New devices can steady damaged limbs

By Russell Rian


Multiple sclerosis patient Dwight Riskey, empowered by a short burst of electricity, walks in a near-normal stride through the rehabilitation center at UT Southwestern.

It’s a device-aided feat that otherwise eludes Mr. Riskey, an active man with a chipper attitude. Progressive MS has left him with what’s commonly called drop foot, in which nerves don’t properly signal the toes to lift up as the heel descends. The result is a foot that drags.

“I started using a cane about eight years ago because I wanted to reduce the number of falls. The Bioness device has really helped me so I don’t really need the cane. I fall 50 times less than I did before,” said Mr. Riskey, a retired marketing executive with Frito-Lay.

Multiple sclerosis patient Dwight Riskey uses the Bioness device to restore function to his legs under the supervision of physical therapist Traci Bacon.

California-based Bioness Inc. has developed two appliances, one for legs and the other for arms, being used by rehabilitation therapists to help people regain the use of limbs that have suffered nerve damage due to accidents, traumatic brain injuries, spinal cord injuries or conditions such as MS. Each device is custom fit and includes sticky electrodes that fire signals to stimulate the particular muscles needed to improve function.

“We use the device as part of the medically designed therapy program aimed at returning as much muscle control as possible,” explained Dr. Karen Kowalske, chairman of physical medicine and rehabilitation, who oversees the outpatient therapy program in the Charles Cameron Sprague Clinical Science Building.

In Mr. Riskey’s case, one part of the Bioness L-300 device straps around his leg just below the knee with two receiver electrodes that are centered on the malfunctioning muscles. Inside his shoe is a wireless transmitter that signals the receivers when his heel hits the ground. The resulting impulse forces the front of Mr. Riskey’s foot up, restoring a more natural stride.

“I took the first three steps and broke into tears,” he said. “When you feel like you’re taking something like a normal step, it’s a pretty amazing experience.”

The device motivates many patients who have long struggled with movement as well as people who are just starting to deal with their condition, Dr. Kowalske explained.

“It is life-changing in the sense that you feel like you’ve opened up new avenues,” Mr. Riskey said. “You can do things you couldn’t do before.”

Some patients find that the impulses can teach the impaired nerves how to function on their own. For others, like Mr. Riskey, the device is worn permanently.

Similarly, the Bioness L-200 is designed to aid hand and arm rehabilitation. It can make it easier to drink from a glass, to reach, write or use both hands again.

Both devices help increase blood flow and extend range of motion, as well as reduce muscle spasms and prevent muscle atrophy.

Mr. Riskey said each Bioness-delivered shock is perceptible, but not painful. The intensity can be adjusted depending on how sensitive his leg is on a particular day.

“It’s so cleverly engineered. If you sit down, for example, it turns off and goes to sleep,” Mr. Riskey said. “When you stand up again, it wakes back up.”

UT Southwestern rehabilitation specialists also use electrical stimuli for diagnostic purposes. Electrodiagnostic studies evaluate nerve or muscle function and determine how it may be contributing to any numbness, pain or weakness the patient experiences. Common tests include electromyographic (EMG) exams, which measure activity in the muscles, and electroencephalography (EEG) exams, which measure brain function. In addition, evoked-response studies use the responses to electrical signals to evaluate hearing, vision, skin sensitivity and even brain-stem functions.

In addition to tapping into the medical center’s broad expertise, rehabilitation involves people.

“UT Southwestern has access to the latest high-tech devices and therapies,” Dr. Kowalske said. “But technology is just one component of a good, comprehensive recovery plan. It’s important never to lose sight of those human elements — the family members, the friends and the compassionate therapists — who help patients use the technology effectively in their unique environment, to benefit their personal goals.”

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Dr. Kowalske directs the Kimberly-Clark Center for Physical Medicine and Rehabilitation Research and holds the Charles and Peggy Galvin Professorship in Physical Medicine.