Filed under: Injuries
For some injured Warfighters, achieving total fitness may include assistive technology (AT). Assistive technology is any physical equipment or system used to improve or help maintain the functional abilities of an individual. There are assistive technologies for almost every disability or injury, such as communication boards, both manual and electronic; technology for vision and hearing impairments (magnifiers, talking watches, hearing aids); tools to assist daily tasks (shower chair, adapted eating utensils); adaptive sports equipment (sit-skis, sport wheelchairs, recumbent tricycles); and technologies that enable mobility (from a cane or walker to sophisticated prosthetic legs and powered wheelchairs). Driving aids and fully equipped vans are other important assistive mobile technologies. Mobile assistive technology can promote independence and increased quality of life. Even phones and apps can be used as memory aids and organization- and time-management tools for helping with traumatic brain injury and psychological health. If you’re an injured Warfighter looking at the possibility of AT (or if you just want to know more), there are many things to consider when choosing the right AT for you, including:
- First and foremost, understand your own goals, priorities, and preferences and discuss them with your healthcare team. A person’s reaction to AT is both personal and complex. You must be closely involved in the choice of your assistive technology to ensure a “good match.”
- Consider where you will be using your assistive technology (indoors or outdoors).
- Consider how you will feel about using your equipment. AT equipment shouldn’t be embarrassing, inconvenient, or cumbersome.
- Have you accepted your challenge, and are you ready to move forward? Finding a "new normal" to accomplish your goals may include using assistive technology, but you must first embrace this concept.
For those who can benefit, AT can be a big piece of Human Performance Optimization (HPO), part of HPRC’s Total Force Fitness mission.
It seems that just about everyone is a runner these days, and it’s an essential part of being a Warfighter. Since 1990, the number of road race finishers in the U.S. has more than quadrupled. Participation in the largest road races has increased 77% in 14 years! More runners means more who need to learn about running injuries. Check how injury savvy you are with the infographic below, courtesy of the Sports Performance and Rehabilitation Department of the Hospital for Special Surgery, educational partners for the New York City Marathon.
These days there’s an app for just about everything, including injury prevention. In fact, there are many apps for that. But the truth is that most of them are not backed by science. Unfortunately, among the thousands of smartphone apps in the fitness, medical, and sports categories, only a handful provide evidence-based information on injury prevention.
After sifting through hundreds of different fitness and sports-related apps, researchers in a 2012 study found only 18 apps claiming to provide tips for injury prevention and rehabilitation. Only four of these apps contained claims for which they could find supporting scientific evidence. For example, the “Ankle” app was developed to implement an exercise program based on results from a well-conducted study. Other of these four apps appeared to be evidence-based only by coincidence, not as the result of a sound background search of the scientific literature. By comparison, five apps provided tips (such as warming up, stretching, proper shoes) to prevent running injuries despite a lack of evidence that the recommended practices actually reduce risk of injury. Other apps contained equally unsupported claims in areas such as shoulder injury, plantar fasciitis, and delayed-onset muscle soreness (DOMS). One even cited published literature that did not support its claims.
If you’re searching for injury-prevention strategies, it’s important to be wary of apps that contain inaccurate or unsupported information. The visual appeal and usability of an app may not necessarily reflect the quality of information, especially when it comes to injury-prevention tips. And while the study mentioned above is more than a year old, it’s unlikely the situation has changed. Check out HPRC’s injury-prevention resources or talk to a physical therapist if you have other concerns about injury prevention.
If you’ve ever had a back injury, you know that the recovery process can take weeks, months, or even years—this is referred to as a chronic condition. Preventing injuries to the back can save you from going down this long road to recovery. Check out our new article on back injuries that includes tips on lifting heavy objects, strengthening the muscles of the back, and maintaining adequate flexibility in the muscles, tendons, and ligaments.
Your knees are major weight-bearing joints and require some ongoing care to keep them functioning well, regardless of your MOS or sport activities. A new HPRC article on knee injuries provides information on knee-injury prevention. We focused on the anterior cruciate ligament (ACL) because this injury is quite common in the military and can put a soldier on profile for six months or even more. ACL injuries typically require surgery, so it’s an injury you want to avoid, if possible. Scientists and researchers have discovered some specific information that can be useful to decrease your risk of ACL injuries.
Ankle injuries are quite common in the military, and you put yourself at a greater risk for sprains and strains if your ankles are weak. There are some simple tips you can use to keep your ankles healthy, including choosing the proper footwear and maintaining adequate strength in the muscles that control movement of your ankles. Check our new information on ankle injuries.
Many military jobs require that you have strong and healthy shoulders. So whether it’s performing well on your push-up test during the PRT or moving the ammunition can during the CFT, you need your shoulders to function well. HPRC has rolled out a new Injury Prevention Strategies series, which includes tips on preventing shoulder injuries. Check out the information on strengthening and flexibility exercises and get started today!
The wounds of war also affect the family members of injured or ill Warfighters. The job of caregiving often falls to a family member, and while it can be a rewarding job, it can also be stressful. Taking time for yourself is important. You run the risk of burnout when your attention is directed solely towards others without time to recharge. Below are tips to help you find balance in taking care of both your loved one and yourself.
- View caregiving as if it were a team sport, not a solo one. Get other people to share the responsibilities.
- Encourage independence by supporting your loved one to do as much as possible for him/herself.
- Take a pro-active and positive perspective.
- Have a take-charge attitude for problems, and then reframe those problems into challenges.
- Avoid tunnel vision; find a balance between taking care of your injured loved one and taking care of yourself and others in the family.
- Create a care plan for yourself that includes fun time, down time, and relaxation methods. For some ideas, check out the Mind-Body Skills section of HPRC’s website.
- Seek professional help when needed.
For more information, read this handout on “Coping with Caregiver Challenges,“ which addresses common caregiver challenges such as stress and symptoms such as headaches and then suggests ideas for coping. Other strategies include keeping yourself healthy with exercise, rest, and eating well. For more ideas, check out the Traumatic Brain Injury website’s “Stress Busters” section. Building your stress-management skills can be a big help. Finally, assess yourself regularly to check on your well-being (to prevent burnout) can also be helpful. You can find assessments for caregiver stress at Afterdeployment.org (online) and Traumatic Brain Injury (for download).
Not only is exercise good for the body, it’s good for the mind. The expert consensus from the International Society of Sport Psychology is that exercise can increase your sense of well-being and help reduce anxiety, tension, and depression.
For veterans coping with depression, PTSD, or other mental-health issues, sports and exercise may be a great way to relieve stress. Scientists have shown the positive benefits of physical activity on symptoms of depression in veterans. What’s more, Veterans’ Administration studies have found that physical activity—especially vigorous activity—can decrease the risk of PTSD among Warfighters. The opposite is also true: Veterans who do not engage in physical activity are more likely to experience PTSD. Several organizations specialize in physical activity and exercise for warriors and their families, but you can always try a yoga class, a family bike ride, or other fitness opportunities in your community.
Getting motivated to exercise and stay active can be especially difficult for those suffering from PTSD and depression. Here are some tips to help you get up and get out the door.
- Make a date with yourself. Put it on your calendar or set a daily alarm—whatever you need to do to remind yourself that you’ve set aside some time for you to exercise. And don’t stand yourself up!
- Set a SMART goal and write it down. Post it on your bathroom mirror, your fridge, your car dashboard—wherever you’ll see it daily to remind yourself of what you want to accomplish.
- Recruit friends or family members to help. Telling people what your goals are is a great way to stay accountable. An exercise partner is especially helpful when you need that extra nudge to get off the couch and start moving.
- Keep a journal. Record your exercise activities and how you felt afterwards. While you may not feel better after every workout, you probably will most of the time. Being able to go back and read/remember how good exercise made you feel may motivate you for the next workout.
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.