The Extremity Trauma & Amputation Center of Excellence (EACE) is a one-of-a-kind organization within the Department of Defense and Department of Veterans Affairs consisting of teams of researchers embedded at the point of care within multiple Military Treatment Facilities (MTFs) across the nation. In line with the congressionally directed mission of the EACE, the research efforts undertaken focus on the mitigation, treatment and rehabilitation of traumatic extremity injuries and amputations with a specific focus on translating their findings into clinical practice to improve the care of Servicemembers and Veterans. The proposed work will be conducted by the EACE-Bethesda team at Walter Reed National Military Medical Center (WRNMMC), the nation’s largest and most renowned military medical center. This world class institution offers a full suite of infrastructure and facilities which are ideally suited for a wide variety of research activities (i.e., bench to bedside). Importantly, the EACE-Bethesda multidisciplinary team is comprised of basic and translational scientists of varying educational background, and clinicians from across the medical spectrum, which when taken together, provides a privileged perspective of the injury conditions that challenge wounded Servicemembers. Within the Department of Rehabilitation at WRNMMC, the Biomechanics and Virtual Reality Laboratories primarily focus on aspects of rehabilitation after extremity trauma or amputation. In particular, we use optical motion capture and force platforms to measure kinematic and kinetic data during human movement; integrated measurements of muscle (EMG) and/or brain (EEG) activity can supplement such evaluations. Additionally, the CAREN system – composed of a 6 degree-of-freedom motion platform, instrumented treadmill, and a 180-degree curved screen – allows patients to interact with virtual environments, for the purposes of evaluating and/or training gait, posture, and other aspects of human movement.
Recently, our work within these labs aims to better understand longer-term musculoskeletal complications following limb loss (e.g., low back pain and osteoarthritis), conditions that are reported at rates much higher than the general population, and likely influenced by various biomechanical mechanisms related to altered gait and movement characteristic of this population. These secondary complications are especially concerning for service members with limb loss, as they typically undergo amputation at a young age and therefore will live with a pronounced and progressively increasing risk for many years. Thus, in 2019, projects/topics available to prospective BESIP interns include biomechanically driven investigations that will enable the student to:
- Assist in the design, development, and execution of clinical research.
- Gain exposure to various technologies and approaches for evaluating human movement and other functional outcomes
- Gain experience with novel prosthetic and orthotic technologies, and understand their influences on human movement and functional outcomes.
Essential to all of these are a basic understanding of mechanics and experience with computer programming (e.g., MATLAB). In addition to learning human movement science and biomechanical research, the intern will also be exposed to other aspects of physical medicine and rehabilitation, including physical/occupational therapy, prosthetics/orthotics, and other related sub-disciplines, as relevant.