- The Washington Times - Tuesday, June 25, 2002

Ronne Irvine refuses to use the word "can't."Mr. Irvine, 45, of Herndon, lost the front of his left foot because of an automobile accident in 1975. Before the amputation took place, he had been an active teen-ager who had participated in cycling, camping, volleyball and hiking. After the accident, he was determined to regain his independence and began cycling again with a prosthesis. Since then, Mr. Irvine has participated in three Paralympics, which feature elite athletes with any disability. The competitions follow the Olympic Games, which take place every two years with both summer and winter events. He also rode around the Earth with World T.E.A.M. (The Exceptional Athlete Matters) Sports, based in Charlotte, N.C. He is riding about 300 miles a week to train for the 2004 Paralympics in Athens.

"I've disproven that it's a hindrance," Mr. Irvine says. "I'm different, but it's OK."

Artificial limbs, also known as prostheses, enable amputees to carry on their lives with vigor. Advances in technology and research are being made continually to help give them every opportunity possible.

Although Mr. Irvine has used about seven different prostheses since his accident, he says he is most pleased with the one he has worn since 1996, which was designed by Charlie Crone, a certified prosthetist at Nascott Rehabilitative Service in Fairfax.

With the help of College Park Industries in Lansing, Mich., Mr. Crone created an artificial limb to fit Mr. Irvine's Chopart's amputation, which is through the midtarsal joint of his foot and based on the method of amputation created in 1792 by Dr. Francois Chopart, a French surgeon. Mr. Irvine's prosthesis includes a fork-shaped piece at the front of the foot, which is attached to a black carbon fiber shell that covers his lower leg. The entire prosthesis costs about $10,000.

Mr. Crone says using artificial limbs opens many avenues for amputees. He says some people who were told that they would never walk again with their natural legs could possibly run with artificial ones.

"Everyone is so different and unique," he says. "You have to dive into their different needs to get the proper formula that will work for them."

John Register, 37, of Springfield severed an artery in his left leg in May 1994 while training for the 1996 Olympic Games in Atlanta, Ga. Although doctors gave their best efforts, they were unable to repair the artery. Therefore, Mr. Register underwent an above-knee amputation.

He had been a three-time All-American track-and-field athlete through the University of Arkansas in Fayetteville, once in the long jump and twice in the 4-by-400-meter relay. He also competed in the U.S. Olympic trials in 1988 in the high hurdles and in 1992 in the 400-meter intermediate hurdles.

Because the prosthesis Mr. Register wore immediately after the accident irritated his residual limb when he was running, he became involved in swimming and swam in the 1996 Paralympics. In December 1998, he was fitted with an artificial limb made of more flexible plastics from RGP Prosthetic Research Center in San Diego, Calif., which enabled him to return to track-and-field events.

Within a month of receiving the new leg, Mr. Register ran 100 meters in 14.1 seconds, which was about four seconds faster than when he had used the previous prosthesis. In the 2000 Paralympics in Sydney, Australia, he placed fifth with a time of 13.84 seconds in the 100-meter event. He won a silver medal in the long jump with a length of 5 meters, 41 centimeters. The world record in the long jump in the Paralympics is 5 meters, 57 centimeters.

Mr. Register also uses a Pathfinder foot, which is made by Ohio Willow Wood in Mount Sterling, Ohio. The heel of the foot incorporates a bicycle air shock by Fox Racing Shox in Watsonville, Calif., that acts as a shock absorber so the force created by running doesn't jar his lower back. He says the toe springs of the device allow him to feel as if he's moving forward with the ball of his foot.

"It's a work of art," Mr. Register says about his artificial limb. "It's a showpiece."

He says he is continually inspired by his competitors because of their passion for life despite any challenges they may face. He plans to participate in the long-jump event in the 2002 International Paralympic Committee World Championships in Lille, France, which will be held July 16 through 28. He also is training for the 2004 Paralympics in Athens.

"I am encouraged every time I step on the track," Mr. Register says. "I am in sheer awe of everybody who has gone forward with their abilities. We all have great fears. These fears can hold us back. We have to push forward."

Helmut Bernat, 67, of Fairfax County, who is a double amputee, started using a prosthesis called a C-Leg on his left leg at the beginning of this month for an above-knee amputation.

With the C-Leg, it's easier to walk on slopes, stairs and other uneven surfaces. The product, made by Otto Bock Healthcare in Minneapolis, is a microprocessor-controlled hydraulic knee that enables amputees to walk without thinking about every step. It adapts to the individual's movements, making adjustments about 50 times a second.

"It's tremendous," says Mr. Bernat, who is still practicing using the leg. "In the future, I'd like to walk to my car, get in it and drive."

On his right leg, which is a below-knee amputation, he wears a silicon liner with a suction socket that has a mechanical lock to keep the prosthesis from falling off his residual limb. The device is part of the Iceross product line by Ossur North America in Aliso Viejo, Calif.

Many other products are available for amputees to wear on their lower extremities, says Gary Wertz, president of Ossur North America. The company recently introduced the Ceterus Flex Foot. Its patented J-shape and CarbonX Active Heel allow amputees to expend less energy and walk farther for a longer period of time. It also features a rotator that enables movement with the ankle and knee.

The pieces in the Iceross product line are placed between the socket of the artificial limb and the skin of the residual limb to reduce friction sores. For instance, a transfemoral liner, which is made from silicon, is worn by above-knee amputees. Below-knee amputees can wear a dermo liner, which incorporates aloe vera inside the silicon to prevent rashes on the residual limb.

Mr. Wertz says many track-and-field athletes use the Flex-Sprint foot. The product was designed after the hindfoot of a cheetah, the fastest land animal. Ossur North America also is working on creating the Rheo knee in association with the Massachusetts Institute of Technology in Cambridge. It uses rotary hydraulics so the amputee's leg feels more natural and stable.

"We are trying to create life without limitations for amputees," Mr. Wertz says. "Even though it's a negative life-changing experience to lose a limb, with one of our products, it allows you to go on living life pretty much the way you did, and it gets you out of a wheelchair."

Richard M. Greenwald, president of Simbex in Lebanon, N.H., hopes to assist amputees in their daily activities through the Active Contact System offered by his company. Many amputees' residual limbs swell during the day, which makes the fit of the prosthesis uncomfortable. This product, a volume-management system created by Robert C. Dean of Norwich, Vt., pumps fluid around the socket and regulates the pressure inside the socket for a stable fit.

"This allows amputees to stay mobile," Mr. Greenwald says. "If you stay mobile, you are less likely to have other health-related issues develop."

Another product that attempts to solve the same problem is Vacuum Assisted Socket System developed by TEC (Total Environment Control) Interface Systems in Waite Park, Minn. It sucks the air out of the socket so the prosthesis remains attached to the residual limb as it changes size during the day.

Although there are myriad products for amputees who have lost their lower extremities, the artificial limbs used to replace upper extremities are not as advanced, says Harold Sears, general manager of Motion Control Inc. in Salt Lake City. Unlike legs and feet, hands have a much more delicate nature that is harder to re-create.

Mr. Sears, who created the Utah arm, is working to solve this problem. The prosthesis he created, one of the most intricate on the market, picks up an electric signal from the contraction of the remnant muscle in the natural arm. The mechanism is driven through small electric motors and rechargeable batteries. Electric wrists also can be placed in most artificial arms.

"Progress still needs to come in different ways," Mr. Sears says. "Hands should be able to move more naturally and be made from lighter materials. They should also be more rugged and made to run longer."

Learning about the various technologies available to amputees is a foreign topic for most of the general public, says Mark Hopkins, physical therapist and certified prosthetist-orthotist in the Physical Medicine and Rehabilitation Department of Johns Hopkins Hospital in Baltimore. He says amputees are relieved when they find out there are so many options available to them.

"You don't really learn about this until you're prescribed your first prosthesis," he says. "There are always new products coming out. They many not all be huge advancements, but they are progressive improvements."


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