There's seemingly no stopping Terrence Karpowicz, not even the king and queen of the Netherlands.

Karpowicz was showing off his bionic leg (see the video below) during the royal couple's visit to the Rehabilitation Institute of Chicago. While he did take pause to shake hands with King Willem-Alexander and Queen Máxima and answer some of their very targeted questions, he was determined to put his thought-controlled prosthetic in the spotlight. Karpowicz, who became an amputee in 1975 following a motorcycle accident, says the leg is "groundbreaking" and will "revolutionize" rehabilitation for amputees.

It's exactly this kind of breakthrough that inspired RIC and IMDI NeuroControl, a consortium of Dutch technology researchers, to sign a memorandum of understanding yesterday during the king and queen's visit. I previewed some of the other innovations that are being worked on by the two organizations in a blog last week.

The collaboration not only gives RIC access to some very unique technology, but also will improve the advancement of scientific ideas, RIC President and CEO Joanne Smith, M.D., told me after the event.

"Our objective is to test, prove and disseminate," she says. "By disseminating what we learn, we raise the standards of care."

RIC first publicized use of the leg a couple of years ago. Sensors detect patient movement and understand what's happening — is the person sitting, standing, going up stairs or down? A computerlike function in the prosthetic analyzes the data and essentially adjusts appropriately to ease patient movement. There is an ongoing clinical trial studying the use of the leg and the Army is beginning to test it as well.

Also on display at the RIC visit was a robotic exoskeleton that aims to help stroke and other patients recover and hasten the return of mobility. The device acts like a physical therapist to a degree. It can accurately measure how much pressure to exert on a patient as they begin their therapy.

Fidel Carabez, who suffered a stroke last year, walked with the device for the king and queen, who again showed great interest in the technology and how it has impacted Carabez's life.

Under normal rehab, two or three physical therapists might be needed to help lift and move a recovering patient. The robotic exoskeleton allows it to be done with just one supervising PT, says Arun Jayaraman, director of technologies and outcomes research at RIC. Carabez has been using the exoskeleton for seven weeks and has already seen tremendous results (see the video).

Jayaraman acknowledges that the cost-benefit ratio of these devices is something that needs further study, especially for smaller providers, but says the clinical outcomes are impressive.

The royal couple's health care tour of Chicago concluded at the Northwestern University Feinberg School of Medicine. Daniel Linzer, the school's provost, announced an expansion of research agreements between Northwestern and universities in the Netherlands (see the video). In particular, he highlighted work being done on aging. The king and queen then viewed a poster presentation.

Sadly for me, this wraps up my coverage of the royal visit. My trip to the Netherlands two weeks ago was an eye-opening experience, but it was especially great to see how clinicians in the two countries are working to make advances in patient care.