Prosthetics and Regenerative Rehabilitation

With advancing battlefield technologies, field medicine and ever-changing arenas of battle, more military personnel are facing multiple limb loss and other related complex issues. The primary goal of this program is to help military personnel lead normal, productive lives and perform activities of daily life 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 sex-based research considers the unique anatomical and other characteristics of the individual to develop solutions that are specifically suited for women. 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

Research solutions must be informed by end-user and collaborator feedback and market needs. Solutions must have solid commercialization strategies with defined timelines and outcomes. Our focus is to take solutions to people. In that path, optimal industry partnerships represent a major cornerstone. 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.

Photos of robotic prosthetic

Emerging Regenerative Rehabilitation of Improved Prothesis ControlĀ 

An amputation is a traumatic event that can leave affected patients feeling disabled and incomplete. Recent advances in prosthetic arm technologies with the innovative approach of Targeted Muscle Transfer (TMR) and Targeted Sensory Re-innervation (TSR) allow patients to move and feel their prosthetics with 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, allowing for more intuitive control of advanced prosthetic arms.

This new technique will overcome challenges associated with current approaches such as lack of precise control, lack of coordinated motions, and lack of sensibility. 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 hand amputee. 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. Ajay K. Seth, MD, an Adjunct Clinical Assistant Professor of Surgery at the Indiana Center for Regenerative Medicine & Engineering, 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.