The use of a computer-assisted rehabilitation environment (CAREN) for enhancing wounded warrior rehabilitation regimens

Abstract Purpose This paper seeks to describe how novel technologies such as the computer-assisted rehabilitation environment (CAREN) may improve physical and cognitive rehabilitation for wounded warfighters. Design/methodology/approach The CAREN system is a dynamic platform which may assist service members who have sustained improvised explosive device injuries during Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. The complex nature of warfighter injuries present unique rehabilitation challenges that demand new tools for quick return to active duty or the civilian community. Findings Virtual reality-based gait training programs may directly influence physiological and biomechanical performance for those who have endured combat injuries. The CAREN system provides a safe, interactive environment for the user while capturing kinematic and kinetic data capture to improve rehabilitation regimens. Conclusions This paper provides an overview of the CAREN system and describes how this dynamic rehabilitation aid may be a translational tool for collecting biomechanical and physiological data during prosthetic training. The CAREN platform allows users to be fully immersed in a virtual environment while healthcare providers use these simulations to improve gait and stability, obstacle avoidance, or improved weight shifting. As such, rehabilitation regimens may be patient specific.

[1]  Donald Gajewski,et al.  The United States Armed Forces Amputee Patient Care Program , 2006, The Journal of the American Academy of Orthopaedic Surgeons.

[2]  Patricia M McAndrew,et al.  Walking Variability during Continuous Pseudo-random Oscillations of the Support Surface and Visual Field , 2022 .

[3]  P. Belmont,et al.  Epidemiology of combat wounds in Operation Iraqi Freedom and Operation Enduring Freedom: orthopaedic burden of disease. , 2010, Journal of surgical orthopaedic advances.

[4]  Sandeep K Subramanian,et al.  Virtual reality environments for post-stroke arm rehabilitation , 2007, Journal of NeuroEngineering and Rehabilitation.

[5]  Vanessa Q. Everding,et al.  Virtual reality enhanced balance training for service members with amputations , 2011, 2011 International Conference on Virtual Rehabilitation.

[6]  A. Hof,et al.  Balance control on a moving platform in unilateral lower limb amputees. , 2008, Gait & posture.

[7]  J. P. Beck,et al.  The road to recovery and rehabilitation for injured service members with limb loss: a focus on Iraq and Afghanistan. , 2010, U.S. Army Medical Department journal.

[8]  Rory A Cooper,et al.  Quality of medical care provided to service members with combat-related limb amputations: report of patient satisfaction. , 2008, Journal of rehabilitation research and development.

[9]  Frans Steenbrink,et al.  D-flow: immersive virtual reality and real-time feedback for rehabilitation , 2011, VRCAI.

[10]  Jonathan B Dingwell,et al.  Comparison of walking overground and in a Computer Assisted Rehabilitation Environment (CAREN) in individuals with and without transtibial amputation , 2012, Journal of NeuroEngineering and Rehabilitation.

[11]  E Otten,et al.  Case study: CAREN (computer assisted rehabilitation environment): A novel way to improve shoe efficacy , 2003, Prosthetics and orthotics international.

[12]  Sarah E Kruger A virtual reality approach to gait training in service members with lower extremity amputations , 2011 .

[13]  Adrian Lees,et al.  Kinematic response characteristics of the CAREN moving platform system for use in posture and balance research. , 2007, Medical engineering & physics.

[14]  Jason M Wilken,et al.  Gait Training With Virtual Reality–Based Real-Time Feedback: Improving Gait Performance Following Transfemoral Amputation , 2011, Physical Therapy.

[15]  C. Scoville,et al.  Amputation Is Not Isolated: An Overview of the US Army Amputee Patient Care Program and Associated Amputee Injuries , 2006, The Journal of the American Academy of Orthopaedic Surgeons.

[16]  Hannah Fischer,et al.  U.S. Military Casualty Statistics: Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom , 2013 .