Advances in Prosthetics, Wheelchairs Help Wounded Vets Push Past Obstacles
By Chad Stewart
Vietnam veterans who came home with their lives altered by amputations and paralysis found their futures bound by the limits of technology.
But that was then.
In the post-Vietnam era, an explosion of growth in the fields of prosthetics, medicine and rehabilitation has allowed veterans living with physical disabilities to travel to new frontiers and reach new heights. The rapid pace of advancements in those areas—undeniably tied to the injuries caused by the wars in Vietnam, Iraq and Afghanistan and aided by gains in computer science—helped improve lives by making mobility and independence a reality.
Instead of focusing on physical limitations, wounded warriors are now thinking about what they are capable of doing. And scientists and engineers are doing the same.
Thought-controlled arms, robotic legs and hands capable of producing the sensation of touch are all are within our grasp. Most observers believe that the steady progression of technological innovation promises to push prosthetic limbs to places that seemed unreachable a generation ago.
Many disabled Vietnam veterans who used to walk on wooden legs and rigid, plastic feet now tread forward on carbon-fiber limbs outfitted with flexible knees and ankles driven by microprocessors. They’ve endured the physical and mental hardships imposed upon them and are now able to lead lives that seemed impossible more than 40 years ago.
Three men—each a disabled veteran and all committed to improving the lives of others—have eclipsed what anyone could have expected of them when they suffered their injuries.
These are their stories.
Kirk Bauer can run circles around most people his age—or any age, for that matter. As the dynamic leader of Disabled Sports USA for the past 32 years, he has summited peaks, run marathons, raced down ski slopes and hiked across deserts. And he’s done it all on one good leg.
Bauer’s life changed when he lost his left leg above the knee during a firefight in Vietnam on March 23, 1969. His Army unit, depleted by casualties during a three-week-long patrol on the Mekong Delta, was setting up a night ambush when the enemy attacked. Bauer said “it was probably an RPG or a grenade that got me.”
Lying wounded in the mud and in great pain, he somehow stayed conscious through the devastating ordeal. He recalls being flown out of the delta on a helicopter with seven fellow soldiers—also wounded.
“They literally stacked us one on top of the other to get us out of there,” he said. “I was lying there and blood from the guy above me was dripping on my face as we were being flown out.”
About a month after his injury, following stops for medical treatment in Saigon and Japan, he was stable enough to be flown back the States. He was sent to San Francisco, where numerous surgeries and an excruciating rehabilitation process awaited.
“I had seven operations basically where they put me back together again and that probably delayed any attempt to put a prosthesis on me.”
He also describes a now-abandoned treatment that seems barbaric by today’s standards. But during Vietnam, it was the best medicine available.
“[Doctors] were doing an experimental process of casting your [residual limb] in a hard cast—even though it was very painful—to keep it from swelling. They still wrap it to keep the swelling down, but they don’t do the casting.”
They literally stacked us one on top of the other to get us out of there. I was lying there and blood from the guy above me was dripping on my face as we were being flown out.
Wounded on March 23, Bauer wouldn’t receive his first prosthetic leg until October. Laughing while describing his first prosthesis, he said the limb—made of balsa wood, plastic and fiberglass—weighed 16 pounds.
“It had a hinged knee and there was a hydraulic unit in there but it was rudimentary. It smoothed out the knee’s action of walking forward but there was no action at all in the foot and ankle unit.”
Today, Bauer’s 8-pound prosthesis is made of advanced, lightweight materials—carbon fiber, titanium and silicone—and has onboard computer systems that assist him in his daily activities.
“Now if you’re walking downhill or your knee is slightly bent, a computer will actually stiffen up the knee … so if you’re walking downhill it’s not collapsing on you.”
It’s a far cry from his first leg. Bauer tells a story that sharply illustrates how fast technology has advanced since Vietnam when compared to previous conflicts. A few years after receiving his first artificial limb, he visited the National Museum of Civil War Medicine in Frederick, Maryland, and realized he once stood on 19th century equipment.
“There was a picture of an artificial leg made in 1864 and it looked exactly like the leg I walked out of the hospital with in 1969. That was a real eye-opener.”
When he became an amputee more than 45 years ago, Bauer says there was no talk of running or climbing mountains on artificial limbs. Since then, advancements in technology have helped him reach places he never envisioned, like the top of Tanzania’s Mount Kilimanjaro and the finish line of the Boston Marathon.
Better medicine and improved prosthetics have also allowed some severely wounded service members from recent wars to stay in the military. For those injured in Vietnam, that was rarely an option.
“The military never even considered keeping you in,” he said. “There were a few who stayed in because they insisted on it. Now, we’re seeing as many as 15 percent of the severely wounded staying in, despite their injuries.”
Marine Captain Dave Gordon, an above-knee amputee who climbed Denali with Bauer, deployed twice to Afghanistan after he was nearly killed by a suicide bomber in Iraq in 2008.
“There was no program to assess our skills and keep us in,” Bauer said, referring to his fellow wounded Vietnam vets. “Now there is.”
As executive director of the Disabled Sports USA, Bauer has witnessed how the advancements in medicine and rehabilitation have helped people with disabilities grow and prosper. The nonprofit organization, which uses athletics and recreational activities to help improve the lives of the people with disabilities, has 109 chapters across the U.S. and offers more than 40 different sports and activities.
“Technology has just been phenomenal in leveling the playing field,” he said. “It doesn’t matter what your disability is, you can participate in most of those 40 sports.”
His organization works with therapists, both military and civilian, to get patients involved in physical activities early on in their recovery process. Bauer believes sports are a vital part of rehab, not just for the physical benefits, but for healing emotional and mental wounds.
“When someone has been blown up and two of their legs have been blown off and they have a traumatic brain injury and they’re in pain and are going through operations, everything that happens to them is negative. It’s a really debilitating experience.
“What we all look for—the therapists and Disabled Sports USA—we’re looking for opportunities to get them engaged so they can have a successful experience and start to believe in themselves again.”
If you watched television or opened a magazine in the late 1980s, you probably remember Bill Demby. Once they’re seared in your memory, it’s hard to forget the powerful images of a double-leg amputee playing basketball against able-bodied competitors.
As the star of a memorable DuPont ad campaign, Demby’s story—neatly captured in a 30-second TV spot—resonated with Americans and inspired anyone with a heart. The award-winning ad, which ran for nearly two years, showcased the company’s cutting-edge technology and the Vietnam veteran’s fierce determination—and his ability to keep up on the court.
He lost both legs below the knees in 1971, when a Viet Cong rocket tore through his truck. Lucky to survive the attack, Demby, then a 20-year-old Army specialist, was sent to Walter Reed Army Medical Center in Washington, D.C., to recover once he was healthy enough to travel. He’d spend the next year learning to walk on artificial limbs.
“When I started out, they had what was called the SACH Foot. Basically, it was a wooden foot with some thick foam around it.”
The SACH—an acronym for “solid ankle, cushion heel”—is technology that dates back to the early 1960s. While the prosthesis was effective for everyday activities, it wasn’t suited for the kinds of athletic endeavors Demby wanted to pursue. He played basketball in a wheelchair for more than a decade after he was injured because the artificial limbs were too stiff and bulky to play standing up.
He explained that walking with his original prosthesis required a lot of effort and force just to take a step. That all changed in 1984, when Demby became one of the original testers of the Seattle Foot, a revolutionary prosthesis that was the first energy-producing foot on the market. Made of Delrin, a plastic developed by DuPont, it has since been surpassed by new technology, but was state-of-the-art for its time.
“The difference was night and day,” he said. “I walked well with the SACH Foot, but I walked even better with the Seattle Foot. It changed everybody’s lives, not just mine.”
The prosthesis attempted to replicate the natural movement of the human foot, and it allowed amputees to engage in more strenuous activities. Also more efficient, it allowed its users to push themselves further without damaging their residual limbs. It also meant that Demby could play basketball standing up—something the former high school athlete had been waiting for since he was wounded in Vietnam.
The four-time Paralympian in track and field and seated volleyball recalls attending a track meet and being amazed by what disabled athletes were doing with the Seattle Foot—and what the device was doing to them.
“Guys were using the [foot] running the 100 meters. I was watching this guy run and literally he looked like he was running to keep up with the artificial limb.”
Today, Demby coaches wheelchair basketball at Walter Reed National Military Medical Center in Bethesda, Maryland, and has led multiple teams to the Warrior Games, an annual event where hundreds of wounded athletes compete in sporting events. Because he walks so well on his prostheses, the newest additions to his teams are usually unaware their coach is an amputee.
“They don’t have a clue who I am and I don’t tell them,” said the Maryland native, who volunteers his time at Walter Reed.
When a player is frustrated or blames their performance on their disability, Coach Demby doesn’t want to hear it.
“You cannot pull that on me. And then I reveal my legs. … After that, I can see a difference in them because they know they can’t use that excuse. … If I can do it, [they] can do it.”
He seems happy with all the improved technology available to new wounded warriors, but he’d like the players in his program to keep their Segways parked.
“They’ll have the [artificial] leg on and they’ll use the Segway to go from one point to the other. What they need to do is walk … because the walking builds muscles and endurance.”
Demby isn’t a doctor, but he is an expert at getting the most out of his body and he understands the hard work needed to recover from debilitating, life-threatening injuries.
“Those who show up with a cane—I say get rid of it. … I’ve gone through this and by me being a bilateral [amputee], somebody gave me a cane. My prosthetist said, ‘Don’t use this. You don’t need this because it’s going to become a crutch. … Once you get used to it, you will never put it down.’ ”
Demby, much like Kirk Bauer, endured some radical medical treatments in the early 1970s. After surgery, some doctors and therapists would cast the residual limb, attach a pylon and a leg and have the patient—almost certainly in immeasurable pain—start putting pressure on the amputated limb.
“I think we were guinea pigs. … They were seeing how fast they could get someone up walking compared to someone who they didn’t do that to,” he said, adding that he also thinks every generation endures experimental treatments so the next wave of wounded warriors won’t have to.
“Someone comes up with an idea and they try it, and it makes things better for the next group. … Now [amputees] are walking a lot sooner. And with all the technology, they are walking a lot better.”
Unlike Bauer and Demby, Dr. Rory Cooper is not a Vietnam veteran, but he is a former soldier who suffered a life-altering injury while stationed overseas.
Then a 20-year-old soldier based in Germany, Cooper was paralyzed below the waist when he injured his spinal cord in a bicycling accident. An avid runner before his injury, he was determined to remain an athlete—even if it meant he had to race and train in his 80-pound, hospital-issued wheelchair.
“When I got my first wheelchair, I could not put it in my car by myself. I took me about six months to build up the strength to do it on my own.”
More than 30 years later, he can pick up his 12-pound chair with one hand.
“In 1980, the chair I used to go to college was the same chair I raced in,” said Cooper, who won a bronze medal in wheelchair racing at the 1988 Paralympic Games. “Prosthetics is the same way. [Back then], the energy-storing foot was still a prototype. Now we have carbon-fiber prosthetics for people who want to redeploy to a combat zone.”
Beyond his athletic prowess, Cooper has also played a vital role in improving the lives of disabled people. As a professor, researcher and engineer, he’s spent his entire professional life working at the forefront of rehabilitation science and wheelchair and prosthetic development.
Long before he earned his Ph.D. in electrical and computer engineering, he was designing his own wheelchairs and racing gear. Cooper, the first person with a spinal cord injury to complete an Olympic-length triathlon, competed in the race using homemade equipment.
“I took three 10-speed bicycles with a friend of mine and we chopped them up to make a handcycle. It was crazy-looking.”
For the past 20 years, he’s been the director of Human Engineering Research Laboratories (HERL), which he founded at the University of Pittsburgh in 1994. Through advanced engineering and clinical research, the organization aims to improve the mobility and function of people with disabilities.
“Technology has been the driving factor in transforming rehabilitation in the last 30 years,” he said. “Not only rehabilitation, but the lives of people with disabilities.”
And it’s not just technology and rehab that have changed—times have, too. Cooper suggests that legal and cultural shifts over the past 30 years have helped enhance the lives of all disabled Americans.
When he recites scenarios to illustrate how society and its institutions have modernized, Cooper’s anecdotes seem archaic in this day and age. Before the Americans With Disabilities Act made it illegal to discriminate against people with disabilities, he had to crawl into most hotel bathrooms when he traveled because his wheelchair wouldn’t fit through the door.
When people’s lives are irrevocably altered by an illness or injury, “Everything that you could do one day very easily becomes extremely difficult the next,” Cooper said.
The landmark civil rights legislation, signed by President George H.W. Bush in 1990, was a game-changer for Cooper and others like him.
“When the guys came home from Vietnam, they couldn’t even rent a car with hand controls. Now, I can call up [a rental car company] a few days in advance and get a car,” he said. “When I would fly to go to races or an academic conference, I would have to ask a stranger to be my attendant because the airlines could deny letting me go on the airplane [if I didn’t have help.]”
With those types of institutional barriers now knocked down, disabled people now have greater mobility which allows them greater independence and a higher quality of life. Cooper is able to work because he can travel to and from his office on his own, which means he can continue to lead a team of researchers and engineers who are dedicated to breaking new ground and opening new doors for the disabled. It also means that he’s able to be a visible, productive member of his community.
“I can get out and go to a restaurant, or to a mall or work or school. … “People see [us] and we’re not a hidden part of society any more. We’re a visible part of society.”
Cooper says living a full, active life helps makes people—disabled or not—healthier mentally and physically. He’s lived longer than his doctors thought he would and he thinks sports played a significant role in keeping him alive.
“I think sports saved my life. … You’re just happier if you can do things you enjoy, and sports have helped me stay strong, flexible and fit.”
Cooper says participation in athletics—made possible by advances in prosthetics and adaptive sports equipment—is an essential component in the rehabilitation of severely wounded troops.
“If you think of a [service member] as a tactical athlete, by using sports in rehab it sends a message that you’re still part of that military culture.
“Through sports they can find a new perception of self.”
–Chad Stewart is the senior editor of On Patrol.