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Richey and Singhal Awarded $1.9 Million To Study Orthosis Effectiveness in Veterans

Dr. Phyllis Richey (Photo provided by UTHSC Office of Research)

Researchers Phyllis Richey, PhD, professor in the Departments of Preventive Medicine, Physical Therapy, and Pediatrics, and Kunal Singhal, PhD, PT, assistant professor in the Department of Physical Therapy, at the University of Tennessee Health Science Center (UTHSC), were recently awarded $1,998,325 to study the effectiveness of a new robotic exoskeletal technology for use by military service members and veterans that have limited mobility due to a neurologic injury.

Funded by the U.S. Army Medical Research Acquisition Activity, this Department of Defense grant entitled, “The Effect of a Powered Ankle Foot Orthosis on Function, Safety, and Quality of Life in Military Service Members and Veterans Who Wear a Prescribed Orthosis,” will allow Dr. Richey and Dr. Singhal to conduct the “Veterans Advancing Lower-limb Orthotic Research” (VALOR II) clinical study at UTHSC. The aim of the study is to determine if a Powered Ankle-Foot Orthosis (PAFO), in addition to a traditionally prescribed fixed ankle-foot orthosis (AFO), will improve walking efficiency, safety and quality of life for the typical service member or veteran who has suffered a neurologic injury resulting in lower extremity impairment. The study will receive funding for three years.

Advancements in technology utilizing powered exoskeletons are being developed to help soldiers carry heavy loads and facilitate walking longer distances. Although these recent orthotic innovations are groundbreaking, the traditional AFO often prescribed for people who have lower-limb impairment resulting from a neurologic injury has not had any major innovation for over 30 years.

This same exoskeletal technology may also be utilized to help “typical” military personnel or veterans with functional limitations due to central nervous system injuries including stroke, spinal cord injury, and traumatic brain or peripheral nervous system injuries including neuropathy or traumatic injury to the muscle and/or nerves of the lower leg. Providing the newest orthotic technology to this group of patients may improve functional performance, walking ability, safety and quality of life.

Dr. Kunal Singhal (Photo by Allen Gillespie/UTHSC)

“It is very rewarding to see this kind of research that we do, here in Physical Therapy and Preventive Medicine, recognized at the federal level,” said Dr. Singhal. “It will be interesting to see if we can not only improve the quality of movement, but also bring about meaningful changes in overall patient function through the use of technology that is often not available to this subset of the population.”

The type of orthotic brace generally prescribed for this type of lower-limb impairment (foot drop) holds the ankle in a relatively fixed position when a step is taken, which alters the normal walking pattern, throwing off balance and increasing the risk of falling, compared to those without foot drop. The innovative design of the PAFO allows the affected ankle to move, both lifting the toe and providing push-off as steps are taken.

“We are very excited about this second Department of Defense award and cross-college collaboration designed to enhance patient outcomes through improved mobility,” Dr. Richey said. “With this project, I am very interested to see if the PAFO may actually improve long-term function in these patients, and potentially carry over to when it’s not being worn.”