The Military Advanced Training Center (MATC), completed at Walter Reed Army Hospital (Washington, D.C.) in September 2007, offers new state-of-the-art rehabilitation and research equipment. Perhaps most remarkably, a high-tech, computer-assisted rehabilitation environment (CAREN) system is one of only two in the United States. Using virtual reality, CAREN immerses service members in real-world scenarios to help them heal, practice, and train. The patient, harnessed in a standing position on a multi-axis platform, faces images projected onto a curved screen for three-dimensional, realistic effect. Movement of the platform is synchronized with the screen projection, while CAREN uses cameras to record the patient's movements. These data help with rehabilitation, patient feedback, and research. Prosthetists work closely with physical and occupational therapists in the clinical care area.
MATC also has a new, large biomechanics lab, featuring 23 cameras to record joint motion and velocity; six force plates that measure the amount and direction of ground reaction forces as the foot hits the ground; and an innovative, instrumented treadmill. Built into the floor, this treadmill for the first time allows biomechanical engineers to collect force-plate data from injured service members while they walk or run with their new prostheses. The process is called a gait analysis.
Information gathered is used in the same way as CAREN's: for clinical analysis, patient feedback, and research. Aside from expediting rehabilitation, both CAREN and gait analysis can greatly assist those who wish to return to active duty.
Those who have lost limbs require carefully coordinated and often complicated care at many levels, which is why psychologists, social workers, benefits counselors, and case managers all have office space at the MATC. Counselors can observe their patients' progress in the gym from their offices, through one-way mirrored glass.
Walter Reed already offered advanced amputee care; now the MATC benefits other patients as well, including those who suffer from traumatic brain injuries, polytrauma and/or post-traumatic stress disorder.
Physically, MATC is a $10 million, 31,000-square-foot, two-story building connected to the main hospital via a skywalk. Aside from clinical care, gyms, counseling, and offices, the facility includes a family lounge and full kitchen for patient and family use.
Returning to Duty?
In the past, military care for those who lost limbs involved mostly getting patients well and mobile enough to be discharged from the armed services and transferred to follow-on care, which the Department of Veterans Affairs provided. This old blueprint has now completely changed, starting with the assumption that discharge follows the loss of a limb. This is no longer necessarily the case, as many individuals will return to active duty.
From War to Hospital to Gym
Conceived as casualties began to return from Operation Enduring Freedom in early 2002, MATC was originally planned for care of combat-related loss of limbs; its capabilities have expanded since then. The building was funded in September 2004, but late that year, the Base Realignment and Closure Commission (BRAC) announced plans to close Walter Reed in 2011. This nearly halted plans for MATC.
After further consideration, senior military medical leadership determined that the center not only needed to be built, but built immediately. The BRAC still has the closing scheduled for 2011, but all of MATC's capabilities and most of its equipment will move along with the rest of Walter Reed to the by-then enhanced National Naval Medical Center in Bethesda, Maryland.
An Amputee Patient Care Board of Directors was established in October 2006, to advise the Secretary of Defense on programs and policies for Defense Department beneficiaries. Thus, as treatment continues to improve, Walter Reed and Bethesda can continue to incorporate state-of-the-art facilities and support.
An indoor running track circles one of two large rehabilitation/workout areas. An instrumented hydraulic ramp inclines to 35 degrees. There's a climbing wall, a Treadwall (basically a climbing-wall treadmill), and numerous weight-training machines. Using standard fitness-center equipment, Soldiers can transition smoothly from here to their hometown or Army installation gyms.
The Firearms Training Simulation System helps service members relearn how to use their weapons, both for basic soldier skills and in preparation for avocational activities such as target and skeet shooting or hunting. The firearms used have the same design, weight, and recoil response as weapons used in combat, but they have been modified to use Bluetooth technology and work in conjunction with the computer software. The firing experience, including recoil, is made realistic with gas cartridges. Various target ranges are used, and scenarios are projected onto a large screen.