ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Thursday, September 26, 1996 TAG: 9609260067
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: ROCKVILLE, MD.
SOURCE: Associated Press
NOTE: Above
The partially paralyzed may soon get an electronic hand to help restore the ability to write a letter, pour coffee, even paint.
Scientific advisers recommended Wednesday that the Food and Drug Administration approve Freehand, a surgically implanted device that would become - if the FDA agrees - the nation's first neural prosthetic to restore function to a paralyzed limb.
Experts emphasized it's not a cure for paralysis. Only certain partially paralyzed patients could use it, not the severely injured such as actor Christopher Reeve. And while it does help those who can use it to move their fingers and thumb, such patients still won't be speed-typing or playing the piano.
``We mustn't give false hope,'' said Dr. Michael Keith, a Case Western Reserve University orthopedic surgeon who helped colleague Hunter Peckham create the device.
But now, ``for most of these patients, there's darn little,'' Keith said. ``We're going to give them more motor control so they can do more things, without assistance, hesitation and delays.''
Today, such patients get some help from external devices that let them type on computers by blowing into a mouthpiece, or feed themselves with a fork strapped to a hand.
An estimated 54,000 Americans have the type of paralysis, caused by spinal cord injury, that would make them eligible for the Freehand, to be sold by NeuroControl Corp. of Cleveland.
The Freehand system essentially is an electronic substitute for the brain's nerve impulses, which in people with healthy spinal cords tell the hand to move.
A surgeon implants a 2-inch device into the chest, threads electrodes under the skin down to the hand and attaches them to hand muscles. Only one hand can be implanted, because the opposite shoulder is needed to control the device. Under their clothing at one shoulder, patients wear a small joystick that controls the opposite hand in response to slight jerky movement of the shoulder.
The jerking motion sends the electronic signal to the implant to tell the thumb to move toward the fingers in a ``pinching'' motion. The faster and harder the patient jerks the shoulder, the faster and harder the hand pinches together to grasp a fork or pen.
Tap a button on the chest with the arm, and the device forces the muscles into a more intricate movement to grasp a larger object such as a cup.
Two hand movements don't sound very impressive, Keith acknowledged, but his evidence that it's more than it seems comes in videotape NeuroControl made of the 38 patients who have used Freehand.
One, identified only as Kathy, previously needed someone to pour her coffee, stick a fork into her hand and wedge a telephone between her shoulder and her ear.
With the device, Kathy did all that herself and even put on her makeup. Keith said the woman has since moved out of a nursing home and is receiving job training.
FDA advisers called Freehand impressive but warned that it will not benefit every patient and that many patients won't want it.
Indeed, six months after NeuroControl's patients were taught to use Freehand, 23 percent said they didn't use or rarely used it, noted Dr. David Good of Wake Forest University.
A patient must undergo a three-month process that starts with conditioning often-atrophied muscles, the surgery, then rehabilitation to use the device.
The system is expected to cost between $40,000 and $50,000.
LENGTH: Medium: 72 linesby CNB