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The “Mobility Saves” Study Published in Peer-Reviewed Journal

The study that started the “Mobility Saves” movement has now been published in a peer-reviewed journal. The recent Military Medicine Supplement published the study: “Economic Value of Prosthetic Services Among Medicare Beneficiaries: A Claims-Based Retrospective Cohort Study”

Military Medicine is the official journal publication of the Association of Military Surgeons of the United States (AMSUS), and this edition arises in conjunction with the topics covered at the December annual meeting of AMSUS.

This study demonstrates, using four years of Medicare data, that timely O&P intervention saves payers’ money.  Dr. Allen Dobson, the author of this research, presented his work at the AMSUS meeting, and the attached manuscript will make this work widely available for citation for use by payers (including both Medicare and private sector providers), and others to show the value of O&P care (page 18).

This edition also includes the manuscript developed by a Multi-Disciplinary Task Force headed by John Fisk, M.D., with physician representatives from both physical medicine and rehabilitation, and orthopedic surgery, a physical therapist, and certified O&P professionals around key issues on the orthotic treatment team, distinctions between off the shelf (OTS) and customized orthotics, the importance of the orthotist’s notes and records, and other key clinical issues (page 11).  This publication is particularly timely in establishing this valuable consensus viewpoint at a time when orthotic care, and its reimbursement are attracting greater attention and scrutiny.

There are also several reasons why we are especially pleased to see both of these articles appearing in Military Medicine.  This journal is a peer-reviewed medical journal, listed in the Index Medicus, which conveys substantial credibility for these papers, placing it in the top tier for purposes of medical citations, and because of the importance of topics covered in this journal to Congressional Appropriations and Department of Defense matters, Military Medicine is circulated to all Congressional Offices, giving these messages great reach to our lawmakers.

Access the articles online.

‘Bionic spinal cord’ aims to move robotic limbs with power of thought

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An exoskeleton prototype used for neuro-motor rehabilitation. IMAGE: BSIP/UIG VIA GETTY IMAGES
Australian scientists hope a device about the size of a matchstick will one day help people with spinal cord injuries get back on their feet.The device, a stent-electrode recording array or stentrode, could allow patients to control powered body armour, known as exoskeletons, or bionic limbs using only their thoughts, researchers announced Tuesday at the University of Melbourne.The stentrode will be implanted in a blood vessel that sits over the brain, and will turn brain signals into electrical commands that could wirelessly move the exterior mechanical technology. Currently, most exoskeletons are controlled by a joystick that is operated manually.

A collaboration between the Royal Melbourne Hospital, the Florey Institute of Neuroscience and Mental Health and the University of Melbourne, the findings were published Tuesday in the journal, Nature Biotechnology.

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The stentrode device went through hundreds of design changes before researchers were satisfied it met their requirements of being light, flexible, bio-compatible and small enough to be threaded into a one millimetre blood vessel.

 

IMAGE: UNIVERSITY OF MELBOURNE

Speaking at a press conference Tuesday, Thomas Oxley, a neurologist at the Royal Melbourne Hospital, said the project began when he had the idea that thought control of bionic limbs could be achieved without implanting a device through open brain surgery.

Preclinical studies have shown that by putting the stentrode in a blood vessel near the motor cortex, a key control centre for the brain, you can get the same recording as people previously obtained by surgically inserting something directly into the brain. He proposed that, using the stentrode, patients will one day be able to control mechanical limbs with their thoughts.

“The idea is the device is much less invasive than previous attempts at doing this and can be implanted longterm,” said Terry O’Brien, head of medicine at the Departments of Medicine and Neurology, the Royal Melbourne Hospital and University of Melbourne. “There is no clinical device that does this at the moment.”

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The stentrode can record brain signals from within a blood vessel next to the brain. These thoughts are captured, decoded and passed wirelessly through the skin to enable control of an exoskeleton.

 

It could also have applications far beyond assisting those with paralysis, he added. The stentrode could be used to record brain waves for those with conditions such as epilepsy, helping to predict when they are about to have an attack. “The applications are incredibly broad, and that’s what makes it so exciting,” O’Brien said.

The device, which has so far been tested on sheep, will undergo its first human trials in 2017. According to a statement from the University of Melbourne, patients will have to, in many ways, learn to walk and stand again by getting familiar with “coding” the signals to their exoskeleton. “With our device, you’ve essentially connected an electronic limb to the patient’s brain, but they have to learn how to use it,” Oxley said, according to the statement.

Nick Opie, a biomedical engineer at the University of Melbourne, told reporters the team hoped the cost of the device, after it has undergone human testing and is ready for market, would be similar to the cochlear implant — around A$15,000 (US$10,567) to A$20,000 (US$14,089). They predict it will be ready by 2022.

It is also hoped the stentrode will be as important to medicine as the cochlear implant, which was invented in Australia. “What cochlear implants have done for hearing, we want to do for mobility,” Opie said.

Interest in bionic limb and exoskeleton technology has been developing rapidly in recent years. Earlier in February, SuitX announced a new Phoenix exoskeleton that aims to replicate human gait.