Prosthetics and Regenerative Rehabilitation

With advanced battlefield technologies, field medicine and ever-changing arenas of battle, military personnel may face limb loss and other complex issues, but many have returned and active in our communities after serving. The primary goal of this program is to help military personnel lead normal, productive lives and perform daily living tasks that are comparable to people without limb loss. An important secondary goal is to enable the return of affected personnel to active duty status. At the Indiana Center for Regenerative Medicine and Engineering (ICRME), scientists and clinicians work with government organizations and industry to address pressing military and veteran needs.

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A gift to the Prosthesis Fund will support research associated with Prosthetics and Regenerative Rehabilitation at IU School of Medicine.

Military Population Focused Solutions

Military servicemen and women have distinctly different prosthetic needs. Our research considers the unique anatomical characteristics of the individual to develop solutions that are specifically suited for them. Aesthetics is an important consideration in this approach. The goal is to maintain and improve residual limb health across a lifetime, coupled with the need to push boundaries in terms of durability, functionality and performance.

Regenerative Rehabilitation

As an emerging field, regenerative rehabilitation integrates regenerative medicine and rehabilitation sciences to develop innovative solutions that are a class of their own. Current research aims to investigate cell-based therapies, tissue engineering and novel regenerative processes that may improve residual limb health and prosthetic performance. Large animal studies, as well as patient-based studies are currently ongoing. Non-invasive imaging plays a major role in this field.

Limb Health

Residual limb health is central to the well-being and physical ability of the amputee. Current patient-based research at ICRME employs in-socket diagnostics and imaging to assess limb health. Observations lead to novel mechanistic hypotheses, which in turn inform clinical study design. The program has the ability to monitor and manage limb volume, limb temperature and other vital health outcomes, which significantly inform advancements in prosthetic technology, resections and performance outcomes.

Academic, Industry and Public Partnerships

Our research solutions are driven by the end user, collaborator feedback and health needs. Solutions should have solid commercialization strategies with defined timelines and outcomes. Optimal industry partnerships help us innovate and reach new heights in improving the health and daily living. For example, a past project focused on further developing an adaptive socket system that detects in-socket residual limb motion and dynamically adjusts internal socket negative pressure to optimize fit and performance. This VA-funded project developed a product which went to market two years after the inception of the idea and is currently used by veterans.

Emerging Regenerative Rehabilitation of Improved Prothesis Control

An amputation can be a traumatic event that can leave affected patients feeling unsure of their capacity to thrive. Advances in upper limb prosthetic technologies with the innovative approach of Targeted Muscle Transfer (TMR) and Targeted Sensory Re-innervation (TSR) allow patients to move and feel their prosthetics without thought. Residual nerves from the amputated limb are transferred to reinnervate new muscle targets that have otherwise lost function. These reinnervated muscles then serve as biological amplifiers of the amputated nerve motor signals, enabling more intuitive control of advanced prosthetic arms.

This new surgical technique will overcome challenges associated with current approaches such as lack of precise control and lack of coordinated motions. It allows the amputee to use more than one pair of muscles intuitively and receive feedback sensation from their prostheses. Ajay K. Seth, MD, a board-certified orthopedic hand and upper extremity surgeon and orthopedic researcher, performed the first Targeted Muscle Re-Innervation and Targeted Sensory Re-Innervation surgery on a transhumeral amputee, an amputation through the arm. The surgery was successful and is now a living example of the newly emerging technology of amputee research where patients can sense through their prosthetics. Dr. Seth is closely working with Mohamed S. El Masry, MBBCH, under the guidance of Chandan K. Sen, PhD, and Sashwati Roy, PhD, to develop a pre-clinical program aimed at understanding the limits of TMR and TSR.