The NYC Lab Helping Veterans Thrive After Limb Loss

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Summary:

• A unique NYC VA lab uses cinema and gaming-grade motion capture to optimize prosthetic care for veterans with limb loss

• The BRAVO Lab combines elite research and clinical care—one of the only facilities in the country to do both

• Veterans receive cutting-edge prosthetics, 3D-printed devices, and experimental bone-imaging technology at no cost

• The BRAVO lab handles some of the VA’s most complex cases, serving veterans in their 30s to 80s across every era of American military service

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Cesar Jimenez refuses to let limitations define him. At 77, this Vietnam veteran and passionate marathon runner—who lost his right leg below the knee in a machine-gun incident decades ago—fishes, hikes mountains, and prepares for the Boston Marathon. He shoveled snow last winter, works as a ski instructor for people with physical challenges, and is a proud member of the Achilles Freedom Team for wounded veterans.

For the North Plainfield, NJ, resident, he views his limb loss as a challenge, not a handicap.

Jimenez credits much of his limb loss recovery, independence, and athleticism to a research lab located within the VA New York Harbor Healthcare System in Manhattan. The VISN2 BRAVO (Biomechanics Research for the Advancement of Veteran Outcomes) Laboratory is a place where advanced science meets personal sacrifice, enabling veterans like Jimenez to challenge what others might see as fixed limits.

Sci-Fi Technology in a VA Lab  

Stepping into the BRAVO Lab can feel like entering a sci-fi film. Its advanced 3D motion-capture system—the same technology used to animate characters in blockbuster films and video games—analyzes every angle of a veteran’s movements to enhance their quality of life. Instead of creating digital avatars, the BRAVO team uses this data to understand the biomechanics of how people move with prosthetic devices.

Eleven motion-capture cameras gather 360-degree views of joint angles and forces exerted during movement, tracking 78 infrared markers attached to a veteran’s body. Movement is recorded at 120 frames per second with markers at joints, joint centers, and body segments, providing a detailed view of motion and inefficiencies.

Force plates embedded in the floor operate based on Newton’s Third Law: each step pushes back on the plates, allowing measurement of forces through the joints and the resulting motion. Two plates with glass tops enable cameras below to capture footfalls from underneath. Veterans walk, run, cycle, and even analyze their golf swings in the lab. In an interview with the New York Post, Jason Maiko, the BRAVO Lab’s director, said that “the sky is the limit” for what can be studied.

“Probably the Best Limb Loss Care in the World”  

BRAVO, established from the ground up about 15 years ago, has grown into what Maikos describes as “probably the most unique lab in VA in the country.” It stands out as one of the few facilities that combines elite research capabilities with specialized clinical services, handling some of the most complex cases.

Its seven-person team—comprising a biomedical engineer, research scientist, physical therapist, clinical coordinator, kinesiologist, and prosthetic technician—dedicates itself to advanced research and direct, hands-on care. Amputee veterans visit for consultations or participate in ongoing research studies, where the team evaluates gait, mobility, and asymmetries, then works to improve their devices or suggest new technologies.

A key advantage BRAVO has over most prosthetic care providers in the country is financial: since the VA operates independently of Medicare, Medicaid, and private insurance, the team can prescribe the most effective technology without reimbursement concerns. Studies suggest lifetime costs for someone with lower limb loss can exceed $500,000—and climb far higher for complex cases. But for these veterans, the cost is zero.

Inside the Biomechanics Research  

BRAVO’s most innovative work includes dynamic stereo X-ray (DSX) imaging—a technique that captures real-time visualization and tracking of bone movement inside a prosthetic socket. Biomedical engineer John Chomack is conducting a DSX study involving nearly 24 veterans and civilians to enhance prosthetic fittings and guide future device designs.

Chomack told the New York Post that they aim to continue developing this technology so it could become part of clinical care to optimize prosthetic fitting.

The stakes are high since one of the main issues in prosthetic care is socket fit, and poor fit can lead to skin breakdown, pain, and falls. Since residual limb skin is not meant for load-bearing, DSX imaging paired with radiopaque markers that highlight bone and skin on X-rays allows the team to analyze skin strain during walking and assess how socket design and suspension impact tissue over time.

Because the technology used is commercially available, researchers and clinicians outside the VA can also apply these findings, broadening BRAVO’s influence beyond New York.

Veterans of All Ages, with Diverse Ambitions  

The lab works with veterans ranging from their 30s to their 80s, representing service from Vietnam and Korea to Iraq and Afghanistan. Nearly 1,700 traumatic amputations have been documented post-9/11 alone. Their aspirations vary: some wish to walk with their grandchildren, while others aim to run marathons.

William Alvarez, an 80-year-old Manhattan resident and double below-knee amputee from a booby trap in Vietnam, is a Purple Heart recipient and passionate marathon runner. He was part of the Freedom Team for combat-wounded veterans before discovering adaptive sports through the lab.

Alvarez shared that he fell into a slump for a while but reached a point where he “didn’t want to be a couch potato anymore.” Now, he participates in regattas by rowing. The lab assisted him in improving posture and stroke efficiency, even designing specialized feet that flex more naturally so he could fully engage in handcycling and rowing.

One of the lab’s most remarkable cases involves a veteran who is both a talented golfer and a double leg amputee who is mostly blind due to active duty. The BRAVO team analyzed his golf swing to help him play with less pain and better mechanics—highlighting, as Maikos said, that to “never count a vet out” means recognizing ongoing potential.

3D Printing and the Future of Care  

3D printing is increasingly integral to BRAVO’s offerings, especially for veterans with limb loss with limited arm mobility. Research engineer David Herlihy explained how the lab’s advanced 3D printer produces custom mouthpieces and controller adapters—personalized video game input devices—enabling veterans with restricted arm use to control equipment with a single hand and improving prosthetic rehabilitation outcomes.

The VA is also testing osseointegration surgery for veterans with above-the-knee limb loss. This procedure involves anchoring a titanium implant directly into the bone, eliminating the socket and providing a more secure, direct connection to the prosthetic limb. BRAVO’s research aims to help shape the development of this emerging technology.

The Spirit Behind the Science  

What sets BRAVO apart isn’t merely its technology, funding, or the quality of research—it’s the deep understanding that, at its heart, veterans who come to the lab have already given more than most will.

For Chomack, with a decade of VA experience and involvement in seven BRAVO studies, this understanding influences every consultation, gait analysis, and socket fitting. Veterans might not speak openly about their service, but they visibly carry their sacrifices in their movement, effort, and support for one another.

Chomack said that they have incredible pride in serving, being part of the community, and being in the lab, especially for research.

This collective spirit—that participating in a study today might ease a fellow veteran’s pain tomorrow—is what sustains the lab’s participant engagement and the significance of its prosthetic care research.

For Maikos, that has always been the core purpose. While the technology is impressive, it serves a simple goal: ensuring that men and women who experienced limb loss and sacrificed their bodies for their country don’t have to give up their independence as well.

Related Reading:

Experimental Robotic Leg Helps Veteran ‘Feel’ Missing Foot

VA Develops Sensor That Gives Real-Time Data on How Your Socket is Fitting

The Mobile Prosthetic and Orthotic Care: Shaping the Future of Limb Loss Support for Veterans