The Stepping Strong Innovator Awards
Hi, my name is Gillian Reny, and my family established the Gillian Reny Stepping Strong Center for Trauma Innovation at BWH to honor the medical heroes who saved my life and limbs following the 2013 Boston Marathon bombings.
Tragically, trauma is the leading cause of death for people ages 1-46, and it accounts for more than 41 million emergency visits per year. The Stepping Strong Center aims to turn tragedy into hope for the tens of thousands of civilians and military personnel worldwide who have suffered from the devastation of traumatic injuries and events. The Stepping Strong Innovator Awards, one of three program areas in the center, supports groundbreaking projects in innovative trauma treatment and recovery.
I am excited to introduce you to three finalists competing for a $100,000 award in the third annual Innovator Awards competition. By watching the video and voting, you will help chart the course of multidisciplinary trauma innovation here at BWH and worldwide.
Giorgio Giatsidis, MD
Stimulating Muscles to Accelerate Rehabilitation
Collaborator: Ken Ritscher (Engineer, Cooper Perkins)
Injuries to the legs and arms often destroy muscle, reducing both mass and strength. Today, there are almost no approved therapies or strategies—for use in conjunction with standard physical therapy—to induce muscle regeneration or accelerate recovery following trauma. Unfortunately, current interventions remain rudimentary, and prolonged hospitalization incurs further tissue damage. Once home, trauma patients face a steep path of rehabilitation. I call this “the trauma iceberg.” That is, what we see—and treat—is only the tip of what our patients actually experience. This project aims to break the trauma iceberg by developing novel therapies to initiate muscle recovery immediately following the trauma, prevent the onset of further inactivity-induced damage and accelerate the rehabilitation path toward a normal life.
Our cells regenerate in response to mechanical stimulation. For example, when we go to the gym, we stimulate muscles by stretching and contracting them, and this activity makes them grow. These principles can also be used to design novel, safe, non-invasive and patient-friendly therapies. This project seeks to address the burden of prolonged trauma rehabilitation by passively stimulating injured muscles to regenerate and accelerate their recovery directly at the bedside. To realize our goals, our team will determine the exact conditions to effectively promote mechanically induced regeneration of injured muscle and, in collaboration with engineers, integrate these findings into the development of a portable device that can be easily applied to trauma patients inside the hospital and at home.
Traumatic muscle injuries to legs and arms are a very common and dramatic occurrence. Trauma care for these patients does not end with the treatment of acute, life-threatening conditions and wounds. It continues through the long, challenging path of rehabilitation. Our proposed therapy and device will help to facilitate muscle regeneration in a hospital setting, prevent the onset of further damage and accelerate the path of rehabilitation.
Michael J. Weaver, MD
21st Century Tools to Measure Bone Healing
Collaborators: Greg Leya (MD/MBA Candidate), Genevieve Laing (Cooper Perkins), Jack Wixted, MD (Beth Israel Deaconess Medical Center), Arvind VonKeudell, MD (Massachusetts General Hospital), Lars Zandbergs (Massachusetts College of Art)
Fractures are an extremely common result of trauma—whether they result from a car accident, an injury on the battlefield or a bad fall. While huge advances have been made in the surgical treatment of fractures, there are currently no medications available to help speed bone healing. The primary reason for this deficit is that, based on current technology, it is challenging to accurately measure bone healing, which makes drug trials exceedingly difficult to perform. The goal of our project is to develop a reliable method of accurately measuring bone healing. This will enable us to collaborate with pharmaceutical companies to develop medications to improve and accelerate the often lengthy bone healing process.
Our project involves combining our understanding of bone healing with advances in CT scan technology that will allow us to measure microscopic changes in bone. We will develop a tool that allows us to measure how much motion occurs between the bone ends at a fracture site, such as a wrist fracture, during the healing process. The device will apply a small load, at a level that produces minimal discomfort, to the broken bone. A high-resolution CT scan will then be used to measure how much motion occurs. Knowing that fractures become stiffer as the healing process progresses, the device will measure the bone knitting together, with less motion over time. This combination of technologies will allow us to more precisely measure bone healing than previously possible, as well as help to spur the development of medications that can expedite it.
Over 7 million people break a bone every year. While there are numerous drugs to treat other common medical problems like high blood pressure or asthma, there are no medications to help heal broken bones. The goal of this project is to develop a tool to better measure bone healing, thus spurring drug development companies to discover medications that will both improve the speed of recovery and decrease the challenge of healing problems. Anyone who has had a broken bone, or knows someone who has, knows how difficult the recovery process is. Innovations such as the one we are proposing that speed the healing process will result in less pain, a quicker recovery and the hope that patients can quickly resume their everyday routines.
Jay M. Zampini, MD
Detecting Neurological Decline to Prevent Paralysis
Collaborator: James Kang, MD
Spinal cord injury represents one of the most devastating and long-reaching effects of trauma. Injuries can range from a subtle loss of sensation and muscle function to complete paralysis. More than 273,000 people in the U.S. are living with spinal cord injury, the ranks of which grow by over new 12,000 cases each year. Typically, patients sustain a spinal cord injury due to a car accident, fall, sports injury or violence. They are transported to a trauma center, where spine surgeons provide treatment designed to optimize the restoration of neurologic function. In other instances, a hospital patient with normal neurologic function may experience a loss of sensation or muscle function for various reasons. Ideally, caregivers can identify these changes rapidly enough to initiate treatment to reverse the symptoms or prevent their progression. Today, a neurologic exam is the only method of detecting changes. The most challenging group of patients to treat for neurologic decline are those whose mental status and ability to cooperate are compromised. They may be unconscious, confused, agitated or delirious. For these patients, a neurologic exam alone cannot rapidly detect a potentially devastating change in neurologic function. We plan to develop a device that automatically detects changes in neurologic function, alerting clinicians to start life- or function-saving treatment.
Assessing active muscle function is the most critical aspect of a neurologic exam, requiring patients to move their hands, feet and muscles. Several methods of measuring muscle activity are available. For instance, electromyography uses needles and skin-surface electrodes to stimulate and monitor muscle activity in patients to assess nerve injury. Similar techniques are available for patients under anesthesia, and accelerometers in the iPhone, FitBit and other athletic monitors can differentiate between activities like running, golf, and elliptical training. The device we propose will adapt available technology for an application that has never been considered before. Our device also takes a time-consuming task of a neurologic examination and automates it, allowing clinicians to better serve their patients.
Our device has the potential to not only benefit patients who are injured and neurologically intact, but also those whose potential neurologic decline is difficult to detect. We hope it will become the standard of care for neurologic monitoring in hospitalized, at-risk patients.