Winter/Spring 2007 Vol. 7 No. 1
Smart Prosthetics: Exploring Assistive Devices for the Body and MindBy Haley Poland
Whether they are helping a blind person see, a deaf person hear, or an amputee walk, prostheses have come a long way. What were once wooden limbs and glass eyes are now man-made electromechanical devices capable of interfacing with the body's systems and communicating, almost intelligently, with the nerves and brain. From joint replacements, cochlear devices, and brain implants to artificial valves, hearts, and limbs, prosthetic devices are beginning to blur the line between technology and biology.
Last November, more than 150 researchers from wide-ranging fields, including biomedical and material engineering, surgery, neurology, and military medicine, converged upon the Beckman Center in Irvine, California, at the fourth annual conference of the National Academies Keck Futures Initiative, "Smart Prosthetics: Exploring Assistive Devices for the Body and Mind." The conference challenged participants to determine just what "smart" means and how best to achieve that smartness in the future. Funded by a $40 million grant from the W.M. Keck Foundation in 2003, the Futures Initiative is a 15-year effort to enhance communication among researchers, funding organizations, universities, and the general public, with the objective of stimulating interdisciplinary research at the most exciting frontiers.
Because prostheses are man-made structures designed to exist beside or within the human body, the field of prosthetics is inherently interdisciplinary. However, a problem that needs to be confronted to continue the progress being made -- aptly stated by Hunter Peckham, who chaired the conference organizing committee -- is that "we've grown up in scientific silos." To bridge the gaps, 13 overview tutorials were webcast live prior to the conference, presenting the basics of relevant fields and the state of the science in those fields today.
In one tutorial, Warren Grill, an associate professor of biomedical engineering, neurobiology, and surgery at Duke University, walked conference participants through the fundamentals of neural stimulation and recording. In another, Bradford Bennett, who is the research director of the Motion Analysis and Motor Performance Laboratory and an assistant professor at the University of Virginia, discussed the promise of patient-specific orthotics that record and adapt to a person's unique gait.
Addressing another integral aspect of prosthesis development, Mark Humayan, a professor of ophthalmology at the Keck School of Medicine, and Frances Richmond, director of the regulatory science program at the University of Southern California, outlined the rigorous regulatory process a medical device must go through on its path "from benchtop to bedside."
"If we choose the wrong path," Richmond said, "we greatly delay and make more expensive our ability to get to a commercial market."
In addition to other tutorials on topics such as brain plasticity and biointerfacing electrodes, two researchers recounted their personal experiences with prosthetic devices, giving insight into the life-changing impact such devices can have. Alexander Rabchevsky, an assistant professor of physiology at the University of Kentucky's Spinal Cord and Brain Injury Research Center and a paraplegic since a motorcycle accident in the 1980s, now uses surgically implanted Functional Electrical Stimulation (FES) to stand, if only for a few moments. Hugh Herr, associate professor of media arts and sciences at Massachusetts Institute of Technology, lost both legs below the knee to frostbite in a climbing accident when he was 17. Calling himself a better rock-climber with his specialized prostheses than he was before the accident, Herr now builds cutting-edge limb devices that use technology to harness and even improve upon the abilities of the human body.
With the tutorials as a foundation, small, diverse groups spent eight hours over the course of the conference trying to address a challenge problem or question. The groups contemplated plans to restore sensory perception of limb movement, design a prosthesis that could grow with a child, replace damaged brain tissue, and design a functional tissue prosthesis. Others tackled problems like electrode longevity, the best way for electrodes to interface with the brain, and how hybrid prostheses might exploit electrical processes within nerve cells.
Both during the task group sessions and periods of relaxation at the conference, an invaluable outcome became evident: relationships formed across disciplines. "I definitely met people that I'll be talking to very soon," said one scientist on the last day. "The important stuff happens after the conference."
For this reason, the Futures Initiative offers an incentive for collaboration as part of its mission to promote innovative scientific investigation. Each year, $1 million in seed grants, up to $75,000 each, are awarded on a competitive basis to conference participants wishing to pursue interdisciplinary research, learn new skills, or perhaps keep alive a fledgling dialogue begun at the conference.
For thousands of people living with disabilities, such collaborations and the evolution in prosthetics that hopefully will result could mean faster rehabilitation, more effective therapy, and even return to an independent life. With conferences like "Smart Prosthetics," the Futures Initiative continues to establish a strong tradition of novel interdisciplinary research and scientific communication.
For more information on the Futures Initiative and this conference, visit <www.keckfutures.org>.