Many of the wounded service members returning from the OEF/OIF conflicts are victims of car bombs or improvised explosive devices (IEDs) that cause severe injuries to several parts of the body. These multiple complex injuries are called polytrauma. Polytrauma can include a combination of injuries to internal organs, limb loss, vision loss, hearing loss, paralysis, chronic pain, burns, and psychological disorders.
Military personnel face many psychological challenges during their tours of duty that can make it difficult to readjust to life back home. As many as one in three service members may seek or need mental health care after returning from duty in Afghanistan or Iraq. Service members may experience symptoms of psychological distress, "readjustment disorders," or more serious problems such as posttraumatic stress disorder (PTSD). Depression and anxiety are fairly common and returning service members, especially younger Veterans, may turn to alcohol or drugs in an attempt to deal with their psychological distress. Use of alcohol or drugs can exacerbate these mental and emotional disorders.
PTSD is an anxiety disorder that may occur after a person experiences or witnesses a traumatic event, such as military combat, natural disasters, serious accidents, or physical or sexual assault. Many service members who have a diagnosis of PTSD respond well to standard treatment, but others do not. Research is critically needed to better understand this disorder so that effective preventive strategies and treatments can be developed and made available.
VA has the largest network of care for spinal cord injury (SCI) in the nation and provides primary and specialty care at 23 regional SCI centers. VA leads the health care profession in defining new methods of rehabilitation through SCI research and engineering. For example, VA researchers identified a molecular basis for "phantom pain," a phenomenon in which patients experience the sensation of pain in a limb that has lost all feeling, as in SCI, or in a limb that is no longer there, as in amputation. This discovery has enabled a better understanding of phantom pain and may eventually lead to new methods of pain relief.
Traumatic brain injury (TBI) is a general diagnosis covering a wide range of injuries to the brain that can occur during combat. These injuries can result in physical symptoms such as vision impairment, dizziness, and headache, as well as cognitive and emotional problems such as memory impairment, poor judgment, anxiety, and depression. VA investigators are conducting cutting-edge research to help return maximum function to Veterans with TBI.
Approximately 6 percent of wounded service members returning from Iraq are individuals with amputations. The number of Veterans accessing VA health care for prosthetics, sensory aids, and related services has increased by more than 70 percent since 2000. VA's Research and Development program currently supports a broad research portfolio related to amputation and prosthetics.
Severe burns cause excruciating pain and debilitation. VA is further expanding its research focus on burn injury to advance knowledge in this area of growing importance.
VA researchers have found that prazosin, an inexpensive generic drug already used by millions of Americans for high blood pressure and prostate problems, improves sleep and reduces nightmares for Veterans with PTSD. A larger trial to confirm the drug's effectiveness is underway.
A neuromotor prosthesis (NMP) is a brain-computer interface that helps replace or restore lost movement in paralyzed patients. The technology uses a miniaturized array of electrodes that picks up brain signals and sends them to a computer for decoding. VA researchers and others recently demonstrated that an NMP could enable paralyzed patients to operate an artificial hand, robotic arm, computer, or television by using only their thoughts.
Nature. 2006; 442(7099):164-71.
VA researchers demonstrated that the intravenous infusion of bone marrow stem cells taken from adults can protect against
brain trauma. This has major implications for an early intervention in Veterans with brain trauma and spinal cord injury.
Currently available prostheses for transtibial (below the knee) individuals with amputations do not help promote normal walking; in fact, their "passive" design can result in balance difficulties and slow walking. A team partly funded by VA has addressed this problem by developing a powered ankle-foot prosthesis that promises to help restore the ability to walk normally. A preliminary study involving three transtibial individuals with amputations confirmed the benefits of the new prototype: the patients expended less energy during walking, had fewer balance problems, and walked 15 percent faster.
Conf Proc IEEE Eng Med Biol Soc. 2007;2007:3020-6.
Many burn injuries result in the loss of fingers. VA researchers are developing a state-of-the-art prosthesis for people who still have a wrist but have lost their fingers due to burns or other injuries.
US Medicine. June 2006. www.usmedicine.com