Submission For The Record of Alvin C. Pike, CP, Minneapolis, MN, Veterans Affairs Medical Center, Lead Prosthetist, Veterans Health Administration, U.S. Department of Veterans Affairs, on his own behalf
Congressman Michaud and members of the Subcommittee on Health, thank you for this opportunity to allow my statement to be a part of your proceedings.
The views and opinions expressed are my own, and do not necessarily represent those of my current employer, the Department of Veterans Affairs or those of the VA research community. They do however represent my forty-three years as a prosthetist with a portion of that time in upper management with the world’s largest manufacturer of components for artificial limbs, and leadership offices within the prosthetics and orthotics profession.
Today we see in the news media - brought about by the coverage given to amputees from Operation Enduring Freedom/Operation Iraqi Freedom - new high tech components for prostheses. An essential component to the success of this new technology is the man/machine interface that is called the socket. Although there have been numerous variations on socket design over the intervening half century, there have been no significant biomechanical studies of this integral portion of the prosthesis since research done at University of California Los Angeles in the 1950s. Any variations on basic designs have primarily come from the work of independent clinical prosthetists in private practices.
In addition to socket design, I believe more research is needed on how the alignment of the components effect function, on socket suspension methods, and on the development of evidence based practice.
Center in Orthotics and Prosthetics conducted an on-line forum followed by a meeting of prosthetists, orthotists, research engineers, and users of artificial limbs and braces. The report generated by this forum/meeting (attached) corroborates the pressing need for the type of research I have listed above. In fact, though virtually all participants agreed on the importance of research, most believed the current quantity of research to be insufficient. I believe this must be rectified to appropriately serve our veterans.
The following is taken from: Prosthetics/Orthotics Research for the Twenty-first Century: Summary 1992 Conference Proceedings - John W. Michael, MEd, CPO, John H. Bowker, MD..
“The period from 1945-1965 is now viewed as a time of unparalleled scientific and technical advances in O&P. Key findings from this era still provide the conceptual basis for virtually all contemporary techniques. Although many factors have contributed to the long-term successes of this era, two key aspects were the coordination of research and evaluation efforts and the long-term commitment of significant governmental funding.”
“Although the field is currently in a relatively high state of clinical development, most advances in recent decades have been technical. Little or no advances in fundamental principles have occurred since the termination of significant governmental funding for O&P research and development in the 1960s.”
In closing I would like to quote The Honorable Anthony J. Principi, from a speech given on November 17, 2003 in
Arlington, Virginia .
“Good afternoon, and thank you for inviting me to help launch a new beginning for both VA’s orthopedic and prosthetics research and development, and for a brighter future for America’s disabled service members and veterans, men and women who now bear the burdens of mid-20th Century technology even as they live surrounded by the envelope pushing technologies of the 21st Century.”
Alvin C. Pike, CP
(Board Certified Prosthetist)
Past President -
Academy of Orthotists and Prosthetists
Attachments: NU State of the Science Report [The attachment is being retained the Committee files.]