REPORT ON A CONFERENCE ON MOTOR PROSTHESES FOR WORKPLACE MOBILITY OF PARAPLEGIC PATIENTS IN NORTH-AMERICA

On May 18, 1992 a symposium at Case Western Reserve University in Clev eland, Ohio, USA had the goal of defining the tasks needed to reach cl inical utility of investigational neural prosthetic ambulation devices . The characteristics and stage of development of four systems were de tailed: the Lousiana State University reciprocating gait orthosis (LSU -RGO) with muscle stimulation; the modular hybrid functional neuromusc ular stimulation (FNS) orthosis; the Cleveland VA-Case Western Reserve University (VA-CWRU) implant system; and the Parastep(R) system. Mult icenter clinical trials are underway for the Parastep system and are p lanned to start within the next 2 years for the LSU-RGO with muscle st imulation, the VA-CWRU 8-channel system, and the floor reaction orthos is component of the modular hybrid FNS system. Current investigational systems provide little advantage over the standing wheelchair in some occupations but they do expand social. recreational. and exercise cap abilities. Disabled people and some leading rehabilitation physicians are willing to test basic ambulation devices but the regulatory approv als must first be obtained for multicenter clinical trials. Corporate partners are central to the development of devices, their clinical tes ting, and their subsequent marketing. A kev requirement for developing and disseminating motor prostheses is the education of clinicians so that they will participate in trials and be prepared to prescribe the prostheses when they reach the market.