[Congressional Record Volume 141, Number 53 (Wednesday, March 22, 1995)]
[Extensions of Remarks]
[Pages E658-E659]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


          ANOTHER MEDICAL BREAKTHROUGH BY VA MEDICAL RESEARCHER

                                 ______


                      HON. G.V. (SONNY) MONTGOMERY

                             of mississippi

                    in the house of representatives

                        Wednesday, March 22, 1995
  Mr. MONTGOMERY. Mr. Speaker, I was very pleased to see news reports 
this week about an important scientific advance for people who are 
paralyzed.
  Stories in the Washington Post, the Baltimore Sun and other papers 
described the Neuroprosthetic Hand Grasp System--a new computerized 
device that can help some people with spinal cord injuries regain use 
of their hands.
  I was absolutely delighted to learn of this exciting work, because I 
believe it will bring hope to thousands of people who have lost so much 
through catastrophic injury.
  But I was also pleased by this news because it reflects the 
tremendous value of an outstanding research program that has not 
received the recognition it is due.
  This development for paralyzed persons--like many other medical 
advances--came from the research program of the Department of Veterans 
Affairs.
  Unfortunately, the public is not well informed about the work of VA 
scientists and researchers. They do not know that, over the years, VA 
research has established an impressive record for achieving health care 
improvements for disabled veterans, while bringing scientific advances 
for the society at large.
  VA researchers are responsible for breakthroughs such as the first 
effective drug treatment for schizophrenia, the pioneer kidney and 
liver transplants, the first cardiac pacemaker implant, and development 
of the scientific basis for computer assisted CAT scanning--which 
revolutionized diagnostic medicine.
  This program is one of the most cost-effective approaches to research 
anywhere in the medical world. It is based on a clinician-investigator 
approach, under which most of VA's scientists work in patient care 
programs, as well as in their laboratories.
  Our Nation owes a debt of gratitude to the entire VA research family. 
On this day, I especially commend the members of the VA research team 
that led the way in developing the Neuroprosthetic Hand Grasp System, 
and to their colleagues in the academic world and the private sector.
  We should take pride in the achievements of our VA medical 
researchers. This is a program that deserves our recognition and 
support as it seeks to improve the lives of all Americans.
  There follows the article which appeared on the front page of the 
Washington Post yesterday morning:
               [From the Washington Post, Mar. 21, 1995]

  Every Movement Counts--Device Gives Quadriplegics a Chance to Grasp

                         (By Paul W. Valentine)
       Baltimore, March 20.--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 
     who was paralyzed below the shoulders in a 1991 trampoline 
     accident, could not move his hands 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 Administration Medical Center today to 
     demonstrate the new technology, called the Neuroprosthetic 
     Hand Grasp System.
       Medical investigators in Baltimore, Cleveland, 
     Philadelphia, Boston, Palo Alto, Calif., and Melbourne, 
     Australia, hope to get U.S. Food and Drug Administration 
     approval of the experimental technology within a year and put 
     it on the medical market within five 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, he said he hopes to 
     become a physician 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 minuscule improvements day to day, said Peter H. 
     Gorman, 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 patients 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 
     said.
       Restoring muscular activity for paralyzed patients is not 
     new, Paraplegics since the late 1970s have used external 
     stimulators on their legs to help them walk.
       But the technology demonstrated today is the 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 
     VA hospital in Baltimore. He also is an assistant professor 
     of neurology at the University of Maryland Medical Center.
       The implant program is not suitable for all paralyzed 
     patients. Of the 90,000 people with quadriplegic spinal cord 
     injuries in the United States, Gorman said, only about 14,000 
     might be eligible--those able to move their shoulders and 
     bend their elbows but not use their hands.
       Another important factor, Gorman said, is to be ``highly 
     motivated to try the new technology.''
       In spinal cord injuries, ``the brain is no longer able to 
     send messages to the nerves in the arm,'' said W. Andrew 
     Eglseder, 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 nerve 
     system.''
       An electrical stimulator smaller than a cassette is 
     implanted in the upper chest and [[Page E659]] connected to a 
     series of wires that are embedded in the arm from the 
     shoulder almost to the wrist. The wires are attached to seven 
     electrodes that are sewn into paralyzed forearm muscles that 
     control the hand.
       The stimulator is attached outside the body to a 
     computerized 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 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 VA medical center.
       The Baltimore program is funded by a $170,000 grant from 
     the Department of Veterans Affairs and involved no cost to 
     the three patients.
       Similarly, programs in the other five cities are funded by 
     the department, the National Institute of Disability and 
     Rehabilitation Research and NeuroControl Corp., of Cleveland, 
     maker of the stimulator device.
       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 pink 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 said, but before the implant surgery, she could 
     only jab at the keyboard with a broken pencil wedged in a 
     splint on her arm.
       ``My typing speed has increased tremendously,'' she said.
       ``I can load and unload paper for my printer, too.''
       

                          ____________________