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The WalkAide: A breakthrough device lets some people walk away from paralysis

These small, feel-good stories have popped up all over the country the past two years, mostly buried on the inside local news pages:

Chicago: Mother of three with MS finds new mobility.

St. Louis: Paralyzed girl walks again, with 'brain in a box.'

Santa Barbara, Calif.: Brain-damaged football player takes first steps.

Here are three new ones, all close to home:

St. Petersburg: Woman weeps as she sheds leg braces to wade barefoot into the surf.

Bradenton: Radiation-ravaged vet steps out of wheelchair.

Dunedin: Stroke victim can now walk to Mass.

Each is a small story about a small machine called a WalkAide. One at a time, they are adding up to a huge and growing medical victory over paralysis.

• • •

The device is an amalgamation of myriad, seemingly incompatible sciences. It combines, among other things, neurology, systems biology, microprocessors and things called accelerometers — the motion sensors in Wii games that translate a wave of your arm into a tennis serve or a golf swing on a video screen.

All of that technology comes disguised as a box that looks like an iPod, attached to a leather cuff. The little thing costs almost $5,000. It works on one AA battery.

At first designed for stroke victims, the WalkAide has been found to work for many with brain injuries, cerebral palsy and multiple sclerosis — those whose injuries or diseases have left them with a form of paralysis called "drop foot."

It doesn't work in every case, but when it does, it's a hallelujah moment — tears of joy guaranteed. People have strapped these boxes on their legs and walked, climbed stairs and danced — on their first day.

The device fires a jolt of electricity through the skin to the peroneal nerve — the nerve that runs along the outside of the lower leg below the knee. The jolt causes the nerve to stimulate the muscles that lift the foot. Each jolt is synchronized to accommodate gait. It fires only as the wearer steps forward, even as he or she speeds up, slows down, pivots or turns.

Medical science, as it is structured today, isn't particularly suited to the collaboration of technologies that are required to build a machine that makes a foot move.

Electrical engineers generally don't know that much about neuro prosthetics. Neurologists don't know much about video-game accelerometers.

"Research, even at universities, tends to be narrow in focus," says Conrad Kufta, chief medical officer of Innovative Neurotronics, maker of WalkAide. He himself is a neurosurgeon who specializes in epilepsy. "People haven't gotten credit for cross-pollinating. We have to think across platforms. We have to learn to work with people who think differently."

Another major challenge: Whatever scientists design for people can't look ugly.

"There are a lot of things you can do that work," Kufta says. "Patients look at them and say, 'Nice try. You don't expect me to wear that, do you?' "

• • •

Tina Mann was 16 when she tried a snowboard at an Ohio ski resort eight years ago. She hit a patch of ice and landed flat on her back. She knew she'd broken her arm. She walked to a ski patrol station, which got her to an emergency room. They put a cast on her arm and sent her home.

Three months later, Tina was paralyzed from the waist down. Doctors had missed swelling in her spinal cord, causing what looked like irreversible neurological damage. Her father, Bill Mann, remembers her lying flat on an examination table. "I watched this guy stick a needle in her leg, and she didn't feel a thing." The Cleveland Clinic said she would never walk again.

"I was shipped to a rehab center to learn how to be a paraplegic," says Tina, who recently moved to the Orlando area.

In rehab, she stared at herself in a mirror. She swore.

"This isn't going to last."

The first sign of hope was a twitch in the quad muscles of her upper legs. Then she was able to rotate her hips and bend her knees slightly. In braces, she was able to get up from her wheelchair and stand. But most of those first two years she spent in a wheelchair. Her triumph was hobbling across a stage in braces to receive her high school diploma.

Soon after, she shed the wheelchair for good and got by on braces. She discovered a ski boot worked like a brace and went skiing again. "I wouldn't go with her," says her father. Her therapy got her interested in orthotics as a career. She volunteered at the Cleveland Clinic. She enrolled in a training program at St. Petersburg College and later found work as a resident at a Hanger Prosthetics & Orthotics center in Clearwater. Hanger Orthopedic Group happens to be the parent company of Innovative Neurotronics, maker of WalkAide.

In early 2007, a few months after the contraption was cleared for sale, she asked to try it. At the Hanger office in Clearwater, an orthotist strapped one to each calf, just below the knee. She walked across the office, her gait perfect. She was walking barefoot. She had not walked barefoot since her accident.

"I felt the ground under my feet."

She drove to the mall and bought sandals and flip-flops. Then she drove to the beach at Treasure Island. She walked across the beach, feeling sand between her toes. She waded into the surf.

"As soon as I hit the water, I started sobbing."

• • •

William Whitehair was a Marine in the 1950s. His job was maintaining 40-ton amphibious assault vehicles in California.

Some of those were used in atomic bomb tests in Nevada in 1953. After the tests, the scorched hulks were shipped back to Whitehair's repair yard. He helped strip them for spare parts.

Whitehair says the 29 other men he worked with are now dead. Four died this past year, he says. In 1992, he was diagnosed with a nerve disorder called peripheral neuropathy — which he thinks was caused by his radiation exposure. It caused extreme weakness in his legs, paralysis in his feet. He was given plastic leg braces. In 1998, he fell and broke his left knee. In 2004, he fell again, breaking his left femur.

Three months ago, the Bay Pines VA Medical Center invited Whitehair to try two WalkAides, one for each leg.

"I was their guinea pig."

Twenty-five doctors and therapists watched as he walked up and down a hallway.

"I sat there and cried," his wife, Brenda, says.

VA let him keep the WalkAides — no charge.

Whitehair's injuries are such that he still needs a cane to walk. But his wheelchair usually stays parked, and he can now help care for Brenda's 95-year-old invalid father.

His triumphs are humble and intimate.

"For the first time in five years," says the 76-year-old former lance corporal, "I walked through a grocery store with my wife."

• • •

Bob Willms was an aerospace engineer for Honeywell. He helped design the space shuttle. He also played a fierce handball game.

A year after he retired in 2005, he had a heart attack on the handball courts. After bypass surgery, he suffered a stroke that left him paralyzed on his left side. He was 63, unable to use his left hand or leg.

Therapy helped him walk again, using a brace and a cane. He returned to the handball courts, took a seat on the bench. For three months, he sat on the bench and watched. That was all he could take.

"I stopped going."

The guys kept his name on the roster.

Willms got a WalkAide last Christmas. It wasn't covered by insurance. He had to cash in part of his 401(k). But he could walk a half-mile to morning Mass. The engineer in him was fascinated with all that technology inside the little box. He resisted taking it apart.

Two months later, his two daughters, Ginny and Kathy, took him as their date to a Valentine's Day dance.

"We danced all night."

Handball is still too much for him, even with his WalkAide.

• • •

Willms also has a paralyzed left hand. Wouldn't a HandAide be nice, he asks. There is no such thing.

"Hands are a goal," says Kufta of Innovative Neurotronics.

The Pentagon is funding a project to develop a bionic arm for amputees. Some of that technology may be transferable to hand paralysis research.

But natural hand motion is far more complex than foot motion. Ask any marching soldier about his feet. He picks them up, he puts them down.

The hand is poetry. It requires the largest part of the motor area of the brain. Imagine the neurological complexities behind the simple act of changing a light bulb — the leaning forward, the slight twist of the shoulder, the grasp of the bulb, the turning action, the reaching into a pants pocket for a new bulb — all done effortlessly, unconsciously.

Kufta says science will likely focus on what people with paralyzed hands want most. They usually say they most want to use a knife and a fork.

"That's a whole lot of movement, balance and counter pressures," he says. "Whatever we develop will not be as simple and elegant as the WalkAide."

But 25 years ago, he says, who would have guessed that amputee athletes would out-sprint two-legged rivals by running on carbon-fiber prostheses that look like machete blades? Those were the product of an MIT "biomechatronics" lab, another breakthrough in the merger of biology, mechanics, and electronics.

"The good news is a lot of people are recognizing this as the new frontier."

John Barry can be reached at jbarry@sptimes.com or (727) 892-2258.

.On the Web

To see WalkAide users walking with
and without the device, see our video report
at magazine.tampabay.com.

For more information, go to walkaide.com.

The WalkAide: A breakthrough device lets some people walk away from paralysis 10/10/08 [Last modified: Sunday, October 12, 2008 9:07am]

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