Advances in prostheses focus of medical museum’s Science Cafe

Photo By Bernard Little | Jamie Boehm, a certified orthotist prosthetist at Walter Reed, shows a current-day prosthetic during the Science Café's program focused on the Department of Defense (DOD) Limb Trauma Care at the National Museum of Health and Medicine on April 27, 2023.  

UNITED STATES

05.02.2023

Story by Bernard Little 

Walter Reed National Military Medical Center

By Bernard S. Little
WRNMMC Command Communications
Staff from Walter Reed who care for patients with polytrauma injuries and limb loss participated in the Science Café hosted by the National Museum of Health and Medicine (NMHM) in Silver Spring, Maryland on April 27.
NMHM regularly hosts the Science Café, which are talks that delve into a diverse range of topics in military medicine, past, present, and future, explained Andrea Schierkolk, public programs manager for the museum.
April’s Science Café focused on the Department of Defense (DOD) Limb Trauma Care in observance of Limb Loss Awareness Month, Schierkolk added. “They discussed emerging trends and technology in caring for limb trauma patients, focusing on the severely to critically injured limb,” she shared. Speakers discussed the evolution in powered orthoses (braces), treatment protocols, and practices in the collaborative care setting.
Dr. Andrea Crunkhorn, chief of Clinical Affairs at the Defense Health Agency’s (DHA) Extremity Trauma and Amputation Center of Excellence (EACE) in the Research and Engineering Directorate, discussed the evolution of DOD Limb Trauma Care: 2001-2023. She explained evidence of prosthetics dates back as far as ancient Egypt with the discovery of mummies found who had prosthetic toes. “So, we’ve had braces and prostheses for as long as humans have had the ability to try and adjust to their challenges, disabilities, and limb differences.”
While earlier prostheses were often made of wood, leather, and metal that limited movement, current state-of-the-art prosthetics are made of lightweight yet strong materials such as carbon fiber and thermoplastic. Many are also now robotic.
The NMHM has more than 25 million objects in its collection which includes prosthetics used by service members throughout the years.
“This last set of wars we’ve been in have really pushed the envelope in an attempt to help people keep the limbs that they were born with,” Crunkhorn said. She added some trauma is so severe that saving a limb is not possible, and it’s more functional for the person to have a prosthesis, which also contributes to a better quality of life.
“Improved prehospital care and acute inpatient trauma care have resulted in increased survivability and increased disability,” Crunkhorn continued. “Reintegrating these survivors into society is important both socially and economically. Rehabilitation focused on maximizing function will allow survivors to return to normal family, societal, and work roles. The patient benefits from a holistic approach to care, with the entire team focused on improved functional outcomes.” She added these team members not only include doctors and nurses, but also prosthetists, physical therapists, plastic surgeons, neurologists, occupational therapists, dermatologists, nutritionists, behavioral health, pain management specialists, and more.
Since 2001, DOD has cared for more than 30,000 beneficiaries with some level of limb loss, according to DHA officials. DOD has treated more than 1,700 deployment-related amputations and returned to duty over 400 service members with amputations.
Crunkhorn explained that EACE facilitates the most advanced care of amputation in the United States. That care is provided at DOD Advanced Rehabilitation Centers, which in addition to the Military Advanced Training Center (MATC) at Walter Reed, includes the Center for the Intrepid at Brooke Army Medical Center in San Antonio, Texas, and the Comprehensive Combat and Complex Casualty Care Center at Naval Medical Center San Diego in California.
Dr. Tawnee Sparling, a physiatrist at Walter Reed, explained that with the advances in modern medicine amputation can be viewed as “not a failure of limb salvage,” but as an alternative [treatment] to improve the patient’s quality of life.
Jamie Boehm, a certified orthotist prosthetist at Walter Reed, explained infection, pain, and limited movement and function in an injured limb often leads to amputation, and because of the advances in technology, a prosthetic often proves more beneficial to the patient.
Caroline Canova, a physical therapist at Walter Reed, said with every patient treated at the MATC there’s a comprehensive evaluation. Care is focused on strength, range of motion, balance, pain and outcome measures. Polytrauma physical therapy includes phases of rehabilitation from acute, intensive, to ongoing. The MATC also incorporates a multi-disciplinary approach with goals, an expectation of success, peer support, leveraging technology and emerging capabilities (pain management, 3D printing, assistive technology, optimizing function), as well as virtual reality (Computer-Assisted Rehab Environment, or CAREN).
Josef Butkus, an occupational therapist at Walter Reed, said physical therapy (PT) and occupational therapy (OT) often work together with patients. However, OT is focused on helping patients regain their independence and ability to perform activities of daily living following illness or injury.
For more information about Limb Loss Awareness, DOD Advanced Rehabilitation Centers and the Extremity Trauma and Amputation Center of Excellence, visit https://health.mil/Military-Health-Topics/Centers-of-Excellence/EACE.
For more information about the National Museum of Health and Medicine, visit www.medicalmuseum.mil. The museum’s next Science Café is scheduled for May 25 at 6 p.m. and will focus on Mental Health Stigma: A Systems Perspective, in observance of Mental Health Awareness Month.

• Date Taken: 05.02.2023
• Date Posted: 05.02.2023 15:41
• Story ID: 443848
• Location: US