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Pankey's biomechanics research at Texas State benefits war veterans

By Marc Speir
University News Service
March 21, 2007


Bob Pankey

Bob Pankey traded in his administrative position last fall as chair of the health, physical education and recreation department at Texas State University-San Marcos to research biomechanics at the Gait Analysis and Innovative Technologies Laboratory (GAIT) in San Antonio.

After six years as chair, the 55-year-old Pankey was drawn back to teaching in order to concentrate on research.

“I felt it was time to go back,” Pankey said. “I missed being involved like that.”

As a result, the university granted him a one-semester developmental leave to reorder his priorities and conduct further study in gait analysis, helping patients relearn to walk safely and efficiently.

The GAIT Lab, formed in collaboration with the University of Texas Health Science Center (UTHSC) at San Antonio’s department of rehabilitation medicine, is a state of the art, multi-million dollar facility housed in the Audie L. Murphy Veterans Hospital.

“Now I can bring resources back to my own university in terms of developmental research, with our own faculty and our own staff ... and they (at UTHSC) are excited Texas State is reaching out to them,” Pankey said.

The hospital provides services for veterans who are suffering from disabling issues by providing rehabilitation through physical therapy and the use of prosthetics.

“Usually a large city has one gait lab,” said Pankey. “There are two in San Antonio and one in Austin. Universities can’t usually afford such amenities, so I collaborated with the UTHSC and the hospital to find one I could use.”

Pankey stays in a dorm room provided by a colleague three days a week at the University of The Incarnate Word in San Antonio so he can be closer to the GAIT Lab.

He spends the remainder of the week in San Marcos, performing research Monday and Friday at the Jowers Biomechanics Lab on campus.

Pankey was drawn to working with veterans and biomechanics from personal experiences.

“My nephew is in Baghdad and his father passed away a year ago,” Pankey said. “This is my way to support him and our troops.”

A grim incident over the holidays also led him to reflect on the importance of his research.

“It’s ironic in the field of work that I do because I lost my mother over Christmas,” Pankey said. “She had balance problems, fell and had a brain hemorrhage. After a few days, she died.”

Center for the IntrepidCenter for the Intrepid

Of the roughly 20,000 U.S. soldiers injured since the start of the Iraq war, military sources report that more than 500 have lost a limb. Military officials don’t count the loss of fingers or toes in their calculations of amputees. As a result, claims of disabling injuries from other sources range in the thousands.

Many active soldiers returning from Iraq requiring rehabilitation services will go to the Center for the Intrepid, a new building replacing the old rehabilitation offices of the Brooke Army Medical Center, also in San Antonio.

The center opened in January by hosting a dedication ceremony littered with numerous celebrities and politicians. More than 3,000 people attended, including Gen. Peter Pace, the chairman of the Joint Chiefs of Staff, and 2008 presidential hopefuls Sens. Hillary Clinton D-N.Y., and John McCain, R-Ariz.

“I was invited to take a look at the facilities (at the Center for the Intrepid),” Pankey said. “They’ve got a lot to offer for active personnel.”

Prosthetic hands
Prosthetic hands await recipients at the Center for the Intrepid
 

Upon treatment from a medical center for enlisted servicemen such as the Center for the Intrepid, military officials attempt to keep soldiers commissioned in their branch of service.

The GAIT Lab Pankey works at services veterans that have been decommissioned from the military.

“We see some kids from the Iraq and Afghanistan wars, but not quite as many as the veterans from older wars,” Pankey said.

Patients at the GAIT Lab need physical therapy for balance issues while many have lost legs due to military service or disease.


Prosthetic leg
More than 500 U.S. soldiers have lost a limb since the start of the Iraq war.

Pankey’s research helps them improve their mobility by providing analysis for physical therapy treatment or so others can construct and fit amputees with proper prosthetic devices for use in walking and recreation.

Combat traumas make up a small portion of the cases treated at the GAIT Lab, while the majority of cases involve other reasons.

“Most injuries are because of extenuating health concerns,” Pankey said. “For example, we had an Afghanistan War veteran that had a stroke and lost the use of her leg.”

Common ailments leading to amputation or issues of balance control include aging, blood clot, stroke, aneurysm, multiple sclerosis and diabetes.

“We have veterans from the Vietnam and Korean Wars that are suffering from some disease like diabetes,” Pankey said. “They lose limbs due to poor circulation.”

While at the GAIT Lab, Pankey works with patients by using interactive software and computer equipment.

First editions of software used at gait labs were designed for the sole purpose of evaluating medical conditions. However, the initial programs weren’t highly accurate and left room for error and incorrect diagnoses.

Pankey’s research helps them improve their mobility by providing analysis for physical therapy treatment or so others can construct and fit amputees with proper prosthetic devices for use in walking and recreation.

Combat traumas make up a small portion of the cases treated at the GAIT Lab, while the majority of cases involve other reasons.

“Most injuries are because of extenuating health concerns,” Pankey said. “For example, we had an Afghanistan War veteran that had a stroke and lost the use of her leg.”

Common ailments leading to amputation or issues of balance control include aging, blood clot, stroke, aneurysm, multiple sclerosis and diabetes.

“We have veterans from the Vietnam and Korean Wars that are suffering from some disease like diabetes,” Pankey said. “They lose limbs due to poor circulation.”

While at the GAIT Lab, Pankey works with patients by using interactive software and computer equipment.

First editions of software used at gait labs were designed for the sole purpose of evaluating medical conditions. However, the initial programs weren’t highly accurate and left room for error and incorrect diagnoses.

The pioneering software was greatly enhanced when discovered by the video game and movie industries for use in the field of entertainment.

The technology has since been used to monitor the precision movement of athletes for video games and to record the mannerisms of actors in such animated films as Monster House. The demand led to superior programs and resulted in providing pinpoint accuracy for rehabilitative services.

“In this (GAIT) lab, the money is dedicated to cameras, hardware and software applications,” Pankey said. “The same design used in games is done in our lab setting to draw skeletal images.”

Cutting edge programs and powerful computers at the GAIT Lab render three-dimensional, 360-degree images by wiring patients with devices and measuring their ability to move. Electric activity in the body and force analysis are also recorded.

“Force analysis is measured with a force plate that can determine whether or not individuals are walking in a balanced manner,” Pankey said. “We use balance assessment machines to gauge resistance of muscles and of the skeletal structure.”

Data compiled from the lab can be used to provide a personalized profile of the disabling issue, allowing doctors and physical therapists to construct an incredibly specific plan of rehabilitation for each patient.

If a prosthetic is required, a mold of a residual limb can be used and a socket fabricated out of plastic and titanium. Burn victims can benefit from scanning an image of their face on a foam card with computer aided design (CAD) software and layering it onto molded plastic. Facial shields can then be constructed to expedite the healing process.

“There are many avenues to this research,” Pankey said. “I want to open a foot mechanics lab with orthotics, too.”

Pankey says that movement science will continue to be a great help and that the market for specialists in therapeutic recreation and biomechanics can only grow. He cites that war veterans require follow up visits and the elderly need ongoing physical therapy.

“I keep telling my students that the baby boomers like me are aging and in ten years there will be a surge in this industry,” Pankey said.

Pankey uses state-of-the-art computers and advanced software to
render three-dimensional, 360-degree diagnostic images of patients.
 

Pankey explores further research applications in San Marcos at the Jowers Biomechanics Lab. It is funded through a $12,000 internal university grant from the health, physical education and recreation department. The lab contains a Biodex balance machine that measures the risk of falling for athletes and the elderly.

Additionally, he plans to study the effects of stochastic resonance. These mechanical vibrations in the legs and the body are used to improve balance, circulation and flexibility. Studies on crayfish sensing vibrations from predators spurred research in the field and Pankey is currently looking into how these low-level sensations may aid balance issues.

“These vibrations can be measured on research patients to see if it might help power, strength and flexibility,” he said. “We know for sure that it affects balance.”

Another of Pankey’s goals is to develop a mobile lab, one that can travel between the facilities at the university and be convenient for patients.

“I want it to be so we can take it to nursing homes and help the elderly with balance issues so they can start rehabilitation services early and give themselves more time,” Pankey said.

Students and faculty at the university have noticed the tenacity of Pankey’s resolve to work in many fields of biomechanics.

“It’s been a great opportunity for him by exposing himself to the latest research and furthering his study,” said Jack Ransone, director of athletic training and rehabilitation coordinator.

Ransone will be researching the effects of stochastic resonance, vibrations, balance and flexibility with Pankey.

“Anything to prevent injuries and allow athletes to be on the field as much as possible is a benefit to athletic training,” said Ransone. “He’s been very supportive of all the individuals in our program, we’re recognized as one of the largest and best in the country.”

Students remember Pankey’s enthusiasm and his devotion to further the field.

“He’s passionate about his work and it makes me motivated,” said Carreye Hieronymus, Wilmington, N.C. native, master of health education student and research assistant for Pankey in the Jowers Biomechanics Lab. “I lucked out because he’s concentrating only on research right now.”

Hieronymus approached Pankey for an opportunity at independent study in order to expand on the knowledge gained from his biomechanics lectures.

“You can’t know the basis of performance without measurability, and I’m excited to understand how that works,” said Hieronymus. “He’s doing a number of studies, so I’ve become more familiar with these machines and the research process.”

Others point out the classroom demeanor exhibited by the former chair of the department.

“He’s a real spark plug,” said Joshua Smith, Lytle native and former student of the master of education in physical education program. Smith was a pupil in Pankey’s advanced biomechanics course.

“You can tell Dr. Pankey is really into his field and excited about all it has to offer,” he said.

Smith said it’s easy to see how often prosthetics show up in daily life if you look for them. He used the example of Heather Mills, former model and estranged wife of Paul McCartney.

Mills is a contestant on the new season of television’s Dancing With The Stars who wears a prosthetic attached at the knee after losing part of her leg from a motorcycle accident.

“He loves what he does and I think he’s right,” Smith said. “You’ll be seeing a huge demand for these services. They make you feel good, too, because you’re really helping people.”

Pankey says providing care for veterans at the GAIT Lab can be a major asset in curbing stress for patients.

“We try to be aware of their dilemma and help them get through it positively,” he said. “We reassure them it will have an impact. The ability to ambulate is something most of us take for granted all too often.”

Pankey says he looks forward to helping former members of the military progress in picking up their lives.

“Making a little adjustment allows a person not to feel so conscience about their disability,” he said. “With all the advancements, we’re able to make them more comfortable, move more efficiently and naturally.”

Pankey will resume teaching full time as a professor in biomechanics and kinesiology next fall.