This is an opportunity to embrace the talents and skills that individuals with disabilities bring to our workplaces and communities. The Telemedicine and Advanced Technology Research Center's Advanced Prosthetics and Neural Engineering portfolio has played an active role in enabling amputees and people with limb differences to enjoy a higher quality of life and functionality.

The APNE research portfolio was created in 2003 with the mission of "Helping our warfighters achieve the highest possible quality of life though the advancement of revolutionary amputee and human performance related research." APNE funds and manages research in areas such as:

• Advanced Prosthetics
• Advanced Orthotics
• Rehabilitation Engineering and Assistive Technology
• Outcomes and Program Assessment, and
• Neural Engineering

Through projects in these areas, APNE supports the missions of USAMRMC's Clinical and Rehabilitative Medicine Research Program and the Army Medical Department's Extremity Trauma and Amputation Center of Excellence, and their relative focus areas of definitive and rehabilitative care innovations to assist our wounded warriors, both in terms of duty performance and quality of life; and to facilitate continuous care and research related to traumatic extremity injuries and amputations across the DoD-VA healthcare network.

Limb difference, such as amputations, can result from numerous pathologies and traumatic events. No geographic or demographic distinction, socioeconomic level, or level of fitness is exempt. Permanent limb difference can mean the life-long use of prosthetic or orthotic devices in addition to assistive technologies. A prosthesis is used to replace the functionality of a missing limb, and an orthosis is used to brace existing limbs and joints that are not fully functional. Historically, prosthetic devices were little more than half a crutch or a wooden arm with a leather strap securing it to the wearers stump, or residual limb. Instead of a peg-leg or wooden crutch, today's advanced prosthetic devices are microcomputer controlled, utilizing hydraulics, electro- and magnetorheologics, microfluidics, springs, motors, and sensors to recreate the lost biological function as closely as possible. Instead of a leather strap, today's devices are attached using a combination of elastomeric gel liners, sockets comprised of carbon fiber and other polymers, passive and active suction, and pin-lock mechanisms.

The APNE portfolio works directly with DoD clinicians, care providers, and patients to determine research needs, but prosthesis and orthosis use goes far beyond our warfighters. Remember the broken arm when you fell off the monkey bars in the third grade, or the sprained ankle when you went ice skating in junior high school? Remember the shoulder injury in high school, or the knee injury in college? Maybe you've had lower back pain or arm numbness that required a few weeks of physical or occupational therapy or even surgery? Remember the pain, the discomfort, the inconvenience, the self-consciousness? If your recovery required an elastic bandage, a brace, cast, crutches, a cane, walker, or wheelchair, etc., then you've used orthotic devices and assistive technology, and however temporary, you lived with limb difference. Beyond this brief experience, you may not think you know someone who wears a prosthesis or orthosis, since most of these devices are unobtrusively worn underneath clothing, but maybe you're just not looking close enough. In fact, it's likely that there are more people who need prosthetic devices than those who don't. Do you wear corrective lenses or know someone who does? You see, it's not "those people" who live with disability, it's we who live with disability.

People who live with amputations and other forms of permanent limb difference engage in the same activities as others, and typically do so quietly and courageously. From domestic chores to the great outdoors, these are some of the most resilient people you will ever meet. When people ask whether amputees should be allowed to compete side by side with able-bodied athletes in the Olympics, I say that the real point is that today's technology has brought us to the point where we're able to even have those sorts of discussions. And much of that advancement is being driven right here through TATRC and USAMRMC.

For more information about TATRC's work in Advanced Prosthetics, Please visit: www.tatrc.org/prosthetics

Troy A. Turner, MBA
Portfolio Manager, Advanced Prosthetics & Neural Engineering
Telemedicine & Advanced Technology Research Center
U.S. Army Medical Research & Materiel Command