PacRim Conference Spotlights Upper-Limb Prosthetics

The 12th Biennial Pacific Rim Conference January 24-28 in Honolulu, Hawaii, marked the end of a quarter-century tradition and the beginning of a new one as the US Member Society of the International Society for Prosthetics and Orthotics (US-ISPO) takes over the event in 2008.

The finale was a grand one, with stellar speakers and presentations, warm hospitality, and the beauty of the "Big Island" itself adding to the luster.

Upper-limb prosthetic management was spotlighted in presentations involving amputee care at Walter Reed Army Medical Center, Washington, DC. John Miguelez, CP, FAAOP, provided a 30-month review of the unique protocols implemented to provide care for a young, athletic, and highly-motivated population. His presentation included surgical considerations, edema control, timeline for prosthetic management, prescription criteria, integration of occupational therapy, and lessons learned through aggressive prosthetic intervention.

Blast wound injuries with resultant heterotopic ossification and other considerations add another layer of complexity to effective rehabilitation.

Working closely with the prosthetists in the program were occupational therapists. Describing the occupational therapy protocol were Capt. Lisa Smurr, MS, OTR, and Kristin Gulick, OTR/L, CHT. The protocol begins during acute stages of wound healing and moves through basic prosthetic training and advanced functional training. Treatment is individualized to meet the physical and emotional needs of the soldier and family; much of the protocol also can be applied to civilians, they noted.

Patrick Prigge, CP, Otto Bock HealthCare, Minneapolis, Minnesota, discussed advances in upper-limb myoelectrics and stressed the importance of the team approach for effective rehabilitation. Don Conyers, CPO, Advanced Arm Dynamics Inc., discussed the challenges involved in fitting upper-limb prostheses on burn patients. Considerations include current status of the skin, soft tissues, bony anatomy, future surgeries, and materials to minimize pressure and shear force.

A new myoelectric hand for Korean amputees was described by Kyung Hoon Kim, PhD, of the Korean Orthopedics & Rehabilitation Engineering Center (KOREC).

Lower-limb surgery and prosthetic care, along with business aspects of O&P, were highlighted in other presentations. A popular presentation was "What Tomorrow's Healthcare Delivery System Means to You," by John M. Latsko, Esq., Schottenstein, Zox & Dunn, Columbus Ohio. Latsko discussed projections for change in the US healthcare delivery system in the coming decade and what these will mean to O&P practitioners and suppliers.

The event was organized by Rodney M.K. Pang, CPO, chairman, Honolulu Orthopedic Supply Inc., chairman; Jerry Fullerton, CPO, Superior Limb & Brace Co., Las Vegas, Nevada, vice chairman; Jeff Kingsley, Kingsley Mfg. Co., Costa Mesa, California, supplier chairman; John Miguelez, CP, FAAOP, Advanced Arm Dynamics Inc., Redondo Beach, California, program chairman; and Teresa LaPorte, CO, Superior Limb & Brace, registrar. There were 106 attendees and 14 exhibiting companies.

Enthusiastic Comments

Participants expressed their enthusiasm for the conference.

Warren Mays, CPO, Artisan Orthotic Prosthetic Technologies, Tualatin, Oregon, attended the PacRim Conference for the first time. Said Mays, "I felt that it was very well organized, and though I didn't enjoy getting up so early to begin each day of speakers, I appreciated how much time that left us in the afternoon for exploring the Big Island. I seriously doubt that I will ever miss another conference, as Hawaii is an incredible setting for such an event...Hats off to US-ISPO for picking up the reins and continuing the conference. And, perhaps more importantly, thank you to the original organizers. I really enjoyed hearing about some of the old-timers who gave so much of their time to start and continue the conference. Having never met Chuck Childs, but knowing the history of his development of the Campbell-Childs feet, I was honored to be there for the tribute to his wife and family. Chuck was a very important player in the shaping and modernization of our field."

Mays continued, "I was most impressed by the reports from the staff at Advanced Arm Dynamics on their work at Walter Reed with the returning injured vets. I also was inspired by the obvious energy of Elizabeth Mansfield, who, it appears, has truly found her niche."

John Miguelez, CP, FAAOP, noted, "Our Scientific Program was strong and diverse, including upper- and lower-extremity prosthetics, surgical perspectives, wound management, orthotics, business development, and practice management presentations. I look forward to future Pac Rim Conferences that will continue on with its unique tradition."

Jan Stokosa, CP, Stokosa Prosthetic Clinic, Okemos, Michigan, who has been a presenter and attendee at most of the conferences, complimented the organizers on their hospitality, enjoyment of the experience by his family, and success of the event. Stokosa also loves Hawaii. "Every conference, and visiting the Islands has been an outstanding adventure in many ways culturally learning about Hawaiian ways. The luaus are great; food is delicious and the healthiest available; adventures are everywhere from horseback riding for an hour or two to a half, full-day, or two-three day excursions; helicopter rides to see the panorama of the islands. Golf is the most beautiful and challenging in the world. Many times I saw whales breaching as I was walking/riding down a fairway toward the ocean."

"I thought the program was superb," said Elizabeth Mansfield, Outsource Marketing Solutions, Hartford, Connecticut, as she congratulated the conference organizers.

Bob Leimkuehler, CPO, Leimkuehler Inc., Cleveland, Ohio, especially enjoyed the presentation on how veterans are recuperating at Walter Reed. He said he also enjoyed the networking and clinical sessions and would definitely want to attend another conference. Leimkuehler also was a first-time attendee; his wife's recovery from cancer was the draw. He had told her that when she recovered, they would take a trip to Hawaii, so the event was an especially happy time for the Leimkuehlers.

Presenter Kyung Hoon Kim, PhD, noted that he was a repeat attendee. "The session which had the greatest impact on me was the talk given by Dr. Gottschalk on transtibial amputation. The location and audiences were great as well." He also said he very much enjoyed the Hawaiian dinner, which was a highlight of the social and networking events.

This year's conference marked the fourth time John Latsko has presented at the event. Latsko stressed his message: "The healthcare delivery system is changing fast, and you need to be ready for the changes. Reimbursement will be frozen by Medicare, managed care will negotiate big discounts, consolidation will take place, competition from providers and suppliers outside O&P will become the norm, the government will put pressure on compliance programs and fraud investigations and those who have are prepared will do well."

Latsko emphasized that change in O&P will be even faster than in the past: "Quality and efficiency are now being recognized as desirable traits in practitioners, and marketing may result in marketing to your competition. Physicians are more and more getting into O&P. The attendees this year seemed more interested in industry trends than eight years ago. The O&P business is in many ways very similar to the medical practice business. Much can be learned from watching how the practice of medicine has changed, and that is the message I have always tried to deliver to the O&P industry."

PacRim Conference: How It Began

The Pacific Rim Conference on Prosthetics and Orthotics was begun in 1986 in response to O&P practitioners asking when there would be a meeting in Hawaii, recalls Rodney Pang, CPO, of Honolulu Orthopedic Supply.

The late Chuck Childs, CPO, founder of Pacific Orthotic and Prosthetic Service in Oregon and a leader in the O&P field, thought it would be a great idea to have a P&O conference in Hawaii with interesting subject matter as well the opportunity to enjoy the islands' beauty, said Pang. Childs, along with Pang and Jerry Fullerton, CPO, with Superior Limb and Brace in Las Vegas, Nevada, joined forces to form the first PacRim conference committee.

The First Biennial Pacific Rim Conference was held at the Intercontinental Hotel on Maui in April 1986. Among the attendees was a young man attempting to get started in the field of O&P named Van Phillips. Phillips, who happened to be visiting Maui, introduced the Flex-Foot ® to the profession for the first time at the conference.

Since that time, the conference has been held on different Hawaiian islands and has been well attended by prosthetists, orthotists, and allied health professionals from all over the United States, along with some Pacific Rim countries, including Canada, Japan, Korea, and Australia. When the current committee members turn the conference over to US-ISPO, any money left in the account will be used to set up a scholarship fund in the name of Chuck Childs, CPO, Pang said.

PacRim Conference Spotlights Upper-Limb Prosthetics

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