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HPRC Fitness Arena: Total Force Fitness
The U.S. Army has developed a device that will not only reduce the number of amputations but will help severely injured Warfighters return to duty. In the past, Warfighters with crushed and battered legs faced amputation or, at best, dysfunction due to pain and weakness. Now, with the introduction of the U.S. Army’s newest orthotic technology, amputations and decreased mobility may be a thing of the past for some.
The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is the latest orthotic technology designed for Warfighters whose legs were crushed in combat. It uses technology similar to that of prosthetics worn by amputees and is higher in user satisfaction and performance compared with other braces available. Unlike other braces, IDEO does not depend on ankle movement, so Warfighters with fused ankle bones, where function is limited, can use them with little pain. With each step, IDEO stores energy and transfers it to the back of the brace, which springs the leg forward (similar to running-blade prosthetics). This allows the wearer to continue rebuilding the muscles in his or her leg while also working on functional movement.
In a study conducted by the Center for the Intrepid, eight of ten patients fitted with IDEO were able to run at least two miles without stopping. All ten Warfighters returned to weightlifting, many returned to playing sports or participating in mini-triathlons, and three returned to combat—two with Special Forces and one Army Ranger. The published report emphasized that the success of these patients was due not only to the innovative IDEO but also to the intense rehabilitation program and—most important—the motivation and drive of the individuals.
In combination with rehabilitation programs, IDEO looks like the newest in a wave of innovations that will help Warfighters return to normal function. If you are interested in learning more about IDEO and other innovative rehabilitation programs, please visit the U.S. Army Institute for Surgical Research and the Brooke Army Medical Center’s Center for the Intrepid.
Winter’s not over yet. The next month or more can bring anything from ice and sleet to “Snowmageddons” and polar vortexes. Winter weather can be dangerous for you, your family, and even your pets if you’re not prepared. In the event of an emergency you should know what to do to protect yourself and your loved ones. The National Center for Disaster Medicine and Public Health has compiled a list of resources that offer information, tips, and checklists for winter-weather emergencies and general cold-weather health. Stay warm, safe, and resilient!
Have you heard the terms “resilience” and “Total Force Fitness,” but you’re not quite sure what they mean or where they fit into the health and performance picture? Read on.
Your health is the foundation. The 2010 article "Why Total Force Fitness?" states, “nothing works without health.” Health is not just physical and not just something to worry about when you’re sick. Health is a combination of physical, mental, spiritual, and social well-being and includes practices that promote wellness in addition to those that help you recover from sickness or injury.
Resilience is next. Resilience is the ability to bounce back—or even better, forward—and thrive after experiencing hardship. It is not the ability to completely withstand hardship but rather the ability to come back from it and grow stronger through the experience.
Next is human performance optimization (HPO). Unlike resilience, which typically requires the experience of hardship, HPO involves performing at your best for whatever goal or mission you have (whether that is your PT test, a combat mission, or raising children). It goes beyond simply resisting challenges; it means functioning at a new optimal level to face new challenges.
Health, resilience, and optimal performance are the foundations of Total Force Fitness, which is defined in the “Physical Fitness” chapter of “Total Force Fitness for the 21st Century” (see link above) as a “state in which the individual, family, and organization can sustain optimal well-being and performance under all conditions.” Being totally fit requires a holistic approach—that is, an approach that doesn’t focus on just one aspect alone such as nutrition or physical fitness, but on multiple domains of fitness. It means attending to your mind (including psychological, behavioral, spiritual, and social components) and your body (including physical, nutritional, medical and environmental components). In order to achieve Total Force Fitness, these factors come together to enhance your resilience and/or performance.
This is where HPRC can help you on your quest for total fitness. By visiting each of our domains—Physical Fitness, Environments, Nutrition, Dietary Supplements, Family & Relationships, and Mind Tactics—you can get evidence-based information on a variety of holistic topics to help you achieve and sustain total fitness. But remember that total fitness is a life-long process that will ebb and flow. And it isn’t just about you; your loved ones are an important piece of the picture, too.
There’s an old adage you may have heard: “Eat after eight, put on weight.” And maybe you’ve experienced it first-hand: You noticed that eating those late night pizzas and ice cream really packed on the pounds. But was your weight gain due to timing or just the high calorie counts? According to research in the field of circadian rhythms (CRs)—the 24-hour cycle of your body’s biological, hormonal, and behavioral patterns—it seems that when you eat could be just as important to weight gain as what you eat.
Deep within your brain sits a small cluster of nerve cells—a “master clock” of sorts—that’s responsible for orchestrating your CRs. Each biological system in your body works on a different CR schedule, and the master clock keeps all the schedules in sync. For example, CRs influence your body’s production of the hormones that regulate hunger, as well as how your body uses and stores fats and sugar, ultimately influencing your body weight, performance, and overall health. Other hormones, such as the ones that tell you when you’re full, are switched on or off according to a variety of inputs.
The two greatest influences on how well your master clock is able to keep things in sync are light and food. Light tells your brain how much sleep you get (think: eyes closed, less light). Food (smell, taste, and consumption) tells your body to produce a myriad of chemicals. As a result, staying up late at night, working shifts, and eating at all hours of the day and night—whether voluntarily or due to the demands of overseas deployments, training demands, shift-work schedules, and even parenthood—can play havoc with your circadian rhythms.
In an interesting twist, not only do CRs influence hunger and body weight, but excess body fat and/or a high-fat diet may disrupt CRs. This can lead to further weight gain, culminating in a collection of health problems known as “metabolic syndrome.” In the U.S., regular loss of sleep closely parallels the occurrence of metabolic syndrome. In addition, researchers have found that people who sleep less or have poor-quality sleep are more likely to become obese.
What to do? Make a conscious effort to “normalize” your daily routines as much as possible to maintain regular mealtimes. Whether you choose to eat three regular-sized meals or four to six smaller meals a day, space them out through the daylight hours to take advantage of your body’s natural rhythms. Here are some suggestions to avoid eating late at night:
- Try to eat a balanced dinner at least two hours before you go to bed, and take a walk afterwards when possible.
- Sip on soothing herbal tea or flavored water (without sugar).
- Be aware that watching TV (especially food-related ads) can trigger your desire to eat.
- Sometimes it can help to create new nighttime rituals that don’t involve eating, such as light stretching or yoga, taking a warm bath, listening to soothing music, or reading (or listening to) a book.
But if you find yourself up late at night—whether it’s due to a hard day at work, regular shiftwork, or temporary shifts due to jet lag or an infant’s night feedings—resist the urge to snack out of boredom or to “keep your energy up.” Shift workers should pack or purchase a healthy meal to eat during their work hours—one that includes lean protein and complex carbohydrates such as whole grains, fruits, and vegetables. Eat early in the shift if possible, so you’ll have the energy you need to think and move efficiently. Travelers and parents should look for healthy snacks that follow a similar pattern. And try to limit coffee, tea, and other sources of caffeine to just two to four servings a day.
Of course, eating is just one half of the CR equation. Getting enough sleep is important too, so read HPRC’s overview for great tips on how Warfighters can improve their sleep.
Misinformation abounds regarding ideal nap lengths for optimal cognitive performance. You need sleep to function at your best. If you do not get the recommended seven to eight hours of sleep a night, then napping can help. Learn more in HPRC’s Answer, “Nap to be at Your Best Mentally.”
Are you or is a service member you know going through rehab for an injury? Well it should be a comfort to know that there are people out there working hard to make sure you/they receive the best and most advanced forms of therapy and technology during rehab. The Center for Rehabilitation Sciences Research (CRSR) is headquartered at the Uniformed Services University, in Bethesda, MD, and their goals are to find solutions for improving rehabilitative care for injured service members and promote successful return to duty and reintegration. Most of their research is focused in the areas of orthopedic trauma, limb loss, and neurological complications, but they’re not working alone. Their expert team of researchers is partnered with other military medical facilities across the country, and they are committed to educating and training future healthcare providers within the military healthcare system. Visit the CRSR website to learn more about their current research, publications, and events.
Garcinia cambogia is being used as a dietary supplement ingredient in some products marketed for weight loss. What is it? And is it effective? Read this Operation Supplement Safety (OPSS) FAQ about Garcinia cambogia to find out. Be sure to check back often, as we add answers to other questions about ingredients in performance and weight-loss supplements and how to choose supplements safely.
If you have more questions about a particular dietary supplement ingredient or product, you can visit the Natural Medicines Comprehensive Database or use our “Ask the Expert” button located on the OPSS home page.
Calling all parents of deployed or soon-to-be deployed Warfighters! With your son or daughter’s deployment—particularly the first one—there are probably questions that need answering before your son or daughter heads out. Experts suggest some of the following may help prepare for your child’s deployment:
- Help your Warfighter figure out what responsibilities need to be covered while he or she is deployed and which ones can be managed from abroad. For example, how will the cell phone bill get paid? If he/she has a pet, who will care for it? (Check out HPRC's article about the latter.) Are there any bills that can be put on autopayment (such as a car payment)?
- Also, who will keep/store the car, motorcycle, or other belongings? Will anyone be allowed to drive or use them?
- Then there are the tough but necessary questions such as who will make medical decisions if your Warfighter becomes disabled and who will be the beneficiary of death benefits.
- Finally, if your Warfighter has a girlfriend/boyfriend/wife/husband, make sure you know them and have established open lines of communication, as they are often the ones with the most information about your son or daughter while deployed.
Planning for these kinds of details ahead of time can help make deployment(s) go smoothly. You can also encourage them to take advantage of their G.I. benefits for schooling while deployed. For more resources to help with deployment, explore the Deployment section of HPRC’s Family & Relationships domain.
The Army has been working to make sure that the small first-aid kits that soldiers carry are equipped with the proper equipment they might need in an emergency. Here’s the lowdown on the additions to the IFAK II.
The new design is compatible with the Improved Outer Tactical Vest, where it can be mounted on the back, out of the way but still easy to reach. The creators of the IFAK II made individual tabs that “feel” different for each of the kit’s contents—so that when a soldier is trying to reach for something quickly, he/she can easily distinguish between products without actually looking at each pouch. This design is critical for rapid access to first-aid materials.
Other upgrades to the kit include the addition of a second tourniquet, a strap cutter, and a rubber-seal device to treat a sucking chest wound (when a bullet penetrates the lung and interferes with proper air flow). The addition of an eye patch to the kit also can help reduce damage to injured eyes.
Some soldiers in Afghanistan are already carrying the kits to test their functionality and provide feedback that can help lead to even more improvements.
In 2013, the Research Institute of Chicago (RIC) presented the first mind-controlled bionic leg, thanks to support from the U.S. Army Medical Research and Material Command's (USAMRMC) Telemedicine and Advanced Technology Research Center (TATRC). Until now, this technology was only available for prosthetic arms. These brainy bionic legs are still being studied and perfected, but it’s hoped that they will be available in the next few years. This life-changing technology will be able to help the more than 1,600 service members who have returned from Iraq and Afghanistan with amputations. Bionic limbs will make the transition to active duty or civilian life smoother for wounded warriors.
In one case study, a civilian who lost his lower leg in a motorcycle accident underwent a procedure called “Targeted Muscle Re-innervation”. This procedure redirects nerves that originally went to muscles in the amputated limb to still-healthy muscles in the limb above the amputation. As these healthy muscles contract, they generate signals that are detected by sensors within the prosthetic and analyzed by a specially-designed computer chip and program The program rapidly decodes the type of movement the individual is preparing to do, such as bending the knee, and then sends those commands to the leg. This allows the person to walk up and down ramps and stairs and transition between activities without stopping. The user also can move (reposition) the bionic leg just by thinking about it, which is not possible with current motorized prosthetics.
The bionic leg is also showing a decreased rate of falling and quicker response time. Stay tuned for availability of this groundbreaking technology.
[Image Source: RIC/NWU]