DTIC ADA541946: Clinical and Rehabilitative Medicine Research: Program Overview

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by  Defense Technical Information Center

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Clinical and Rehabilitative Medicine Research
Program Overview
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COL Janet R. Harris RN PhD
26 January 2011
US Army Medical Research and Materiel Command
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JAN 2011 2. REPORT TYPE 00-00-2011 to 00-00-2011
4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER
Clinical and Rehabilitative Medicine Research: Program Overview
5b. GRANT NUMBER
5c. PROGRAM ELEMENT NUMBER
6. AUTHOR(S) 5d. PROJECT NUMBER
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7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION
US Army Medical Research and Materiel Command,504 Scott REPORT NUMBER
Street,Fort Detrick,MD,21702-5012
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13. SUPPLEMENTARY NOTES
Presented during the Military Health System Conference Held January 24 - 27, 2011 at National Harbor,
MD
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USAMRMC
Mission and Vision
MISSION
VISION
Responsively and responsibly create and deliver medical
information and products for the warfighting family.
A trusted partner for leading biomedical research and
materiel innovation for global health.
2011 MHS Conference
USAMRMC
Customer-Focused Programs & Outcomes
Research to produce
medical knowledge
Medical Medical Medical Strategic &
Research & Technology Advanced Development Operational Logistics
Program Program Program
(4) Advanced Component Development Acquire, field, distribute, centrally
(1) Basic Research, (2) Applied
& Prototypes and (5) System manage, sustain/maintain and dispose
Research, and (3) Advanced Technology
Development & Demonstration of tech- of medical products, supplies and
Development to prove tech-base
base concepts or commercial products equipmentfrom the tech-base,
conceptsfor medical products (drugs,
into FDA-approved war-ready medical advanced development, or from the
biologics & devices) and information
products commercial sources
Congressional Special Interest Programs
2011 MHS Conference
CHANGE DRIVERS FOR THE
MILITARY MEDICAL RDA MISSION
June 26, 2008 SUSTAIN
Secretary Gates Memorandum Sustain Soldiers, Civilians and
Caring for Our Wounded Personnel Families, through recruiting and
and Their Families improving quality of life
“I request the development of a tailored Taking care of wounded Soldiers
plan to provide R&D investments that Rehabilitate Soldiers and get
advance state of the art solutions for them back into the fight
world class medical care with an
emphasis on Post Traumatic Stress PREPARE
Disorder, Traumatic Brain Injury,
To continue to prepare Soldiers for
prosthetics, Restoration Sight Eye-Care,
successin the current conflict
and other conditions directly relevant to
Continue to adapt its training and
the injuries our soldiers are currently
equipment to keep ahead of an
receiving on the battlefield.”
adaptive enemy
Training leaders and Soldiers
April 6, 2009
Secretary Gates News Conference RESET
Details New Pentagon Priorities Continue to reset units and to rebuild the readiness consumed in
FY2010 Defense Budget: “Continue the operations, to prepare them for deployments and future
steady growth in medical research and contingencies
development by requesting $400 million Reset for the future, not the past
more than last year.”
TRANSFORM
Transformthe Army to meet the demands of the 21stcentury
Continually modernize our forces and put our Cold War formations
and systems behind us
Future Combat Systems research and development is currently
the Army’s largest effort to modernize
2011 MHS Conference
CHANGE DRIVERS
What is driving change in the military R&D environment?
Contemporary War Casualties
•Current war casualties are
driving changes in healthcare
needs and therefore changes
Trauma Team at
Kirkuk Air Base in Iraq
TBI Suffered in Iraq
in R&D
•Specific types of casualties
driving changes:
– Traumatic Brain Injury (TBI)
– Blast Injuries
Workshop at the Walter Reed Amputee Center
– Amputations
% Body WWII Korea Vietnam OIF/OEF
– Other TArareuama (Eye/Ear injuries)
Blast Injury from
– Post Traumatic Stress Disorder (PTSD) Exploding Ordnance
Head & Neck 12% 21% 21% 16% 29%
Chest 16% 14% 10% 13% 6%
Abdomen 11% 8% 8% 9% 11%
Extremities 61% 58% 60% 61% 54%
Owens, J Trauma FEB 2008
2011 MHS Conference
RESETTING WOUNDED WARRIORS
R&D to Help Reset the Force
Evidence-based
return-to-duty
standards and
evaluation criteria
Return to
Reorientation
Duty
and Reunion
Redeployment
Medical
Warrior Transition Units
Evacuation (Army)
Return to
Transitional Reentry Sites
(Defense and Veterans Brain Injury Center Civilian
(DVBIC)
Life
2011 MHS Conference
CRMRP MISSION, FUNCTIONS,
AND PARTNERS
Mission
Focus on definitive and rehabilitative care innovations
required to reset our wounded warriors, both in terms of
duty performance and quality of life
Functions Coordinating Partners
 Manage a core research program consisting
of intramural and extramural efforts
 Leverage the congressional special interest
research programs administered by
DoD laboratories and medical centers
USAMRMC, and research efforts in other
DoD Congressional special interest
federal laboratories, universities and industry.
programs
 Coordinate the CRMRP research program
National Institutes of Health
with complimentary programs
Defense Advanced Research Projects
Scientific Steering Committees, a Joint Program Agency
Committee, and a Joint Technology Coordinating
Department of Veterans Affairs
Group were established to advise CRMRP on
program direction and priorities
2011 MHS Conference
CRMRP PROGRAM AREAS
Neuromusculoskeletal Injury: (Incl. Amputee) Regenerative Medicine and Transplants:
• Address psycho‐social recovery aspects • Improve speed of healing and decrease scarring
• Improve rehabilitation for limb salvage and spinal injury  • Regenerate missing tissue and repair nerve gaps
patients • Improve functionality and appearance following      
• Exercise and fitness systems and strategies   craniofacial repair
• Improved orthotics, prosthetics, robotics to improve  • Develop architecture to integrate created tissue
extremity function • Reduce need for tissue rejection therapy
• Incorporate neural interface/feedback • Improve surgical approaches and limb/tissue function
Sensory Systems: (Vision/Hearing/Balance)
Pain Management: (Acute/Chronic/Battlefield)
• Repair damage to the eye and visual system
• Improve management of battlefield, acute and chronic pain
• Restore hearing
• Establish safety margins for individual prescriptions
• Treat tinnitus
• Identify and treat pain generators
• Improve diagnostics
• Develop strategies to empower patient in managing pain
• Rehabilitate TBI‐associated sensory dysfunction
2011 MHS Conference
REHABILITATION
• Focuses on the rehabilitation of neuromusculoskeletal injuries,
including amputee care and prosthetics
• Coordinating with the Center of Excellence for Extremity Injury and
Amputation
• Major Initiatives:
 Military Amputee Research Program
 Prosthetics
 Leveraging Orthopaedic Congressional funding (Peer-Reviewed Orthopaedic
Research Program)
o Major Extremity Trauma Research Consortium
o Orthopaedic Rehabilitation Clinical Consortium
2011 MHS Conference