Military medicine
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Equine-assisted therapy (EAT) for post-traumatic stress disorder (PTSD) has attracted great interest despite lacking empirical support, a manual, and a standardized protocol. Our team of experts in EAT and PTSD developed an eight-session group EAT treatment protocol for PTSD (EAT-PTSD) and administered it to two pilot groups of military veterans to assess initial effects. ⋯ This article presents the first standardized EAT protocol. Highly preliminary results suggest our new manualized group EAT-PTSD appears safe, well-regarded, and well-attended, yielding short-term benefits in symptomatology and quality of life if unclear length of effect. Future research should test this alternative treatment for PTSD more rigorously.
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Soldiers' lower limbs and feet are frequently affected by overload- and overuse-related injuries. In order to prevent or limit the incidence of these injuries, the use of foot orthoses is often recommended. The aim of this study is to assess the effects of shock-absorbing insoles on in-shoe plantar pressure magnitude and distribution in a group of professional infantry soldiers wearing military boots during standard indoor military training. ⋯ Shock-absorbing insoles can be an effective solution when fitted inside military boots. The present functional evaluation shows that wearing a prefabricated shock-absorbing insole can provide a significant amelioration of perceived foot comfort and plantar pressure parameters. Further studies are now needed with a larger population and more demanding exercises.
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Future challenges for the U.S. Department of Defense (DoD) include operating in a contested environment against near-peer adversaries. Providing casualty care in an anti-access/area denial (A2/AD) region would be potentially challenged by impaired logistical ability to reconstitute supplies or adapt to evolving needs. Additive manufacturing (AM), also known as 3D printing, offers an ability to regenerate stocked items as well as modify them or even create novel products de novo. ⋯ This paper encourages further investigation of the use of AM/3D printing downrange to create surgical instruments and medical supplies in austere, A2/AD, and other logistically challenging environments. Not only would this support regeneration of supplies, but also modification and even creation of novel products to adapt to changing needs. If 3D files could be created of common surgical instruments for print on designated resins downrange, and FDA approval obtained, an online library of files could be created for easy access to DoD members across the globe to support our nation's commitment to provide the best possible care for service members any time, any place.
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In patients with prior myocardial infarction (MI), cardiac rehabilitation (CR) has been shown to reduce all-cause mortality, cardiac mortality, and risk of recurrent MI. Medically supervised cardiac rehab has challenges such as increased patient and center cost, patient transportation issues, patient time commitment, and increased need for resources. Home-based cardiac rehabilitation (HBCR) is an innovative alternative to medically supervised CR which can help to address some of the aforementioned issues. HBCR has been shown to have similar patient outcomes when compared to medically supervised CR; however, implantation efforts and experiences within Veteran Affair (VA) facilities were limited. Thus, we sought to describe our implementation efforts and outcomes of HBCR at our VA medical center, since our VA medical center does not offer an on-site medically supervised CR program. ⋯ HBCR is an effective alternative to facility-based CR. Veterans who completed the program showed improvement in physical capacity and functional status. Compared to those who were eligible but did not complete the program, hospitalization for heart failure was reduced after completing HBCR.
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This study examined working memory impairment following mild traumatic brain injury (mTBI) among active duty service members charged with criminal offenses. The prevalence of mTBI among service members involved in the military justice system is unknown. Impairments associated with mTBI may affect cognitive processes related to psycholegal capacities, and history of mTBI may have a persuasive appeal when explaining questions of culpability. The degree to which mTBI affects psycholegal abilities through cognitive impairment, however, is unknown. ⋯ This study suggests that a history of mTBI is common among service members charged with criminal offenses. The findings that working memory scores were in the average range among service members with mTBI history may suggest that history of mTBI does not impair psycholegal relevant cognition. More research is needed to clarify how history of mTBI affects service member psycholegal capacities.