If it sounds far-fetched for a man without lower legs to become one of the fastest runners on the planet, how about typing by just thinking the words - or staying sporty well into old age?
Such prospects motivate work at Ossur, the Icelandic group behind the prosthetics that vaulted double-amputee Oscar Pistorius into the limelight with his bid to compete in the Beijing Olympics.
Besides producing carefully adapted artificial limbs to change the lives of disabled people, the world's only major listed prosthetics maker is also looking ahead to the day when robotics and neuroscience can change those of many more.
"What we should do is compare to the real body," Ossur's Chief Executive Jon Sigurdsson told Reuters. "And then we see that there is a long way to go. It is a very humbling experience to try to imitate God."
Ossur working closely with Pistorius
With market capitalisation of about $431 million, the company is small in the field of medical equipment, but positioned for growth. Hilmar Janusson, its head of technology, envisions a day when prostheses can be controlled by our nerves rather than by systems such as the computer keyboard.
What is needed - Janusson almost makes it sound easy - is a grasp of the signals running through our nervous system. "As soon as we start to understand, and basically de-code it into something, then things will happen very, very quickly," he said.
It's a goal to date pursued in the academic world. In May, the University of Pittsburgh School of Medicine reported how a monkey wired up with microelectrodes could use brainpower to direct a robotic arm to pluck a marshmallow from a skewer and stuff it into its mouth.
In the meantime, Ossur is gaining plenty of attention from its work with Pistorius.
The Blade Runner won three gold medals in the Paralympics after failing to achieve the qualifying time for the main games. Born without a fibula in either leg, he has become a symbol of perseverance, while the Cheetah Flex-Foot product he runs on sparked a debate about what constitutes an unfair edge in sport.
Progress being made
Janusson said the Flex-Foot may look nothing like human anatomy, but from a biomechanical perspective it is actually similar. The big difference: human feet are more efficient.
"We now know that the whole body is a spring that is loaded and you don't waste a joule of energy," he said.
Ossur did not invent the Flex-Foot. That was an American man named Van Phillips, himself an amputee. Ossur bought his firm in 2000 and has since fine-tuned the product.
The company knows the world it supplies. Sigurdsson says of the 220 or so staff in Reykjavik, half a dozen are amputees. Its founder, Ossur Kristinsson, was born without a foot and wears a prosthesis.
Janusson said remarkable progress has been made toward helping someone who has lost a limb lead a more normal life. "For below-knee, we're probably replacing up to 50 – 60%," he said. "We're pretty good below-knee. And there is no reason for below-knee amputees not to participate fully. Above-knee, we're down to 20 – 30%."
Arms are tougher. "Maybe 3 – 4%," he said.
Big breakthrough 'not far off'
To achieve that remaining 96 to 97 % will require progress on many fronts, including a better understanding of the nervous system and advances in tissue engineering, where scientists work with cells to replace biological functions.
The big breakthrough may not be all that far off, according to Yoky Matsuoka, a specialist in robotics and neuroscience at the University of Washington, who is working to control arms and hands by nerve signals.
"I think we are already witnessing the beginning of the big step," she said of the prospect of de-coding the nervous system. "Of course, a complete decoding and perfectly natural control may not happen in our lifetime."
Matsuoka expects scientists will certainly get to the point where a person could manipulate an object by thinking. "Spinning a pen or crumpling a paper at human speed may be a bit harder. Having enough sensory feedback to replace a surgeon's hand may take even longer," she said.
Money poured into research
Ossur - whose main competitor in the prosthetics field is unlisted Otto Bock of Germany - has generated investor interest in its niche, as well as in its more esoteric ideas.
"The only problem is it's the only listed company in its field," said Haraldur Yngvi Petersson, an analyst at Icelandic bank Kaupthing.
Petersson is one of just four analysts who cover the company, but he notes that unlike most Icelandic groups, Ossur has some foreign investors, including fund manager Fidelity.
The analyst is enthusiastic about products such as Rheo knee and Proprio foot which, aided by computer technology, adapt to the way a person walks and moves.
"I would say that we are just now starting to see real revenue potential," Petersson said of them.
Shares in Ossur, are down a little more than 25% from a lifetime high in 2006. But they are still double what they were worth in 2004. The company does not pay dividends, preferring to pour money into research and development. Sales reached $93 million in the latest quarter, more than 40% from prosthetics, when the company reported net income of nearly $4 million. Bracing and support products make up the biggest share of revenues.
Protheses for all in the future?
But Janusson, the technology chief, is also energised by simpler issues. He talks about a day, for example, when people wounded by landmines can get state-of-the-art prostheses at little cost.
He points to the switch to digital watches from wind-ups in the 1970s. Initially, the digital ones were expensive, but as technology progressed, they became the stuff of dollar stores.
He believes prostheses one day could be used to help a much broader portion of the population. Allowing the elderly to stay active, for instance, could extend life itself.
"Everyone in the profession would agree with me, that the level of activity makes a difference in how long you live," Janusson said. – (Reuters Health, September 2008)
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