ABLEnews Extra

                    Helping Hand

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Baltimore--Slowly, laboriously, his brow knitted in concentration,
Kevin Hara picked up the pen in his right hand, positioned it firmly
between his thumb and first finger, and scribbled his name.

A few months ago, Hara, 21, a Georgetown University student paralyzed
below the shoulders and upper arms in a 1991 trampoline accident,
could not move his hand or fingers.

Now, with an experimental electrical stimulator implanted in his chest
to bypass his injured spinal cord and activate hand muscles, he is
able to write, grasp a cup, shave, brush his teeth, and tap out
letters on a computer keyboard.

Hara was one of three quadriplegic patients who gathered at the
Veterans Affairs Medical Center today to demonstrate the new
technology, called the Neuroprosthetic Hand Grasp System.

Medical investigators in Baltimore, Cleveland, Philadelphia, Boston,
Palo Alto, CA, and Melbourne, Australia, hope to get US Food and Drug
Administration approval of the experimental technology within a year
and put it on the medical market in 5 within 5 years.

"It's made a big difference in my life," Hara said. "I'm able to do
more, but it's also improved my confidence." A junior at Georgetown,
he said he hopes to become a doctor and specialize in psychiatry.

Restoring the ability to do things "the rest of us take for granted"
is often slow and halting, with rewards measured in miniscule
improvements day to day, said Peter H. Gormon, the neurologist who
heads the Baltimore program.

"After you break your neck," said Jo Heiden, 30, of Arlington, a
quadriplegic who was injured in a fall 11 years ago, "anything you can
do to get some independence back is important."

Besides the patient in Baltimore, an additional 21 are enrolled in
similar programs in the other cities. The implant surgery and long
follow-up therapy for patients to learn how to use the muscle
stimulator costs about $35,000, doctors say.

Restoring muscular activity for paralyzed patients is not new.
Paraplegics since the late 1970s have use external stimulators on
their legs to help them walk. But the technology demonstrated today is
th only one using a surgically implanted stimulator to restore
functional movements in the hands and fingers of quadriplegics,
according to Gorman, chief of rehabilitative services at the V.A.
hospital in Baltimore. He is also an assistant professor of neurology
at the University of Maryland Medical Center.

Not all paralyzed patients are suitable for the implant program. Of
the 90,000 people with quadriplegic spinal injuries in the United
States, Gorman said, only about 14,000 might be suitable--those able
to move their shoulders, and bend their elbows, but not use their
hands.

In spinal cord injuries, "the brain is no longer able to send messages
to the nerves in the arm," said W. Andrew Egsleder, an orthopedic
surgeon who performed the implants on Hara, Heiden, and Jeanette Semon
last year. The new technology, he said, "sends signals to the muscles
directly, in effect, bypassing the patient's damaged nervous system."

An electrical stimulator smaller than a cassette is implanted in the
upper chest and connected to a series of wires embedded in the arm
from the shoulder almost to the wrist. The wires are attached to seven
electrodes sewn into paralyzed forearm muscles that control the hand.

The stimulator is attached outside the body to a comoputerized radio
transmitter control unit that the patient attaches to the back of a
wheelchair. The control unit also is attached by wire to another
device taped to the chest and shoulder. By moving the shoulder up and
down or backward and forward, the patient signals the control unit to
send electrical impulses through the stimulator and down into the arm
muscles to activate finger and hand movement.

After the surgery, patients are usually hospitalized for three to four
weeks. Then slowly they begin months of physical therapy, learning
"grasp patterns" and "integrating them into their daily routine," said
Linda M. Marshall, chief of occupational therapy at the V.A. hospital.

The Baltimore program is funded by a $170,000 grant from the
Department of Veterans Affairs and involved no cost to the three
patients.

The three Baltimore patients, sitting side by side in wheelchairs,
eagerly displayed their newly recovered skills.

Semon, 30, a Department of Agriculture budget analyst who lives in
Chantilly, leaned forward, picked up a fork, and pierced a oink ball
of Play-Doh on a plate. "Yum," she said, pretending to take a bite.

Heiden, a computer software engineer, typed a quick message on a
computer keyboard with one finger. That may not seem much, she siad,
but before the implant surgery. She could only jab at the keyboard
with a broken pencil wedged in a splint on her arm.

[Every Movement Counts, Paul Valentine, Washington Post, March 25,
1995]

CURE Comment: We applaud and encourage efforts to improve the
              opportunities of all persons to enjoy the goodness of
              life. But in a TAB society that judges people by the
              superficial criteria of what they can DO, we remind
              ourselves and others that what really counts is what we
              ARE--and that is a function of our hearts and souls (our
              being), not our arms and legs (our doing). In sum, we
              respect our brothers and sisters because we are
              created in God's image, not because we can do tricks.

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