Affordable Prosthetic Knee Joint for Developing Countries Amputees

Pham Quy Thi upper limb amputee sheds 36 years of phantom limb pain with Mirror Therapy

Pham Quy Thi shares his amazing outcome with Robert Johnson PT

On November 23, 2013, Pham Quy Thi, a Vietnamese farmer, did not expect that his chronic phantom limb pain would be reduced just by concentrating on the movements of his intact hand in a mirror for ten minutes. Mr. Pham had lost his right arm in 1977 because of an exploding cluster bomb and suffered chronic pain in his phantom limb since then.

After just ten minutes of using Mirror Therapy, Mr. Pham exclaimed, "This is an amazing therapy! It is my very first time I have the chance to be experienced this and I know it works for me. I surely will bring this home and teach other survivors in my community”.

The fifty-eight-year-old was one of four land mine victims being trained by Robert Johnson of Achieve Orthopedic Rehabilitation and an Associate of End The Pain Project, to administer Mirror Therapy in a newly formed Peer-to-Peer program sponsored by Handicap International. The setting for this training workshop was the Mine Action Visitor Center run by Project RENEW in Dong Ha,Vietnam. 

Le Kien and Robert Johnson use a mirror to reduce Mr. Le's phantom limb pain

Mr. Le Kien was gardening in 1991 and struck a hidden cluster bomb. Not only did Mr. Le lose his left leg, he lost his baby daughter at the same time. Now a 55-year-old carpenter, he is a frequent guest speaker and story-teller at mine risk education programs for local school children.

In 1986, Hoang Xuan Phuong was tampering with an M14 mine also called a gravel mine in the vicinity of a former U.S. base when it exploded. Mr. Hoang was startled when he clearly 'saw' the mirror image of his lost arm. “It is the very first time, I can really recall my memory about my lost limb after more than twenty five years since the day I was amputated in a landmine blast”.

 Rear: Nguyen Thi Huong, Le Kien. Nguyen Xuan Tuan, Hoang Xuan Phuong, Phạm Quý Thí; Front: Phu Nguyen Thanh, Robert Johnson

The four volunteers at the Center also raise awareness of the many unexploded mines in Quang Tri Province and promote and advocate for the full application of the rights of persons with disabilities. 

This group was newly formed by Phu Nguyen Thanh, Facilitator/Support Staff at the Mine Action Visitor Center in August, 2013. Once the quartet have completed their own 30-day mirror therapies, they will go into surrounding communities to help other amputees still suffering phantom limb pain.

Huso, an upper limb Bosnian amputee in mirror session

Huso, an upper arm Bosnian amputee, was introduced to mirror therapy at an End The Pain Project workshop given in the Sarajevo headquarters of Hope '87, September '13. At the time he had been suffering phantom pain for over twenty years, a legacy from the war in Bosnia during the '90s.

Huso practiced the mirror therapy at home for thirty days, following a two times a day for fifteen minutes each session schedule. The outcome as Huso happily reports, is that the pain is reduced about 75% from what he had been experiencing.

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University of Leicester Insect Study could help boost biomechanical prosthetic limb development

Photo ©Tom Matheson

University of Leicester study shows insects can move without muscles using ‘clever biomechanical tricks’.

Neurobiologists from the University of Leicester have shown that insect limbs can move without muscles – a finding that may provide engineers with new ways to improve the control of robotic and prosthetic limbs.

The study, published in the journal Current Biology, helps to explain how insects control their movements using a close interplay of neuronal control and ‘clever biomechanical tricks’.

Research shows that the structure of some insect leg joints causes the legs to move even in the absence of muscles. So-called ‘passive joint forces’ serve to return the limb back towards a preferred resting position.

The passive movements differ in limbs that have different behavioral roles and different musculature, suggesting that the joint structures are specifically adapted to complement muscle forces. The researchers propose a motor control scheme for insect limb joints in which not all movements are driven by muscles.

Dr Tom Matheson, from the Department of Biology at the University of Leicester led the research and said he hoped the research on locusts and grasshoppers would “spur a new understanding of how limbs work and can be controlled, by not just insects, but by other animals, people, and even by robots”.

ETPP Mirror Therapy Workshop Focuses On Cardiovascular Amputees

Vascular Amputee uses Mirror

A recent Mirror Therapy Training Workshop at Holy Family Hospital, Vancouver, B.C.  for thirteen staff members focused on Mirror Therapy for Cardiovascular amputees.

A physiotherapist at Holy Family noted that her cardiovascular amputee clients usually suffer less intense pain in their phantom limbs than clients who were involved in a traumatic accident, perhaps because they do not carry a 'frozen' image connected to their phantom limb. 

The volunteer, a recent below knee amputee had been experiencing disruptive sleep because of phantom pain. Further investigation determined that he sensed his foot and toes contracted into his knee stump, a situation which would have complicated the mirror therapy treatment. 

Working as a team, the trainer and amputee brought the phantom limb down to the level of the intact limb. This adjustment will also help balance when learning to walk with a new prosthetic.

If neuropathy is evident in the 'intact' foot of a cardiovascular amputee, it may present further complications. A possible solution is for the client to wear a plain sock on the intact foot so that the mirror image limb is believable. 

 

New Research on Neurological Signals to Control Lower-Limb Prostheses

Researchers from North Carolina State University, Raleigh, and the University of Houston, Texas, have joined forces on a new, four-year, $1.2 million collaborative project to use neurological signals to control lower-limb prostheses and create a prototype device. Their work is funded by the National Science Foundation (NSF).

In recent years, researchers have developed powered prosthetic devices that use internal motors to improve the motion of the artificial limb. The goal of the NSF project is to improve the connection between the prosthesis and the person using it with sensors to pick up the neuromuscular control signals from residual muscles in the area where the prosthesis is connected to its user. The aim is to develop an algorithm that translates those neuromuscular signals into machine language that will control the powered prosthesis—making it easier for the user to move seamlessly from standing up, to walking across the room, to climbing the stairs.

The team also plans to build a prototype powered prosthesis that incorporates the new technology and will be exploring ways to use neurological signals from the brain to control prosthetic legs.

This is important for patients who have little or no residual muscle in the area of the missing limb because that lack of muscle makes it difficult to pick up neuromuscular signals. In those cases, signals picked up directly from the brain may be able to control the prosthesis.

Mirror Therapy Introduced To Bosnia

Bosnian Health Professionals

Though the war in Bosnia ended more than twenty years ago, there are still many amputees left who experience debilitating phantom limb pain.

To address this wide-scale problem, five Mirror Therapy workshops were presented in Bosnia during September '13 by Moira Judith Mann, co-founder of End The Pain Project .

The workshops marked the beginning of certified health professionals training other health professionals in Bosnia, with the expectation that Mirror Therapy will eventually reach amputees suffering phantom limb pain throughout the Balkans.

Training with mirror

Two workshops were held at Hope87 headquarters in Sarajevo, arranged by Dr. Amira Karkin-Tais and Dr. Murid Muftic and coordinated by Zana Karkin and Ivana Vujasin of the NGO. Fifteen health professionals received ETPP certificates of completion, which enables them to teach the therapy to other health professionals.

In Banja Luka, two workshops were presented to sixteen staff members of the ZFMR Rehabilitation Hospital through the cooperation of Dr. Natasa Tomic, ZFMR's Medical Director.

Banja Luka amputee using mirror

A workshop presented directly to amputees suffering phantom limb pain was held at the Organization of Amputees UDAS in Banja Luka, organized by Nikola Zec. The results were astounding and included the unfurling of phantom fingers by an amputee who had been experiencing a phantom clenched fist for twenty years after a device exploded in his hand.

Jasmin Avdovic, Physiotherapist/Occupational therapy practitioner, introduced Mirror Therapy training as an idea for future to 260 fellow physiotherapist members of UFFBiH in October, at their 1st Annual Congress. Participants from Bosnia, Serbia and Croatia responded to it with great interest due to high number of people with amputation, especially in Bosnia. He and others mentioned in this post plan to spread the benefits of Mirror Therapy through pan-Balkan workshops.

Targeted Muscle Reinnervation Improves Control of Prosthetic Devices for Amputated Arms

End The Pain Project's X-Border Wine Benefit A Success!

Jim Byrnes, Blues Guitarist

On August 10, 2013, residents of Point Roberts WA, a small resort town on the Juan de Fueca Strait, came out in droves to attend End The Pain Project's X-Border Wine Benefit and to enjoy the legendary blues guitar of Jim Byrnes.

Funding raised at this bi-annual event is dedicated to presenting Mirror Therapy Training Workshops in Bosnia this September and additional mirrors for amputees in central Vietnam.

A highlight of the benefit was Co-Founder Madeleine Anderson explaining the intricacies of Mirror Therapy to a rapt audience.

 

End The Pain Project acknowledges the support and generosity of its neighbors and the extraordinary efforts of volunteers who helped to make the Benefit a success.

First Rwandan Mirror Therapy Training Workshop

The first ETPP Mirror Therapy Training Workshop for Rwandan medical professionals was held on June 1, 2013 at St Paul Economat General, Kigali, Rwanda. Those who received certificates to practice Mirror Therapy included five nurses, two physiotherapists and one psychologist.

The four-hour Workshop was conducted by Jean Luc Ngarambe, an accredited Physiotherapist and the first certified End The Pain Project Mirror Therapy Trainer in Rwanda.

Many amputees suffer Phantom Limb Pain in their missing limb, often for years after the amputation. Phantom limb pain can be safely eliminated in just four weeks with simple, non-invasive Mirror Therapy.  The mirror reflection of the amputee’s good limb during specific exercises to retrain the brain’s sensory pathways, releases the pain.


End The Pain Project’s mission is to offer information and mirror therapy training for those aiding amputees in countries such as Rwanda where conflicts, trauma and disease make amputation more prevalent.

The  ETPP Mirror Therapy Training Workshops are ongoing in Rwanda and depends solely on public donations.

"End The Pain Project's contribution can be seen as a supplement to prosthetic and orthotic rehabilitation,” says co-founder Moira Judith Mann, ”It’s a very accessible means for amputees to recover from pain.”

Your Donation = A Pain-Free Life

Dear Friend,

That's Tanja H. smiling at you -- she's a Bosnian amputee, happy to be free of long-term Phantom Limb Pain after experiencing guided Mirror Therapy!

Over 80% of amputees in third world countries affected by land mines, war, and disease experience pain in the missing limb. This pain is called Phantom Limb Pain and can be agonizing, interfering with all aspects of life.This pain can be experienced decades after the amputation operation. Suffering is the same anywhere in the world.

Phantom Limb Pain can be safely eliminated in just four weeks with Mirror Therapy. The techniques are simple and non-invasive. The mirror's reflection of the patient’s good limb engaged in specific movements retrains the brain’s sensory pathways and releases the pain. Over 1,000 amputees have successfully undergone Mirror Therapy treatment at Walter Reed Army Medical Center.

    End The Pain Project (ETPP) trains and supports small grassroots teams of medical clinicians to deliver these non-invasive Mirror Therapy techniques and related information to amputees in hard-hit third world countries.

     In 2011-12, ETPP trained and certified 100 doctors, physical therapists and prosthetists in Vietnam and 36 physical therapists in Cambodia. This year, End The Pain Project brings mirrors and training workshops to Rwanda and Bosnia, where many survivor-amputees from the 1990 conflicts still suffer Phantom Limb Pain. Your thoughtful contribution to either project goes directly to logistical support, training, tools and other needs and is tax-deductible.

Consider honoring your Mom for Mother's Day with a donation to ETPP -- she'll be proud of you! Just click the yellow button on our ETPP website.

Thank you!

Moira Mann, Co-Founder
End The Pain Project
http://endthepainproject.org

Support End The Pain Project Mirror Therapy Training Workshops in Rwanda * Bosnia

Free Mirror Therapy Offered to Boston Marathon Amputees to Relieve Phantom Limb Pain

End The Pain Project, a non-profit organization, has created a special outreach project offering Free Mirror Therapy to Boston Marathon Amputees who are experiencing Phantom Limb Pain. The sooner this therapy is experienced, the sooner the relief and healing begins. Out of respect, ETPP will not solicit these maimed.
 

So we urge you to share this information on Facebook and Twitter in the hopes that it will reach a Boston Marathon Amputee in need. To donate to this effective ETPP Outreach Project, click on http://endthepainproject.org/

.For further information contact info@endthepainproject.org. Thank you for your support.

Free Mirror Therapy for Boston Marathon Amputees

End The Pain Project is offering one-on-one Free Outreach Mirror Therapy for Boston Marathon Amputees.







 For further information contact info@endthepainproject.org. To donate to this special program, go to http://endthepainproject.org and click the 'Donate' button.

Out of respect for the victims, ETPP does not solicit patients. We urge you to share this information on Facebook and Twitter in the hopes that it will reach a Boston Marathon Amputee in need.

Thank you.

Double Amputee Farmer Supports His Family Through Mushroom Farming

The inspiring full article Mushrooms-Help-Vietnam-Farmers-Maimed-by-War-Time-Munitions  appears in the Gulf Times 3/17/13.

Quadruple Amputee Gets New Hands

In 2012, Lindsay Ess underwent revolutionary hand transplants  after losing her limbs to an infection.

View an inspiring ABC slideshow at http://abcnews.go.com/Health/slideshow/lindsay-ess-quadruple-amputees-hands-18126047.