T. Walley Williams III

[caption id="" align="alignnone" width="250"] Williams employs his carpentry skills making balusters for a friend. Photographs courtesy of T. Walley Williams III.[/caption] T. Walley Williams III, MA, product development director at Liberating Technologies Inc. (LTI), Holliston, Massachusetts, embarked on his career as an inventor while very young, and at age 81 he is still at it, full steam ahead. "I used to make all kinds of stuff when I was a boy—small radios, mechanical toys, things like that," he recalls. As he was growing up in Englewood, New Jersey, across the Hudson River from New York, New York, Williams says, "Unbeknownst to my mother, I would take the bus across the George Washington Bridge and go down to Portland Street and buy radio parts. I had mastered the subway system by the time I was ten years old." Williams' fascination with mechanics and electronics has led to his involvement with landmark inventions in the O&P industry, including the Boston Elbow, now called the Boston Digital Arm™ System. The Boston Elbow was the first battery-powered prosthetic elbow to restore function to people with transhumeral amputations, capturing muscle signals from sensors on the skin surface to myoelectrically control the speed and direction of the limb. Bilateral amputee Jesse Sullivan, often called the "world's first bionic man," used an advanced version of the Boston Digital Arm. Williams also helped design the "Cookie Crusher" circuit for children's myoelectric hands, which was much simpler and easier for youngsters to learn and operate. One of Williams' latest projects, the LTI Locking Shoulder Joint, won the 2006 Gold Engineering Award from Product Design and Development Magazine , and is now being used worldwide. Recognizing his contributions to the O&P profession, the American Academy of Orthotists and Prosthetists (the Academy) honored Williams with its Clinical Creativity Award in 1998, and in 2002 he was awarded honorary membership in the Academy. Williams has published a number of articles in research journals, authored book chapters, and has presented at numerous professional conferences, including the Myoelectric Controls Symposium (MEC) hosted by the University of New Brunswick, Fredericton, Canada, and the International Society for Prosthetics and Orthotics (ISPO). Williams' involvement in O&P professional organizations includes membership on the board of the U.S. National Member Society of the ISPO (USISPO) from 1989-1990, and active membership in the Academy's Upper Limb Prosthetics Society. Career Path From his start as a young inventor, Williams learned and built upon valuable skills that helped him in each subsequent stage of his academic and professional life. After finishing a year of junior high school in Englewood, he followed in his father's footsteps and attended Kent School, Connecticut, a private boarding school. The summer after graduation, Williams helped one of the faculty members build a house, which added to his practical skills in electrical work, plumbing, and carpentry. He then attended the University of Virginia, Charlottesville, as a Naval Reserve Officers Training Corps (NROTC) student, graduating with a bachelor's degree in physics in 1954. He then spent three years in the U.S. Navy, including a year and a half serving with Marine Corps units. [caption id="" align="alignnone" width="200"] Williams and his wife, Lynn, enjoy their annual backyard Labor Day party in 1988. Lynn Williams, PhD, was a professor of writing and publishing at Emerson College, Boston, Massachusetts.[/caption] After leaving military service, Williams earned his master's degree in physics at Columbia University, New York, in 1960. From 1960-1965, as his wife, Lynn, whom he married in 1959, was completing her doctoral degree in English, Williams worked for the university's Physics Department, designing physics teaching equipment and running the physics labs. The next stage of his career took him to Ealing, Cambridge, Massachusetts, where he was the product manager for physics teaching equipment. The other two product managers handled research optics and film loops, respectively. Film loops were 8mm short films showing a demonstration or another "hook" to engage students' attention and interest in the subject they were learning. "When [the product manager] needed to make film loops on physics, I got involved in that too," Williams says. "We ordered physics teaching equipment from overseas, but we also designed some of our own." At Ealing, Williams learned the ins and outs of importing items, plus he became an expert in small-quantity manufacturing, a valuable skill he brought to O&P. "Physics teaching equipment is not a big field. You don't make a million of anything; you make a hundred," he explains. [caption id="" align="alignnone" width="250"] Williams riverrunning the Swift River in New Hampshire's White Mountains in 1988.[/caption] In 1973, Ealing suffered a severe downturn and reduced its product management staff to save money. "That's when I looked around and said to myself, 'In the next 20 years the intersection of medicine and electronics is probably where things are going to go.' So I started looking around to see what was going on in those fields," Williams says. He met Allen Cudworth, ScD, then the director of the Liberty Mutual Insurance Company (now Liberty Mutual Group) Research Institute for Safety, Hopkinton, Massachusetts. During the 1960s, Melvin Glimcher, MD, was in charge of rehabilitating upper-limb amputees for Liberty Mutual. His frustration with existing devices for transhumeral amputees led him to put together a group of institutions to develop a myoelectric elbow. The first Boston Arm was a joint effort of the Research Institute for Safety; Massachusetts Institute of Technology (MIT), Cambridge; Harvard Medical School, Boston, Massachusetts; and Massachusetts General Hospital, Boston, to rehabilitate persons who had suffered upper-limb loss. The original myoelectric device that was developed there, the Boston Arm, "was a great concept but couldn't work for amputees because it was too heavy and noisy," Williams says. So Liberty Mutual developed a second-generation device but, as Williams remembers, was having difficulty securing an interested manufacturer in the O&P industry. Williams continues, "I chatted with [Cudworth] about how the company could produce the device itself and how to go about doing that—and so I got a job that weekend!" [caption id="" align="alignnone" width="200"] Williams visits with other members during the 1986 Annual Dinner of the Appalachian Mountain Club, headquartered in Boston, Massachusetts, with chapters in several states. A long-time member, Williams served as its president in 1985 and 1986.[/caption] For the next six years, Williams and his colleagues developed versions of the Boston Arm that were only used for fitting Liberty Mutual patients. However, by then the device had advanced to the point that Williams thought it should be commercialized. Among attendees at a meeting to introduce the product were representatives of Hugh Steeper Limited, Rochester, Kent, England (now RSLSteeper). This meeting led to a long and fruitful relationship that still continues between LTI and RSLSteeper. Williams' import/export know-how proved very helpful as both companies began importing each other's products. By the mid-1980s, "we had a fair business going," Williams says. "Although it was part of Liberty Mutual's research center, it was an intrapreneurial project." Williams then talked with another project director, William J. "Bill" Hanson, MBA, and Cudworth about Hanson heading the business end of the enterprise, thus beginning a strong professional relationship between Hanson and Williams that has lasted almost three decades. In 2000, Liberty Mutual decided to offload all products except its core business in insurance-related products. Hanson then bought Liberty Technology, including the Boston Elbow, which had been recently renamed and introduced to the market as the Boston Digital Arm, with transfer of ownership occurring in late 2000 or early 2001, according to Williams. "We couldn't use the name 'Liberty' but got close to it with 'Liberating Technologies,' because we wanted to have continuity in people's association with our company," Williams says. After the purchase, LTI operated in the Liberty building until Liberty Mutual needed to tear it down and replace it. In September 2001, LTI completed the move to its current location. Milestone Moments The first prosthesis that could be controlled naturally and intuitively by simply thinking about a movement marked a significant step forward in O&P history, one in which a landmark surgical technique, a prosthesis that could accommodate the task, and a determined user all came together. [caption id="" align="alignnone" width="250"] Williams in Lijiang, Yunnan, China, during a 2009 trip to China and Tibet.[/caption] In 2002, Todd Kuiken, MD, PhD, director for the Center for Bionic Medicine and director, Amputee Services for the Research Institute of Chicago (RIC), Illinois, pioneered a procedure called targeted muscle reinnervation (TMR) in which nerves that formerly controlled the amputated limb are transferred to healthy muscle tissue. When reinnervated in the new location, these nerves still "think" they are controlling the limb, so when the brain thinks about a movement, these nerve impulses activate the new muscles, generating myoelectric signals captured by surface electrodes and activating the desired movement in the mechanical arm. Jesse Sullivan, a bilateral upper-limb amputee, was one of the first people to undergo TMR successfully. This surgical technique was paired with a prosthesis Williams helped to develop from a variety of existing technologies, including the Boston Elbow. "Would you believe Jesse Sullivan's original arm system, developed for research purposes, was built in my basement?" Williams says. "It was a real conglomerate, with a hand from China with an electric wrist flexion unit, an Ottobock wrist rotator, a Boston Elbow for flexing and extending at the elbow, and a mechanism from an old Boston Elbow that had been made into a humeral rotator." [caption id="" align="alignnone" width="300"] Williams adjusts Sullivan's thought-controlled prosthesis, which incorporates a third-generation Boston Elbow (now called the Boston Digital Arm). Photograph courtesy of Rehabilitation Institute of Chicago.[/caption] Williams says that the shoulder flexion and extension unit the team obtained did not have the power to overcome the weight of the prosthesis. To address this problem, he rigged a couple of pulleys and some bungee cords, so that "as the motor flexed the arm and it started to move upward, the bungee cords would do more and more of the lifting until the arm was fully out in front." Following the final version that was used for the initial trial, the Boston Digital Arm System has undergone three major revisions and several minor ones, as technology continues to improve. The "Cookie Crusher" In the late 80s, Tom Haslam, CP, a prosthetist in Houston, Texas, was looking for a single-muscle voluntary-opening myoelectric control for use with infants, since available controls were too complex to be used easily by young patients. "So over a beer at a meeting at the University of New Brunswick, Tom and I invented the concept of the 'Cookie Crusher' circuit," Williams says. "The Cookie Crusher is activated by flexing one muscle, which opens the hand. If you stop flexing the muscle, the hand closes at full strength, so if you happen to have a cookie in your hand, it will crumble the cookie," he explains. Although the original circuit has been replaced by microprocessor control, the name has stuck, he adds. Keeping Patients in the Equation Williams is a passionate advocate for being involved and knowledgeable about patient care. "It's important to understand prosthetic fitting and function from the prosthetists' and patients' viewpoints; we're not inventing things in a vacuum," he points out. In fact, working with patients can not only spark new ideas, but the toughest patients help develop the best devices, Williams says. "When you come up with a new piece of gadgetry, what's the first thing you do? You take the worst patients you can think of in terms of mishandling stuff. If they don't break it, I know I've succeeded; if they do break it, I know exactly where to make changes to fix it." For instance, a shoulder joint design that LTI acquired was not proving to be durable in the field. "When we did a complete redesign on that shoulder joint [now the LTI Locking Shoulder Joint], with many more locking positions and electric locking capability, we had some failures-about one patient in 30. But that was enough so that early on we were able to make improvements, and since then we haven't had any failures." Williams says, "Getting involved with patients is a key to my approach to new designs and inventions." What's on the Horizon Williams finds time for cross-country skiing, hiking, and leading Appalachian Mountain Club trips-the most recent being trips to Italy and Yellowstone National Park, Wyoming. Whitewater kayaking and canoeing have been a passion, although he is no longer active in the sports. He authored the second edition of the White Water Handbook , revising the first edition by John T. Urban, and was part of a memorable 212-mile expedition down the Colorado River, among other adventures. For Williams, the future is beckoning. He is now working with University of New Brunswick researchers on pattern recognition technology, which enables more intuitive prosthetic control as the nerve impulses activating myoelectric muscle signals more accurately decipher what the amputee wants to do. He is developing a special electrode to use with the technology. Williams finds his work satisfying and enjoyable. "When a patient succeeds and when a new product turns out be a winner, well that's very gratifying. I don't have to work; I now have multiple sources of income." In fact Williams donates his LTI earnings to various nonprofit public service and charitable organizations. As he explains, "I work because they pay me to have fun!" Miki Fairley is a freelance writer based in southwest Colorado. She can be contacted via email at miki.fairley@gmail.com

T. Walley Williams III

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