21st Century medicine

Clinical rehabilitation as a fast moving field in medicine

There is an ever increasing number of exciting scientific and technical advances in the field of clinical rehabilitation that promise to transform our approach to rehabilitation in the future. Through the application of translational research, technologies that were still research concepts only 2-3 years ago have become products that people are now using every day.

The Surgeon General explains how the MoD intends to transfer its knowledge and expertise in order to remain at the leading edge of clinical rehab.

Examples of these include:

Bionics

This area of research and development is typically well publicized and is one of the most fast-moving.

In one example, engineers at Vanderbilt University have been spending the past 7 years working on a 'bionic' above knee prosthesis that has a powered knee and ankle and a microprocessor to coordinate function. Amongst other benefits, the device lets amputees walk 25% faster, and uses 30-40% less energy than traditional devices.

In a second recent example, the London Evening Standard (16 Jun 15) reported that Nicky Ashwell had been fitted with what was described as the world’s most life-like bionic hand. Launched by a British company and containing 337 mechanical parts, the hand is built around a skeletal structure with miniaturized components designed to mimic exactly the functions of a real hand. It has allowed Nicky to perform tasks previously not possible, such as using cutlery, riding a bike and even opening her purse.

Neuroprosthetics

Advances in the use of neural signals to control devices such as computers or prosthetic limbs are likely to play an increasingly significant role in the future, using invasive and non-invasive methods of connecting with muscles, nerves, or the brain to provide increased functionality for patients experiencing disease or injury, including amputation.

A study published in the journal Science Translational Medicine (8 Oct 14, Vol 6, Issue 257) and reported by the Daily Telegraph (8 Oct 14) shows how a 42 year-old Swedish man fitted with the world’s first mind-controlled prosthetic arm has been able to return to work as a truck driver after the device proved to be a complete success. He is able to flex his fingers, catch balls and operate a petrol pump during his normal job. He can even tie the laces on his children’s skates, unpack eggs and chop wood. The technique, developed by a research scientist at Chalmers University of Technology in Gothenberg, Sweden, works by connecting the prosthesis directly to his bone, nerves and muscles.

http://www.telegraph.co.uk/news/science/science-news/11150037/Man-with-first-mind-controlled-prosthetic-arm-shows-off-his-new-skills.html

For a more detailed look at what cutting edge technology can do and how it can transform lives, a 2014 presentation by MIT Professor Hugh Herr, himself a double amputee and featuring Adrianne Haslet-Davis, a ballroom dancer who lost her left leg in the 2013 Boston Marathon bombing, is well worth watching. Click here to view the clip.

Regenerative medicine

Looking further ahead, the field of regenerative medicine, potentially in conjunction with nanotechnology and stem cell therapy, could in time have a game-changing impact on both the nature and the practice of clinical rehabilitation.

A simple definition of regenerative medicine is that it replaces or regenerates human cells, tissue or organs, to restore or establish normal function. A great deal of research in this area is being carried out around the world and, whilst clinical applications are still limited today, the prospects for translational research increasing the number of applications are good. We are still a long way from being able to regenerate limbs, but a recent strategic partnership between Imperial College London and Georgia Institute of Technology (Georgia Tech) in the US is leading to the creation of a bold new initiative aimed at researching and developing regenerative medicine treatments for landmine injuries. Funded by the Find a Better Way charity established by Sir Bobby Charlton, the REgenerative medicine SOLutions for the Victims of landmine Explosions (RESOLVE) initiative will unite academic and clinical experts at these two leading universities to focus on the fundamental goal of engineering biological replacement limbs created from an individual’s own cells. Professor Anthony Bull, who leads the Centre for Blast Injury Studies at Imperial, will coordinate activities there and the London end of the £60M programme will occupy the Michael Uren Biomedical Engineering Research Hub at the new Imperial West campus.