New Brace Salvages Limbs, Mobility, Morale

SAN ANTONIO – A wound­ed war­rior limped into Ryan Blanck’s office at the Cen­ter for the Intre­pid here one day with a plea for help.

Ryan Blanck, a pros­thetist and devel­op­er of the Intre­pid Dynam­ic Exoskele­tal Ortho­sis, dis­cuss­es how he makes the device in his lab at the Cen­ter for the Intre­pid in San Anto­nio, Nov. 9, 2011. The brace reduces pain for sol­diers who suf­fered low­er leg injuries and increas­es mobil­i­ty, includ­ing the abil­i­ty to run.
DOD pho­to by Lin­da Hosek
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Ryan Blanck, a pros­thetist and devel­op­er of the Intre­pid Dynam­ic Exoskele­tal Ortho­sis brace, fits one of his braces on Army 1st Lt. Matthew Ander­son, an infantry pla­toon leader, at the Cen­ter for the Intre­pid in San Anto­nio, Nov. 10, 2011. Anderson’s heel shat­tered when he stepped on a land­mine in Kan­da­har, Afghanistan, in Octo­ber 2010. The brace reduces his pain and enables him to run again.
DOD pho­to by Lin­da Hosek
Click to enlarge
Army 1st Lt. Matthew Ander­son, an infantry pla­toon leader with an injured low­er leg, tries out the fit of an adjust­ed Intre­pid Dynam­ic Exoskele­tal Ortho­sis brace as Ryan Blanck, the brace’s cre­ator, watch­es him walk at the Cen­ter for the Intre­pid in San Anto­nio, Nov. 10, 2011. Ander­son returned to the cen­ter to have one brace adjust­ed and get fit­ted for anoth­er.
DOD pho­to by Lin­da Hosek
Click to enlarge

The doc­tors at Brooke Army Med­ical Cen­ter had saved the ser­vice member’s leg after a com­bat injury, but due to the pain, he couldn’t walk com­fort­ably, let alone run.

Blanck, a lead­ing pros­thet­ic at the state-of-the-art rehab cen­ter, found him­self in an unfa­mil­iar posi­tion: at a loss. “There wasn’t a go-to option,” he said, refer­ring to devices for wound­ed war­riors with low­er leg injuries.

So Blanck cre­at­ed one. He designed the Intre­pid Dynam­ic Exoskele­tal Ortho­sis, or IDEO, a stream­lined, ener­gy-stor­ing brace that deliv­ers near­ly instan­ta­neous results. Now, most troops with sal­vaged limbs who wheel or limp into his office walk out a short time lat­er, pain and limp-free.

The injured war­riors are impressed by the results. When they strap on the brace for the first time and start walk­ing, Blanck said, some stum­ble mid­way across the room, but not due to dis­com­fort.

“They’re uncon­trol­lably weep­ing,” he said. “It’s the first time they’ve walked with­out pain in two or three, or sev­en years in one guy’s case.”

Brace Proves to be ‘Game-Chang­er’

Blanck’s cre­ation is a light­weight, stream­lined car­bon-fiber device that can be tucked under a pant leg and into a boot or sneak­er. It com­pris­es a cuff that wraps around the leg just under the knee con­nect­ed to a foot­plate by car­bon-fiber rods.

The brace works by offload­ing the limb and allow­ing the patient to oper­ate the low­er limb in a way that avoids pain, he explained. When a ser­vice member’s heel strikes, the device stores ener­gy through the gait cycle, then deliv­ers it back to pro­pel the foot for­ward.

“That’s the con­cept behind it all; ener­gy stor­age and pow­er,” he said.

Pri­or to IDEO, Blanck not­ed, “there wasn’t a com­bi­na­tion device that would allow offload­ing, ade­quate range restric­tion and then pow­er gen­er­a­tion.”

The device is prov­ing a “game-chang­er” for ser­vice mem­bers with sal­vaged limbs, said John­ny Owens, a CFI phys­i­cal ther­a­pist who is work­ing hand-in-hand with Blanck in treat­ing IDEO-fit­ted war­riors. “We’re see­ing imme­di­ate changes we don’t usu­al­ly see,” he said. Owens said the device also is sin­gle­hand­ed­ly help­ing to turn the tide on a trend of wound­ed war­riors opt­ing for delayed ampu­ta­tions — ampu­ta­tions sev­er­al months after injury. He attrib­ut­es the trend to the slow, and some­times frus­trat­ing, recov­ery for troops with low­er leg injuries.

“Pri­or to all this, limb sal­vage was a lit­tle bit of an unknown,” Blanck explained. “You couldn’t tell a patient, ‘you’re going to run.’”

But amputees — depend­ing on the sit­u­a­tion and bar­ring oth­er injuries — can regain sig­nif­i­cant func­tions about six months after ampu­ta­tion, he not­ed. Mean­while, limb sal­vage patients sit on the side­lines watch­ing their amputee bat­tle bud­dies walk­ing or run­ning as their own progress pro­ceeds painful­ly slow.

Frus­trat­ed by their lim­i­ta­tions, some troops with sal­vaged limbs opt­ed for late ampu­ta­tions.

“It’s entic­ing,” Owens said. “You’re in pain, but if you cut your leg off, you can run. Many invest­ed a year or two in recov­ery and then decid­ed to cut [a limb] off. It was psy­cho­log­i­cal­ly frus­trat­ing to see these guys work so hard and then just cut it off.”

Thanks to IDEO, these troops now have anoth­er option, he said, that enables them to not only walk, but run, sprint and jump.

Return­ing to Ser­vice

Word is spread­ing of IDEO and its astound­ing results, and Blanck now is fit­ting troops from around the coun­try with his device. After hear­ing of Blanck’s and Owens’ suc­cess, Army 1st Lt. Matthew Ander­son trav­eled here from his unit at Fort Car­son, Colo., hop­ing for sim­i­lar results.

Ander­son, an infantry pla­toon leader, was injured in Octo­ber 2010 while on a dis­mount­ed com­bat patrol in Kan­da­har, Afghanistan. As his unit cleared a build­ing, he stepped on a land­mine. “It felt like a jack­ham­mer hit­ting my ankle,” he recalled. The explo­sive shat­tered his heel into a dozen pieces.

The doc­tors sal­vaged his limb, but the injury left Ander­son in pain and with a pro­nounced limp. While he was able to start walk­ing again after about six months, this strap­ping, life­long ath­lete fig­ured his run­ning days were over.

It took Blanck just a few min­utes to prove him wrong. With the IDEO, Ander­son was walk­ing com­fort­ably with­in min­utes and run­ning with­in days.

“It put the biggest smile on my face,” the infantry pla­toon leader said. He had stopped by the CFI ear­ly one morn­ing so Blanck could make adjust­ments to his device and fit him for anoth­er.

“I went from walk­ing with a severe gait issue and a limp to walk­ing nor­mal­ly,” Ander­son said.

Blanck fin­ished his adjust­ments, and Ander­son pulled a sneak­er over the foot plate and walked across the office with a smooth stride.

Once he got the brace, “I could run on it, jump ver­ti­cal­ly, lat­er­al­ly shuf­fle,” Ander­son said. “Things that there’s no way I’d be doing with that much speed, effi­cien­cy or lack of pain.

“For a guy that’s in his late 20s that’s always been a jock ath­lete, being ham­pered by these injuries is pret­ty tough men­tal­ly,” he con­tin­ued. “When you’re giv­en the option to get back into it, it’s huge; it means a lot to me.”

Ander­son soon will return to duty at Fort Car­son. Of the near­ly 200 cas­es they’ve seen, Owens not­ed, more than 30 have returned to ser­vice and 11 have com­bat deployed.

As they test and improve the cur­rent design, Blanck and Owens also are look­ing into what they call a “wide­spread poten­tial” for peo­ple with issues such as ankle arthri­tis, strokes and head, back and oth­er injuries.

The program’s suc­cess has one lim­i­ta­tion: space. Between amputees and war­riors with sal­vaged limbs, the CFI can get crowd­ed at times. The pair would like to see a rehab cen­ter like the CFI, but devot­ed to wound­ed war­riors with sal­vaged limbs. There would be no short­age of demand, Owens said, not­ing that for every one amputee, there are about 10 limb sal­vage patients.

Mean­while, they have no plans to cut back, no mat­ter how great the demand. Just see­ing the joy in a wound­ed warrior’s face at walk­ing again pain-free, they said, makes every extra hour at work worth­while.

“I nev­er thought I’d come to work and get hugged by a 220-pound, 6‑foot‑4, Spe­cial Forces guy,” said Blanck with a smile, “but I’ve had a few hugs.

“I loved my job before this, but this is a whole new lev­el.”

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs)

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