Casualties of war: robotic, biological research aiding military amputees.

• Author: Pappalardo, Joe

Hugh Herr sits alongside a colleague, watching the man's extended right foot rotate in mid-air. Herr, a double amputee who lost his legs to frostbite when he was 17 years old, attempts to replicate the motion, but the brain's commands stop at the stump just below his knee. Nevertheless, Herr's nervous system is still sending electrical signals as if the entire limb were there.

Researchers, the Massachusetts Institute of Technology assistant professor says, need to translate those brain signals into a language a robotic limb can understand. That way, advances in artificial limbs have the potential to approach the capabilities of a real leg. "In five to 10 years, I think we'll see an unprecedented level of innovation," Herr says.

Herr is a leading researcher in the Department of Veterans Affairs new five-year program, aimed at helping soldiers who lost limbs in combat. At the core of this program are new technologies meant to seamlessly fuse prosthetics with the human body.

Herr's role in this new effort is creating ankles and knees that are controlled by the amputee's nervous system and possess their own self-generated power. His blueprint for this is the human body: "We're trying to steal nature's secrets."

It is the first time that the many disciplines needed to create a biorobotic hybrid limb have been gathered under one structure. Success depends on developing new ways to grow bone, fuse robotics with the body parts and control artificial limbs using commands from the brain.

The VA's renewed emphasis on limb loss is its answer to the casualties of wars in Afghanistan and Iraq. According to statistics from the New England Journal of Medicine, for every soldier killed in Iraq, nine others have been wounded and survived, the highest rate of any war in U.S. history.

"Thanks to advances in battlefield first aid and protective body armor, many soldiers or Marines who otherwise would have been killed in action are able to return home," says Stephen Fihn, the VA's chief research and development officer. "Unfortunately, many of them must undergo amputation of the feet, hands, arms or legs, and in many cases, multiple limbs."

The VA's research and development service in late 2004 dedicated $4.7 million to establishing a center that is dedicated to researching these cutting-edge technologies to help make prosthetics more effective. The project involves partners such as Herr at MIT and medical researchers at Brown University.

Roy Aaron serves as the director of the Restorative and Rehabilitation Center that was created specifically for the project. It is located at the VA Medical Center in Providence, R.I. Aaron says that the project now just exists as a sign on a door, but he hopes it will evolve into two physical centers for research and rehabilitation.

For now, all research and clinical care is being done at the research labs and hospitals, a "center without walls." It is his job to integrate the many sciences into actual products that are used by amputees. In February, center officials visited Walter Reed Army Medical Center to coordinate the research and assess the needs of their patients.

"It's important to recognize this as more than just a research grant," Aaron tells National Defense. Some of the technologies will be ready before others, and the goal...