Have you ever wondered why some people are talking to themselves, only to find out that they are actually on the phone with someone speaking via a wireless hands-free set? I've made the mistake many times of thinking someone is talking to me when they are carrying on a conversation with someone else over the phone through a small device that fits over their ears and serves as both the receiver and speaker for their cell phone. The technology that enables this ease of use of the cell phone is called Bluetooth.

Bluetooth is a wireless personal area network that allows for communication among low-power-consumption devices within a short range of one another. While this technology is most commonly known for simplifying the use of cell phones, it is transforming the lives of amputee patients by helping them walk again.

At the Walter Reed Army Medical Center, two Iraq war veterans, both double-leg amputees, are using Bluetooth prosthetics. (Read the full story in the News section of our Web site.¹) These innovative artificial legs feature computer chips in each leg that send signals to motors in the artificial joints so that the knees and ankles move in a coordinated fashion. The prosthetics have Bluetooth receivers strapped to the ankle area. The Bluetooth device on each leg tells the other leg what it's doing and how it's moving—for example, whether or not the legs are walking, standing, or climbing steps.

Due to the fact that the legs mimic each other, patients can vary their speed while walking and going uphill or downhill. Patients put resistance on their thigh muscles to slow the prosthetics down or stop.

One of the amputee patients currently using the Bluetooth prosthetic at Walter Reed is Marine Lance Cpl Joshua Bleill. Bleill lost both his legs above the knees when a bomb exploded under his Humvee while on patrol in Iraq in the fall of 2006. He has 32 pins in his hip and a 6-inch screw holding his pelvis together.

The Bluetooth legs allow Bleill to walk longer before he gets tired, due to built-in motors. Older models of computer-controlled legs need to be "programmed" via wire by laptop computers before the amputee can use them. These older models require more movement from the amputee's remaining thigh muscle to generate motion in the prosthetic leg.

Some limitations and challenges of the Bluetooth prosthetics are that they only react to how the patient moves, and it takes time for the patient to learn how to manage body movements for the proper leg reaction. In addition, the legs must be charged overnight—just like a cell phone—as no spare batteries for this product are available yet.

Most recently, another Bluetooth device is making waves in the rehabilitation industry. The Nintendo Wii not only revolutionized video gaming, but it also forged its own niche as an effective therapy tool. At the recent Combined Sections Meeting of the American Physical Therapy Association on February 7-9, 2008, one of the most popular booths in the exhibit hall was a long-term rehabilitation center that was holding a contest to win a Wii system.

Bluetooth is just one example of how the technology available today is applicable to rehabilitation, thus changing treatment protocols and patient recovery. Stay tuned for our next issue, the annual Physical Therapy Products Product Guide, which will showcase all of the latest tools available in the physical therapy market. In the meantime, I'd love to hear about the products and/or technologies you are using in your practice to improve patient outcomes.

Arati Murti

Reference

1. Shaughnessy L. Double amputee walks again due to Bluetooth. www.cnn.com/2008/TECH/01/25/bluetooth.legs/index.html. Accessed February 15, 2008.