Questions and Answers
Q:What is meant by the term "reset"?
A:The term "reset" refers to providing the restorative and rehabilitative care necessary to return wounded warriors' physical and cognitive capacities to a state where the patient can return to a productive life. The goal of this care is to return these patients to their prior military duties, or when not possible, an alternate duty or civilian life.
Q:What is driving change in the current military research and development environment?
A:Contemporary war casualties are driving changes in health care needs and therefore changes in research and development. Specific types of conditions driving changes include:
- Traumatic brain injury
- Blast injuries
- Amputations
- Other trauma (e.g., eye/ear injuries)
- Post-traumatic stress disorder
Q:Why is there a need for the CRMRP?
A:The CRMRP is necessary to create a critical mass of research expertise that will lead to definitive and rehabilitative care innovations required to reset our wounded warriors, both in terms of duty performance and quality of life. The focus on return to duty has become a key theme in Department of Defense military care for wounded warriors.
Q:What is the payoff for the Warfighter?
A:CRMRP products will aid in decreasing the ultimate debilitation, disfigurement, and disability that follow injuries to Soldiers. This will yield benefits that include:
- More rapid return to duty
- Fewer losses of personnel to permanent disability
- A decrease in costs for long-term care of wounded personnel
- An increase in Warfighter morale
Q:How is the CRMRP related to the AFIRM?
A:The CRMRP is the lead program for oversight of the AFIRM, which is a virtual organization consisting of multiple universities working in conjunction with the U.S. Army Institute of Surgical Research under the framework of a 5-year cooperative agreement. Whereas the main focus of the AFIRM is on wound repair and organ/tissue regeneration, the CRMRP also addresses other restorative technologies as well as the rehabilitative care innovations required to reset wounded warriors.
Q:What are some of the capability gaps for people with spinal cord injuries?
A:Capability gaps that have been identified in this area include:
- Repair of nerve defects
- Limited ability to control immunomodulation to promote healing and limit injury
- Long-term success of implants is problematic
- Rehabilitative strategies for spine injury
- Guidelines and standards of care
- Psychosocial aspects of rehabilitative care
- Pain management
- Models of health care delivery and related costs
Q:What are some of the proposed products of the CRMRP?
A:The CRMRP anticipates developing products in the following areas:
- Engineering skin products, bio-printing of skin in the field, and repairs using stem cells derived from amniotic fluid
- Reducing the inflammation after surgery that can lead to increased pressure, impaired blood flow, nerve damage, and muscle death
- Reducing functional detriments associated with severe wound scars, as well as improving cosmetic appearance
- Capitalizing on advancements in neural interfaces, nanotechnology, prosthetic design to improve foot and knee prosthetics, improved knee prosthetic control, improved haptic feedback, and applying neural interfaces to limb prosthetics.
- Improving drugs and protocols to control transplant rejection in patients
- Engineering tissue and scaffolds for rebuilding lost tissues and bone
- Developing exercise and fitness systems and strategies for amputee and neuromusculoskeletal injury rehabilitation
- Developing new technologies and improved strategies for managing acute and chronic pain
- Improving methods for diagnosing and treating eye injuries
- Developing treatments for visual system dysfunction associated with traumatic brain injury and other injuries
- Developing retinal and prosthetics devices to restore vision
- Developing vision rehabilitation technologies
Q:What are the goals for the CRMRP in its association with the Military Amputee Research Program?
A:In coordination with the Military Amputee Research Program, the CRMRP seeks to capitalize on advancements in neural interfaces, nanotechnology, and advancements in prosthetic design to improve foot and knee prosthetics, knee prosthetic control, and haptic feedback, and to apply neural interfaces to limb prosthetics. The program will coordinate research into improving clinical practices and strategies with the objective of improving performance of prosthetics.