(Inside MossRehab/Winter 2015) - Andreas Kannenberg, PhD, executive medical director of Ottobock North America, says there are several prosthetic technologies in development right now, some of which may be commercially available in the next few years and others that are likely still more than a decade away.
“These are completely powered, andI hesitate to call them orthoses because they’re acompletely new type of device,” says Dr. Kannenberg.“They were mainly developed for the military tosupport soldiers traveling long distances and carrying heavy loads, but they have been modified to serve patients with paralysis or paresis of the leg muscles.
"ReWalk which was tested and first introduced toclinical use in the U.S. by MossRehab is an example of this category of devices. While these exoskeletons could have potential valuein the inpatient rehabilitation setting-getting patients into an upright position and walking-practicality for daily life or the home environment is still being developed. Dr. Kannenberg says further research and development is needed to make the devices safer andmore manageable.
EMG-Controlled Lower Limb Prostheses:
According to Dr. Kannenberg, a few groups have been working on improving control of lower limb devices by deriving EMG signals from the residual limb.
"For passive prosthetic components, EMG controlis not really necessary because walking is a highly automated process you can mimic with currenttechnology," he says. "But this EMG control may help with powered prostheses when a patient tries to walk upstairs or on an incline."
Instead of limiting signal input to two channels, researchers are looking to use an array of electrodes to recognize and predict the functional intent of muscles in the residual limb.
“This is very promising, and it may help patients to use functions of different prosthetic components simultaneously instead of in a sequential pattern,” says Dr. Kannenberg.
Researchers are also looking at implantable electrodes that would transmit EMG signals wirelessly and respond to pattern recognition—coordination between muscles that would predict what activity the patient wants to perform.
Dr. Kannenberg says several groups are working on implementing sensory feedback into upper limb prostheses through pressure or direct nerve interfaces.
Brain-Computer Interface Prostheses:
Research of technology that would enable patients to control prostheses through thought—while exciting—is years from creating a commercially available product, says Dr. Kannenberg.
"The very important point to consider is who is going to pay for these technologies," he says. "Will healthcares ystems reimburse adequately so future development is not hampered?"