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HPRC Fitness Arena: Physical 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.
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.
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]
Activity monitors, also known as “activity trackers” or “accelerometers,” provide an easy way to track how much exercise and sleep you get each day, and some even track your diet. Most are small enough to be a convenient, easy way to keep you accountable and on track for getting the recommended amount of exercise each day. They also offer computer and/or smartphone apps for on-the-go tracking. Check out our comparison chart of some of the more popular trackers to find the right one for you and your budget.
Self-myofascial release, commonly known as “foam rolling,” has caught on in gyms and physical therapy clinics—and for good reason. It can help loosen tight muscles, tendons, ligaments, and fascia (the covering of the muscles), increasing your range of motion (that is, how much your muscles and joints can move). Foam rolling can also reduce the muscle soreness that results from working out too hard or too long. One recent study found yet another benefit: If you foam roll before a workout, it can possibly reduce the fatigue you feel during the actual session, thus increasing the length of time that you can exercise or even how hard you work out. How does foam rolling work? More research is needed to understand all its effects, but it is known that muscles have specialized receptors called Golgi Tendon Organs (GTOs) that are sensitive to changes in muscle tension, so when you roll over them, the muscles relax.
How do you get started? First, check with your doctor to make sure that it’s safe for you to do, and then follow these guidelines:
- Don’t foam roll over recently injured areas.
- More density = more pressure, so choose a low-density foam roller if you are just starting, and then progress to one that’s more dense.
- Foam roll over tension spots you feel in your muscles, or use continuous rolling over a muscle to loosen it.
- Gradually increase the amount of time you roll over each muscle. Generally, one or two minutes per muscle group is recommended if you are just starting.
Maintaining good oral health has long been a challenge for Warfighters. As early as the 4th century BC, Greek historian and soldier Xenophon noted that his fellow warriors had sore, foul-smelling mouths. During World War I, the term “trench mouth” was coined to describe poor oral health among soldiers engaged in trench warfare. Despite advances in dental care and hygiene, deployed Warfighters are still at risk for trench mouth—now referred to as necrotizing periodontal disease (NPD)—a condition that can lead to painful ulcers, spontaneous gum bleeding, and a foul taste in the mouth. Poor oral health adversely affects readiness and could cost you your career. A variety of factors can contribute to the problem of poor oral health, so we offer a few solutions.
Poor hygiene. Warfighters often have little time for oral hygiene when deployed, and you could fall out of your normal routine of brushing and flossing. In addition, you may overlook the need to pack a toothbrush, toothpaste, and floss in your personal hygiene kits, making it even more difficult to keep your mouth and teeth clean.
Solution: Be sure to pack a few travel-size tubes of toothpaste, some dental floss, and a travel-size toothbrush in your travel bag and establish a routine as quickly as possible.
Tobacco use. Using tobacco products can lead to gum disease by impairing blood flow to your gums, which can cause tooth loss and make you more susceptible to mouth infections. Tobacco use affects other aspects of performance, too.
Solution: It’s never too late to quit—check out these great tips to become tobacco-free.
Poor nutrition. Eating right can be challenging in the field. The stress of combat and training missions can dampen your appetite and—let’s face it—MREs aren’t the same as a good, home-cooked meal. But not eating enough food or not eating a variety of foods can cause vitamin and mineral deficiencies that reduce your ability to fight infections.
Solution: Although MREs can’t replicate the tastes of home, they are nutritionally balanced to prevent vitamin and mineral deficiencies among Warfighters during training and combat missions. It’s important to eat a variety of MREs and to eat as many of the different components as you can to make sure you get all the nutrients they provide.
Stress. There’s no doubt that stress adversely affects many aspects of performance and overall health, to include dental health. Stress can cause dry mouth and sore, inflamed gums.
Solution: HPRC’s Stress Management section can help you find ways to cope with your stress.
While any one of these factors can contribute to dental problems such as tooth decay, when taken together, they can create a “perfect storm” that can cause serious dental issues such as NPD. Maintaining a good oral-health routine (even when deployed), cutting back on tobacco, eating right, and managing your stress can go a long way toward helping you maintain good oral health and your performance. For more information, look into these tips on oral health from the Centers for Disease Control and Prevention (CDC).
And be sure to take care of your teeth (while you still have them)!
It’s time to get up off the floor and add something new your core-workout routine. Crunches aren’t the only way to strengthen your core. The Human Performance Resource Center now offers a six-video YouTube series on Vertical Core Training. Your core is more than just your abs; it includes other muscles that stabilize your shoulders, hips, and pelvis. Whether it’s lifting ammo cans or loading a truck, a strong core will help you move safely and efficiently. Use these videos to guide you through various exercises that will help improve total core strength and stability for everyday activities and optimal performance. You can also find these videos and other training resources online in HPRC’s Physical Fitness domain.
Many Warfighters exposed to bomb blasts in the field walk away unscathed—or so it would seem. However, there could be some damage they’re not “seeing.”
Many Warfighters survive bomb blasts without obvious injuries, but the high-pressure shockwaves from explosive blasts can cause serious physical damage to a Warfighter’s eyes. In fact, up to 10% of all blast survivors experience significant eye injuries, either from projectiles thrown into their eyes, eye perforations caused by the high-pressure blast waves, or effects on the eyes associated with traumatic brain injury (TBI). If you were exposed to a blast while in the field but were not otherwise injured, don’t wait to set up an appointment with your eye doctor. Your vision is extremely important! Don’t let potential eye injury go untreated. For more information on how blast waves can affect your vision, visit the Vision Center of Excellence.
You’ve been training, and now you’re in pain. It could be you’re having a painful introduction to one of your tendons. Strong tendons connect your muscles to the bones in your body and help you move by pulling on the bones when your muscles contract. Damage to tendons can occur from repetitive activities (including running and firing your weapon repeatedly over an extended period of time) or from sudden movements that put too much stress on a tendon. If you can’t avoid these activities, then pay attention to the warning signs that a tendon could be reaching its breaking point: pain, especially when moving the affected area; swelling over the area of pain; and, possibly, loss of motion in the joint.
The best way to avoid having to get treatment for tendonitis is to prevent it from happening in the first place! Follow these tips:
- Overall health: Maintain a healthy diet and weight, and check out HPRC’s Nutrition domain.
- Posture and body mechanics: Pay attention to your posture and make sure that you use correct body mechanics, especially when lifting and moving heavy objects.
- Maintain adequate muscle strength so your body can react to stresses you place on it.
- Maintain adequate flexibility.
- Consider proper workout gear, especially footwear; check out this HPRC article for more information.
- Activity modification: Rest the affected area. This could mean taking some time off from activities that cause pain and further damage. For example, if you’re a runner with Achilles tendonitis, try biking instead until the tendon has healed enough.
- Ice: Cold can help to decrease pain and swelling.
- Physical therapy: Gentle stretching and strengthening exercises, as well as massage, might help but should be done under the supervision of a healthcare provider.
- Anti-inflammatory medications: Ask your physician about medications that can help your condition.
- Bracing or casting might be needed in severe cases.
You should see your doctor right away if you experience fever, redness, and warmth in the affected area, or multiple sites of pain. For more information on injury prevention, check out HPRC’s “Preventing common injuries,” which covers six specific areas of injury: wrist and hand, knee, ankle, rotator cuff, back, and IT band.