Advanced Arm Dynamics

ISPO 13th Congress in Leipzig, Germany

“It's a conference on steroids.” -John Miguelez, CP, FAAOP, president and senior clinical director, Advanced Arm Dynamics, Redondo Beach, California

Leipzig brings O&P to the World Stage

From the O&P EDGE, July 2010

Dancers, performance artists, music, and multilevel product display booths complete with bars, cafe tables, and mini-theaters set the tone for the combined meeting of the International Society of Prosthetics and Orthotics (ISPO) 13thWorld Congress and the ORTHOpADIE + REHA-TECHNIK 2010 International Trade Show, held from May 10-15 in Leipzig, Germany.

But when Miguelez summed up his experience at the record-setting event, he was referring to more than the electric atmosphere created by exhibit hall booths the size of a small city block. He was also referring to the palpable energy created by the global exchange of ideas. The combined meeting "gives you the opportunity to spend the day visiting the exhibit hall and listening to presenters, and then in the evening go out in a group and ... share your clinical experience with people from all over the globe;' Miguelez said. "That's so invigorating. It's a really unique opportunity to extend past the borders of the United States and open yourself up to new approaches, techniques and technologies.” 

'Most Successful’ World Congress Ever

Building on the theme, "Research and Innovation for Human Technology;' the ISPO World Congress brought together 630 speakers from 55 countries. Presentations covered the latest developments and research results in the fields of orthotics, prosthetics, orthopedic technology, orthopedic footwear technology, and compression treatment, and drew in approximately 2,600 visitors. Sessions focusing on neuroprosthetics were well received, with one in five participants saying they were strongly interested in the subject. 

"It was our most successful Congress ever;' said Dan Blocka, immediate past-president of ISPO. "In some keynote presentations, all seats were taken.”

The l3th World Congress also marked the end of Blocka’s three-year term as ISPO president. During the closing ceremonies, Blocka officially handed over the baton to incoming president Ian Geertsen, MD, a specialist in physical medicine and rehabilitation (PM&R) at the Center for Rehabilitation, Groningen, Netherlands. Exhibitors seized on the global marketing opportunity presented in Leipzig.

More than 550 exhibitors from 45 countries filled 40,000 square meters of exhibition area, presenting mobility aids in the fields of prosthetics and orthotics technology, orthopedic and rehabilitation technology, orthopedic footwear technology, medical foot care, and compression therapy. ORTHOpADIE + REHA-TECHNIK drew in 21,200 visitors from 108 nations, according to Area Manager Klaus Ernst.

More than 50 new products were launched at the trade fair, including the world premier of the SacroLoc lower-back orthosis by Bauerfeind AG, Zeulenroda-Triebes, Germany; the world premier of the  PowerKnee by Ossur, Reykjavik, Iceland; the world premier of the bebionic myoelectric hand system by RSLSTEEPER, Rochester, Kent, England; the European premier of the Pro Digits partial hand system by Touch Bionics, Livingston, Scotland; and the world premier of the Genium lower-limb bionic prosthetic system and the Michelangelo Hand, both by Otto Bock HealthCare, Duderstadt, Germany.

"This was the best ORTHOpADIE + REHA-TECHNIK we have ever seen;' said Hans Georg Nader, CEO of Otto Bock HealthCare. "Combining the ISPO Congress and Trade Fair is a model for the future. The world comes together in Leipzig.”

“Regardless of what discipline a clinician specializes in-upperlimb, lower-limb, orthotics, prosthetics, or pedorthics, “Miguelez said, "The World Congress is an incredible, unparalleled educational opportunity. The World congress offers a unique opportunity for clinicians to exchange ideas with other experts from around the world.”

The next ORTHOpADIE + REHA-TECHNIK International Trade Show will be held in Leipzig May 16-19, 2012. ISPO will hold its 14thWorld Congress February 4-7, 2013, in Hyderabad, India.

Iraq War Quadruple Amputee Says He's "Fortunate"

Brendan Marrocco Only Soldier to Lose All Four Limbs and Survive; Heat of Bomb Instantly Cauterized His Wounds
By David Martin

Sooner or later it had to happen - a soldier losing all four limbs and yet surviving. It happened to Brendan Marrocco on Easter Sunday of 2009 in Iraq, when his vehicle tripped a roadside bomb.

"It just took both arms, my left leg off completely and my right leg was still attached a little bit," Marrocco said, "and killed my gunner - my best friend."

Then there's that nasty scar on his neck.

Brendan Marrocco, 23, works with a trainer at Walter Reed Army Medical Center in Washington, DC. Marrocco, the first quadruple amputee of the wars in Iraq and Afghanistan to survive, lost both arms and legs to a roadside bomb in Iraq on Easter Sunday, 2009.  (CBS)

"Yeah, I severed my carotid artery," Marrocco said. "That alone should have killed me."

Carotid artery severed, both arms and left leg completely off - why didn't he bleed to death? The answer is a gruesome irony: the heat of the blast instantly cauterized the same wounds it had caused.

"I was barely bleeding from them," Marrocco said. The same weapon that took half his body saved his life. Just barely.

"I wasn't expected to live," Marrocco recalled. "I died three times and came back." No pulse. "Flat-out dead."

Read more about Brendan

Tigard company builds DYNAMIC ARMS

Advanced Arm Dynamics not only builds prosthetic upper limbs, but helps its patients get their lives back to normal

By Nick Peterson

The Times, May 13, 2010

When you first see Chino Acosta, there is nothing unusual that catches your eye — even if you know beforehand that he is missing an arm.

Then you look him up and down, and you see it. His left hand. It looks a little different, but only slightly. If it was his right hand, you wouldn’t hesitate shaking it.

But it’s his left hand, and he can do some amazing things with it.

Acosta has a dynamic arm — an electronic prosthesis, created by Tigard’s Advanced Arm Dynamics — an arm that helps him lead a fairly normal life.

And he likes it a lot.

“One of the things I like about it is for driving,” Acosta says, making a motion like he’s holding onto a steering wheel with his artificial hand. “Driving is really comfortable.”

Acosta lost his hand in a job-related accident six years ago. After some reconstructive surgery that didn’t produce the results he was hoping for, he decided to have his arm amputated just below the elbow. Then he came to Advanced Arm Dynamics and they built him the arm he now uses — a myoelectric prosthesis that has rotation at the wrist and an open-close function for the hand. And it looks surprisingly natural.

Acosta’s face lights up with a little, sly smile as he rotates his hand 360 degrees — something those of us with natural hands can’t do.

The “skin” on his prosthetic hand and forearm is made of silicone and painted to match Acosta’s natural skin. The forearm even has hair taken from his other arm embeded in it.

The only problem, Acosta jokes, is that in the summertime it doesn’t tan like his real arm.

The hand looks uncannily real, right down to the veins on the top of the hand and the fingernails — which, by the way, never need clipping.

The movement of the hand is limited. It is fixed in a cupped, gripping shape, looking like it’s constantly ready to grab something. Besides the unlimited rotation, its basic movement is to open and close.

Those movements are controlled by the flexing of two basic muscles in Acosta’s forearm. The twitching of one muscle causes the hand to open and the twitching of another muscle causes it to close. A quick flexing of respective muscles causes the hand to rotate one way or the other.

Acosta said learning to use the arm was relatively easy and only took a couple of weeks. Training begins with a computer program that uses myotraining and simulation software to virtually imitate the movement of the prosthetic hand.

“Before they even think about making you this,” he says, motioning toward his prosthetic arm, “they train you on the computer. By the time you get this, you just put it on, and no problem.”

Getting back to normal

Mac Lang, the clinical director and prosthetist of the Adavanced Arm Dynamics Northwest Center of Excellence in Tigard, says the company exclusively specializes in upper limb prosthetics. And one of the things that sets the company apart from other prosthetic providers is its emphasis on long-term rehabilitation.

“We provide the prosthesis, but we also provide the rehabilitation for the patient to work that prosthesis into their everyday life,” says Lang.

The clinic’s occupational therapy room is equipped with various real-life objects which patients can train on to get used to using their limb.

“Something as simple as stacking cones may not be exciting or fun, and they often get tired of doing it here 100 times,” Lang said. “Then they go out to Starbucks and have to pick up a cup of coffee and because they’ve done it here 100 times, it takes the anxiety away of having to do it in public in an uncontrolled setting.”

Lang says a typical patient for them is one who, like Acosta, lost a limb in a job-related accident.

READ MORE

30th Annual Texas History Day

Advanced Arm Dynamics (AAD), an upper extremity prosthetics provider, recently played a role in the 30^th Annual Texas History Day Contest; albeit, one behind the scenes.  When the business was approached by a group of 8^th graders from a Texas middle school who were creating a play on the history of innovation in prosthetics to perform as their submission for the contest, the AAD team was more than happy to help. They worked with the students over a period of months, which included showing them various prosthesis and how they work, introducing them to patients, providing a tour of the facilities and lab, and even lending them four prosthetic arms to use when performing their play. 

After first winning their school and the Dallas Fort-Worth regional competitions, the students were among the 1,000 students out of 45,000 who were allowed to compete at the state-level this past weekend at the 30^th Annual Texas History Day Contest, the official affiliate of the National History Program, which was held at the Texas State History Museum in Austin. The students received 4^th place out of the 45,000 state competitors.

The theme of this year’s Texas History Day was “Innovation in History.” For their submissions, students in 6^th through 12^th grade had a choice of submitting performances, Web sites, historical papers, documentaries or exhibits in accordance with the theme.

  PHOTO CAPTION (Left to Right): Rebecca Gold, Shelby Johnson, Amy Lytle, Corinne Kowald

 

About Texas History Day

Texas History Day, the official Texas affiliate of the National History Day program, is a yearlong education program that culminates in an annual state-level history fair for students in grades six through twelve. It provides an opportunity for students to develop their knowledge of history and their critical thinking, analytical reading and writing, presentation, media design, and public performance skills through creative and original papers, performances, documentaries, web sites or exhibits.  The Texas State Historical Association coordinates the Texas competition, which involves over 45,000 young Texans statewide. The 2010 event was co-hosted by the Bob Bullock Texas State History Museum and The University of Texas at Austin College of Education. Over 1,000 students participate in the state level History Day contest with approximately 60 students representing Texas at National History Day each year in Washington, D.C.

Rob Dodson, CPO, LPO lectures in Guadalajara, Mexico on Upper Extremity Prosthetic Care

I recently had the unique opportunity to travel down to Guadalajara to participate in the first annual International Forum on Biomedical Engineering at the Tecnológico de Monterrey campus Guadalajara.  I have known the Director of the Biomedical Engineering department, Dr. Misael Caballero, for the past four years.  In 2006, we had the opportunity to collaborate together on a prosthetic case involving a patient who sustained wrist disarticulation amputations on both her right and left arm.  Earlier this year Dr. Caballero invited me to speak at this conference on the topic of Advancements in Upper Limb Prosthetic Technology.  And although my Spanish is pretty non-existent, I decided this would be an excellent opportunity to teach about our field and provide exposure to not only the advancements in technologies but also the advancements that have been made in therapy and psychosocial considerations for those patients dealing with an upper limb amputation.

So, my tickets were purchased and I was on my way for this adventure.  My past experience with Mexico involved beaches and margaritas so I was unsure of what to expect going to Guadalajara.  Upon my arrival, I met with Dr. Caballero and one of his students, Ana HeRay and was taken to my hotel.  On the ride to the hotel, I was informed that I would be the first speaker and that I should be prepared for around 100 participants.  Once at the hotel I was able to put my finishing touches on the presentation for the next morning. 

The next day, Ana picked me up to take me to the University.  Once there, I was given a tour of the exhibit hall which included approximately 15 vendors from various aspects of the health field including such companies as Arthrex and Stryker.  Dr. Caballero personally introduced me to the representatives from each of these companies.  I quickly realized that the entire conference was student driven and on a very high level!  I was incredibly impressed by the professionalism of the student workers and by the overall feel of the conference.

It was then off to get prepared for the opening ceremonies and the presentation at 10:00 sharp.  Some very influential people were in attendance including the president of the university and the Minster of Health for the county of Jalisco.  The venue for the meeting was an outdoor gymnasium that held approximately 1,000 chairs.  Five 40” LCD screens were positioned around the audience as the main projector was unfortunately not bright enough to show on the main screen.  The presentation went very well and we had approximately 900 + attendees during the lecture which was amazing! 

After lunch, Ana and another student by the name of Eduardo gave me a tour around the campus.  I have a new appreciation for what the field of biomedical engineering means in Mexico and I am hopeful that a few of the students will be interested enough to consider the field of upper limb prosthetics as a career that they can bring to Mexico.  We had a Gala dinner that evening which included lectures by Intel on their venture into Guadalajara.

The next day was full of more lectures (unfortunately in Spanish which did not bode well for this Texan!) as well as a repeat lecture from me to those students that were not able to attend the original lecture.  It was then off to the airport for a quick flight back to Dallas.

I truly enjoyed my time in Guadalajara and was very impressed by the hospitality of the students and Dr. Caballero.  I am looking forward to this becoming a common conference that we can be a part of in the future and hope that we can help influence the career choices of some of these students as they begin to understand the nature of prosthetics and how it relates to their degree.  This was an excellent opportunity to showcase the philosophy of Advanced Arm Dynamics and I am grateful to Dr. Caballero for his invitation to participate in this event. 

Rob Dodson, C.P.O., L.P.O.
Upper Extremity Specialist
Advanced Arm Dynamics

Lieutenant Mark Wise

ABC 7 NEWS/WASHINGTON

- "The military's Purple Heart award is hard-earned. Service members must be wounded or killed in battle to receive the honor.  But when a Springfield soldier received his Purple Heart six months ago, he didn't even know it. He was in a medically-induced coma when the award was pinned to his pillow.  First Lieutenant Mark Wise never dreamed of receiving a Purple Heart. He hoped he would come out of battle in Afghanistan without one but now that he has he says he's grateful to wear this badge of honor...."

WATCH THE VIDEO of Advanced Arm Dynamics patient Lt. Mark Wise featured on ABC 7 News in Washington, DC.

Grabbing Gracefully, With Replacement Fingers

New York Times
By ANNE EISENBERG

Published: April 9, 2010

ERIC JONES sat in a middle seat on a recent flight from the New York area to Florida, but he wasn’t complaining. Instead, he was quietly enjoying actions that many other people might take for granted, like taking a cup of coffee from the flight attendant or changing the channel on his video monitor. These simple movements were lost to Mr. Jones when the fingers and thumb on his right hand were amputated three years ago. But now he has a prosthetic replacement: a set of motorized digits that can clasp cans, flimsy plastic water bottles or even thin slips of paper.

“Pouring a can of soda into a cup — that is a mundane daily action for most people, but to me it is a very big deal,” said Mr. Jones, who lives with his family in Mamaroneck, N.Y. “I slip my bionic fingers on like a glove, and then I have five moveable fingers to grasp things. It’s wonderful to have regained these functions.”

Mr. Jones’s prosthesis, called ProDigits, is made by Touch Bionics in Livingston, Scotland. The device can replace any or all fingers on a hand; each replacement digit has a tiny motor and gear box mounted at the base. Movement is controlled by a computer chip in the prosthesis.

ProDigits was released commercially last December, said Stuart Mead, the chief executive of Touch Bionics. About 60 patients have been fitted worldwide, he said, and some have been wearing it for three or four years. The cost is $60,000 to $75,000, including fitting and occupational therapy.

The technology used by Touch Bionics is based on prostheses that the National Health Service in Scotland developed for children there who suffered effects of the drug thalidomide, he said. The company, founded in 2003 as a spin-off from the health service, adapted the technology from custom prostheses into ones that could be produced commercially. It had funding from investors including Archangel Informal Investment and the Scottish Co-investment Fund.

The company’s first product, released two and a half years ago, was the i-Limb Hand, an entire hand that opens and closes and can grasp objects. It has been a success, Mr. Mead said, with more than 1,200 patients fitted with it in 40 countries.

The company then turned to creating ProDigits. “We decided to develop the technology to mechanize not just a hand, but individual fingers,” he said. “We always knew that it would be the bigger market — more people lose individual digits than lose entire hands — but also the most challenging technically."

The individual, motorized fingers are a new and promising development in the field, made possible in part by miniaturization of components, said John Miguelez, founder and president of Advanced Arm Dynamics of Redondo Beach, Calif. The company specializes in prosthetics for hands and arms for, among others, soldiers returning from Afghanistan and Iraq at Walter Reed Hospital in Washington. “More voltage and current can be applied to the motors,” he said, “creating increased speed and force.”

Dr. Douglas G. Smith, a professor of orthopedic surgery at the University of Washington and Harborview Medical Center in Seattle, agreed. “Motors are getting stronger and smaller, and the batteries are thinner and smaller, too,” he said, making it possible to fit mechanical components into the space formerly occupied by a finger.

Eric Jones has been wearing a ProDigits prosthetic for 18 months. The artificial fingers are slightly larger than the originals, but that is not a problem, he said. “The fingers look cool,” he said. A switch on the side turns the power on and off, and he charges the digits overnight, as he would a cellphone

Mr. Jones starts the action by flexing or relaxing a muscle in the palm of his hand. Sensors built into the prosthesis pick up the signals sent by the muscles and send the message to the computer chip that controls the motor. The artificial fingers stop closing when they detect resistance, said Karl Lindborg, professional services director for Touch Bionics.

A single, outstretched prosthetic finger can operate a microwave oven or a cellphone; a finger and a thumb can hold a chess piece; three or more fingers can grasp a sphere. Mr. Jones said the fingers also provided a touch of class. “I can grasp a wine glass with my bionic fingers,” he said. “My pinkie and ring finger curve under the bowl very elegantly.”

PRODIGITS may be opened and closed not only by sensors that pick up muscle contractions, but also by dime-size pads put at the base of the fingers to detect pressure exerted by remnant bone. “If you can wiggle the bones in your palm, Mr. Miguelez explained, “that wiggle can be translated into controls to open and close the fingers.”

Robert J. Green of Bel Air, Md., who lost the fingers and thumb on his dominant left hand last year, operates his ProDigits in just that way. He uses his prosthetic fingers, for example, to write with a pen or a pencil. The artificial digits have actually improved his handwriting, he said, and he likes their appearance, too. “I look something like Arnold Schwarzenegger in ‘The Terminator,’ ” he said.

Watch the video, click here.

Advanced Arm Dynamics Southwest Center patient featured on WWLTV

T Minus Five and the second annual Amputee Ski Weekend

Recently, AAD and T Minus Five joined together to host the second annual Amputee Ski Weekend in McCall, Idaho. AAD patients Tom Seibert, Connor Howe and Bernie Diamond (left) along with Dan Conyers were among the participants.   Skiers were provided adaptive equipment donated by AWeSOMe, Adaptive Wilderness Sports of McCall along with instructors. Skiers and snow boarders arrived from California, Texas, Oregon, Arkansas, Idaho, and Utah to participate.

The AWeSOMe group at Brundage Mountain in McCall, Idaho has been working for years to bring recreational opportunities to local residents, mostly youngsters diagnosed with autism, cerebral palsy and other medical conditions. The Ski Weekend event attracted teens, adults and retirees with upper and lower limb amputation.

Mary Seibert, founder of T Minus Five organized the event.   The Seibert family founded T Minus 5 after their son, Tom, lost a hand in a wakeboarding accident as a teen. The name of the group stands for “Tom minus his 5 fingers” and represents Tom’s desire to continue in his pursuit of an active outdoor lifestyle.

2nd Annual Winter Weekend