Revolutionizing Prosthetics

Nicole Sasson ’84

A photo portrait of Nicole Sasson '84

As recently as the early 2000s, a service member who lost an arm, whether in battle or from an illness or an accident, often ended up wearing a hook-like artificial limb based on World War II-era technology. The prosthesis couldn’t mimic the sophisticated movements of the human arm, so veterans weren’t able to perform critical everyday tasks on their own.

The U.S. Department of Defense took note. Seventeen years ago, it launched a $100 million project to revolutionize prosthetic limbs. As part of the program, Segway maker and inventor Dean Kamen created the DEKA arm, the first prosthetic arm to perform simultaneous movements controlled by electrical signals from a person’s muscles. It better mimics the human arm, including movements such as flexing the wrist and flexing the fingers. As chief of physical medicine and rehabilitation at Veteran Affairs-New York Harbor Healthcare System, physiatrist Nicole Sasson ’84 was instrumental in helping test and fine-tune the robotic arm. (A physiatrist is a medical doctor who specializes in physical medicine and rehabilitation.)

As principal investigator for the VA’s New York campus, Nicole led clinical trials, testing the technology with veterans. “When this research opportunity came in, I jumped at it,” she says from her office, where she is surrounded by photos of military family members. “I love braces and orthotics. I’m very mechanical and like working with my hands.”

Nicole’s military connections go back generations. Her maternal uncle served in World War II and the Korean War. Her maternal grandfather was a member of the so-called “Lost Battalion,” U.S. Army units of WWI soldiers whom the Germans isolated and surrounded in France. And her great-grandfather on her mother’s side made corsets and prostheses for injured soldiers from the Austro-Hungarian Empire and was captured by the Russian army to do the same for their soldiers in the 1917 Revolution.

For more than eight years, Nicole used virtual reality environments to teach veterans how to use iterations of the DEKA arm. “This study drew people from all over the U.S. to our facility,” she says. Some of the veterans had infrequently left home previously. “People don’t realize how mentally exhausting it is to use a prosthesis,” she says. “But it’s easier after you’re properly trained.” Then, she watched veterans in their homes as they used the arm to cook, paint, and play the guitar or piano.

The FDA approved the DEKA arm as the “Luke Arm” in May 2014. Six months later, Nicole and colleagues published research reporting that more than 90% of users could perform new activities they hadn’t been able to do with their previous devices. (The arm is now available commercially as the LUKE arm.)

“Some veterans I worked with liked to play golf or rock climb or kayak. Now, they’re back out there, living their best lives,” Nicole says.

In addition to heading up the VA department that helps veterans with disabilities and pain and supervising residents and physical therapy and occupational therapy students, Nicole serves as a professor of rehabilitation medicine at NYU School of Medicine. For decades, she’s incorporated complementary and integrative medicine into her work and teaching.

At Wellesley, she studied molecular biology and anthropology and was pre-med. After residency training, she worked in rehabilitation medicine at Bellevue Hospital Center/NYUMC and then the Jewish Home and Hospital in the Bronx. At Bellevue, she developed the country’s first physical medicine and rehabilitation acupuncture clinic.

In her nearly 20 years at the VA, Nicole has seen the patient population shift, notably to include more women. This year, Veterans Affairs modified its mission statement to eliminate the “him” and “his” pronouns in a line from President Abraham Lincoln’s second inaugural address—on which VA’s mission is based—creating a more gender-inclusive statement.

“The VA has come a long way since its inception,” reinventing itself as “a health care system that was for our granddads, dads, uncles, and brothers, to one for our mothers, aunts, and sisters, too,” Nicole says.

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