Medicaid reform should: include incentives to stimulate voluntary initiatives to drive continuous quality improvement, provider accountability, and reduced costs; foster training, recruitment, and retention of long-term care workers; bolster efforts to develop appropriate home- and community-based care options; and encourage programs to support informal caregivers, who provide long-term care.

The NCQLTC was established in October 2004 by the National Quality Forum (NQF). The Commission is charged with evaluating the current quality of long-term care, identifying factors that influence the ability to improve quality of care, and tracking improvement in the years ahead. Initial funding for the Commission is provided by the Alliance for Quality Nursing Home Care, the American Association of Homes and Services for the Aging, and the American Health Care Association.

The mission of the NQF is to improve American health care through endorsement of consensus-based national standards for measurement and public reporting of health care performance data that provide meaningful information about whether care is safe, timely, beneficial, patient-centered, equitable, and efficient. Established as a unique public-private partnership, the NQF has broad participation from all sectors of the health care industry.

APTA Promotes Exercise for Disease Prevention
Women who participate in regular moderate-intensity physical activity are building a defense against heart disease, the number one killer of American women, says the American Physical Therapy Association (APTA).

APTA supports the US Surgeon General’s recommendation that moderate-intensity physical activity done five or more times a week has significant health benefits, including reducing risk for coronary heart disease, as well as relieving pain from some forms of arthritis.

“Prevention and risk factor modification, and overall wellness, must become a first line of defense against heart disease,” said Dianne V. Jewell, PT, PhD, APTA cardiovascular and pulmonary section president. “As experts in prevention and rehabilitation, physical therapists can educate patients about healthy lifestyles and develop and implement safe and effective exercise programs that are uniquely appropriate for each individual.”

INDUSTRY NEWS

Sitrin Medical Rehabilitation Center
The wheelchair curling team of Sitrin, New Hartford, NY, part of the RecNet Adaptive Sports and Recreation Program, won the 2004 National Wheelchair Curling Championship, against a team from Belfast, Me.

Team Maine won the first game with the score of 7-5. Sitrin’s Team New York won the second and third games with scores of 8-6 and 5-4, respectively. As a result of winning the national title, the Sitrin team represented the United States at the 2005 World Wheelchair Curling Championship in Braehead, Glasgow, Scotland.

Sitrin began its wheelchair curling program in 2002, after a call from Utica Curling Club member and longtime curler Bill Rotton to occupational therapist and RecNet coordinator Marc DePerno. Rotton, along with a group of Sitrin staff and curlers, have coached the team since. Last year, team member Mark Taylor was chosen to join the American team at the 2004 World Wheelchair Curling Championship in Sursee, Switzerland, where Taylor helped the team secure a fifth place finish out of 14 teams.

Members of Sitrin’s wheelchair curling team include Mark Taylor as skip, Jim Pierce as vice-skip, Jim Joseph as second, Melissa Keiser as lead, and Bob Prenoveau as alternate. Wheelchair curling will make its debut as a medal sport at the 2006 Paralympic Games in Torino, Italy.

Gillette Children’s Specialty Healthcare
The Commission on Accreditation of Rehabilitation Facilities (CARF) has awarded a 3-year accreditation to Gillette Children’s Specialty Healthcare, St Paul, Minn, for its pediatric family-centered rehabilitation program. This is the fifth consecutive CARF accreditation award for Gillette’s program. To achieve accreditation, a rehabilitation program must conform to a core set of program standards. A pediatric family-centered rehabilitation program must meet more than 40 additional standards, focusing on the role and involvement of families in rehabilitation.

Weisman Children’s Rehabilitation Hospital
Weisman Children’s Rehabilitation Hospital, Marlton, NJ, has opened its Sports Medicine Division, making it one of the only pediatric sports medicine programs in its area. The treatment provided blends sports medicine and pediatrics.

The wide range of sports injuries treated by Weisman Sports Medicine include: back strains, sprains, and soft tissue injuries; knee bone, ligament, and cartilage injuries; ankle bone, ligament, and cartilage injuries; shoulder dislocations, instability, and rotator cuff injuries; and elbow tendonitis, tendonosis, and epicondylitis.

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