[Congressional Record (Bound Edition), Volume 155 (2009), Part 6]
[Senate]
[Pages 8052-8053]
[From the U.S. Government Publishing Office, www.gpo.gov]




                  REHABILITATION INSTITUTE OF CHICAGO

  Mr. DURBIN. Mr. Presdient, researchers at the Rehabilitation 
Institute of Chicago pursue scientific discoveries that blend the most 
advanced medicine with technology to create ability where it has been 
lost.
  Their most recent innovation replaces a lost limb with a robotic one, 
which is controlled just as their lost arm was controlled--by thoughts 
and commands transmitted by the brain.
  It has captured the world's attention. Their research was published 
recently in the Journal of the American Medical Association and 
highlighted by the New York Times. It gives us a taste of what might be 
possible as doctors, scientists, and engineers continue to learn more 
about the human body's nervous system.
  It also provides new hope for all Americans who have an amputated arm 
or leg, including the hundreds of Iraq and Afghanistan veterans who 
have lost a limb through their service to our country.
  You almost need to be a biomedical engineer to even pronounce the 
name of the technique developed at the Rehabilitation Institute of 
Chicago: pattern-recognition control with targeted reinnervation.
  But it is easy to understand the procedure's importance to people 
around the world who have lost a limb.
  When a person loses a limb, their brain does not know that the limb 
is gone. The brain continues to send signals through the nervous 
system, as if that lost arm or leg still existed. So, when a person who 
has lost an arm thinks about closing her hand or pointing a finger, her 
brain continues to send signals intended for the missing limb.
  Dr. Todd Kuiken, a biomedical engineer and physician at the 
Rehabilitation Institute of Chicago, has found a way to harness these 
signals. His technology allows a patient to operate her prosthetic arm 
by thinking of the movement, as if her natural arm still existed.
  First, Dr. Kuiken takes the good nerves that remain in the shoulder 
after the loss of an arm. Through surgery, these nerves are redirected 
and implanted into a patient's healthy remaining muscles in the chest.
  When the patient thinks about closing her hand, the brain sends a 
signal through those redirected nerves into the reinnervated muscle, 
instead of in the direction of the missing arm.
  The next step is to interpret those signals. It is not an easy task. 
Our hands alone can perform hundreds of movements, from the slightest 
finger wiggle to the clenching of a fist. Each movement is the result 
of a different pattern of signals from the brain. The challenge becomes 
deciphering which pattern means ``close the hand''? Which pattern means 
``turn the wrist''?
  Working to unlock the code, Dr. Kuiken and his colleagues now know 
which pattern is intended to produce a particular arm or hand movement. 
They place tiny antennas on the patient's chest to detect the patterns. 
The antennas convert the patterns into digital signals and send those 
signals to an advanced artificial arm worn by the patient. The signals 
tell the arm how to move.
  The results of Dr. Kuiken's research have been promising. Amanda 
Kitts was one of the first patients to be fitted with one of the new 
prosthetics developed by the Defense Department's advanced research 
program, DARPA.
  Amanda owns three daycare centers in Tennessee. She started working 
with the Rehabilitation Institute in 2006 and spent the following years 
traveling between Chicago and her home in Knoxville.

[[Page 8053]]

  Amanda lost one of her arms in an automobile accident. The years she 
received therapy were difficult for her. She credits the therapists at 
the Rehabilitation Institute for giving her the strength to realize 
that her injury didn't have to change her outlook on life.
  Amanda thought she would never be able to hug children again, 
including her son. But because of her new arm, she can.
  She says of her new arm: ``It was wonderful . . . It made me feel 
more human because I could work it almost like a regular arm. I just 
had to think and it responded. My new arm made me feel like I could do 
anything again.''
  Dr. Kuiken and the Rehabilitation Institute of Chicago have been 
working for several years to transfer this technology for the benefit 
of our wounded servicemembers. Through this collaboration, 10 wounded 
warriors have received this remarkable surgery at the Brooke Army and 
Walter Reed Medical Centers and are having their new prostheses fit at 
these state-of-the-art medical facilities.
  Dr. Kuiken and the other researchers on this project deserve our 
thanks for their efforts, as does the Rehabilitation Institute of 
Chicago. Every year since 1991, U.S. News and World Report has 
identified the facility as the best rehabilitation hospital in the 
United States.
  The Rehabilitation Institute is led by the indefatigable Dr. Joanne 
Smith, who did some of her training and subsequently consulted on 
patients at the VA. In addition to having expertise in prosthetics, the 
hospital is a leader in the treatment of traumatic brain injuries, the 
signature injury of the wars in Iraq and Afghanistan. Dr. Smith has 
worked to make her hospital's expertise and rehabilitation services 
available to the VA and the military services.
  More work remains to be done to develop the targeted reinnervation 
technique. The researchers at the Rehabilitation Institute tell me that 
the sensation nerves to and from a hand--which relay touch sensations 
from hot to cold and sharp to dull--can also be harnessed. Doctors are 
working to put sensors into a robotic limb that has the ability to pick 
up these sensations.
  If successful, the technique would allow patients to feel what they 
touch, as if they were touching it with their missing hand.
  Such technology will help someone like Amanda Kitts regain her 
ability to sense touch from--feeling the texture of an object to 
knowing how hard she is squeezing her son's hand. The advance in 
sensing touch would help her reconnect to her world.
  I am proud to have supported a $2 million request in the fiscal year 
2009 Defense appropriations legislation to help advance Dr. Kuiken's 
research in Chicago. Those men and women in uniform who have lost a 
limb in service to our country deserve the best technology we have to 
help them regain their full abilities.

                          ____________________