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Veterans Health Administration

VA Delivers Cutting-Edge Bionics to Above-Knee Amputees

Veteran standing sideways, one foot on the ground, the other, a bionic leg, on a stepladder

Former Marine William Gadsby displays his cutting edge hardware: a BiOM ankle linked with an X2 microprocessor knee made by Ottobock.
Photo: John Fox

The Department of Veterans Affairs now has the technology to enable Veterans with above-the-knee amputations to walk with a healthy, natural gait, just the way they did before they were injured.

“The BiOM is a unique piece of technology that actually mimics the human body and allows an amputee to walk with the same, natural gait as a non-amputee,” said John Fox, supervisor of the Orthotic & Prosthetic Services Lab at the Hunter Holmes McGuire VA Medical Center in Richmond, Va. “The system even contains a battery and a motor that provide you with a ‘power push-off,’ propelling you as well as the weight of the device. It literally mimics what our feet do when we walk.”

He added: “With a traditional prosthetic, you get tired because you’re using so much additional energy to move. With the BiOM, no additional effort is needed, so you don’t get tired.”

Over several hundred people with below-the-knee amputations currently wear the BiOM ankle, developed by a company called iWalk. Made possible by funding from the Department of Veterans Affairs and the Department of Defense, iWalk’s BiOM ankle is the world’s first bionic ankle system that utilizes robotics to restore the function of missing anatomy in the calf muscle and Achilles tendon.

Recently, however, VA has begun mating the bionic ankle with a microprocessor knee to allow Veterans with above-the-knee amputations to walk normally. iWalk refers to this ankle-knee combo as the BiOM ‘AK.’

“This device is literally a miracle,” said William Gadsby, a 34-year-old Veteran who has been outfitted with both the BiOM ankle and a microprocessor knee known as the X2, made by a company called Ottobock. “A few months ago I was walking at nighttime and had my hands in my pockets. For the first time in four years I was able to look up at the stars without stopping to balance myself. I’ve been able to walk up steep hills and stairs. I can walk down steep grades, and have been able to do some Yoga stances. Just walking —in and of itself— is awesome.

“I recently took my family to the Outer Banks in North Carolina,” he continued. “I was able to walk up the sand dunes with no problem. In fact, I kept shouting to my wife and my three-year-old son to keep up with me! I also went hiking in the Shenandoah Valley area of Virginia with a 50-pound pack. I was going up some pretty steep trails, and I wasn’t getting tired.”

“I feel like a normal person again.”

— Former Marine William Gadsby

Gadsby is a former Marine who was badly injured by an IED while on a foot patrol in Al Anbar Province, Iraq. He said his iWalk equipment has not only allowed him to walk as fast or faster than ‘organic’ people, but has also made a big difference for him emotionally.

“I am a cranky guy normally,” he admitted, “but my wife has noticed a major psychological change in me. Before the BiOM my body was more worn out with pain and I was always dead tired when going somewhere. Now I’ve got zero back pain. I’m active from the time I wake up till the time I fall asleep. My depression has largely receded. I’m more confident and feel closer to how I felt before I was wounded. I feel like a normal person again.”

Along with providing state-of-the art bionics, VA also makes sure the equipment is fine tuned to each individual wearer.

“Personal Bionic Tuning is a proprietary process where a computer first overlays an accepted range of natural motion for the gait cycle,” explained iWalk Representative Ryan Hixenbaugh. “The BiOM is then adjusted for that individual to perform within ‘normal’ parameters. The device is then further adjusted to fit the preferences of the wearer. It’s an incredible level of personalization.”

Cezette Leopold, a VA prosthetics representative based at the VA medical center in Richmond, said VA’s goal is to transform Veterans who have lost limbs into completely able-bodied individuals who do everything they want without thinking about their mobility.

“And the real payoff is better health,” Leopold noted. “Amputees outfitted with this technology will be healthier because they can lead much more active lives.

“Healthier amputees equates to a significant reduction in health care costs,” she continued. “Amputees who have less exhaustion and less pain tend to move around a lot more. They lose weight. They reduce their reliance on pain medications. They even return to work.”

Dr. Douglas Murphy, a staff physician at the Richmond VA Medical Center, agreed. “The BiOM ankle,” he said, “when coupled with the microprocessor knee, significantly improves the physical health of above-the-knee amputees by normalizing metabolic and walking speeds. This, in turn, enables reductions in energy consumption and also alleviates things like lower back pain and knee osteoarthritis.”

He added: “This technology is going to mean the difference between night and day for many of our amputee Veterans. Here at VA we’re very proud to have helped pioneer this incredible breakthrough in bionics.”

Related link: Prosthetic and Sensory Aids Service (PSAS)