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  • NHRC Scientists Receive Award for Transforming a Rehabilitation Tool to Prevent Injury, Promote Resilience

    SAN DIEGO (NNS) -- The National Training and Simulation Association (NTSA) recognized scientists from Naval Health Research Center (NHRC) with the Outstanding Achievement in Modeling and Simulation (Cross-Function) award Dec. 1.

    NHRC's Physiological and Cognitive Operational Research Environment (PhyCORE) team was honored for their work in expanding a virtual reality walking and balance-based rehabilitation tool for injured warfighters into one now capable of promoting injury prevention and resilience.

    "This award is well deserved," said Capt. Rita Simmons, commanding officer of NHRC. "The PhyCORE team embodies the professionalism, expertise and collaborative spirit that can be found in each of our researchers. This recognition also spotlights the type of innovative work that goes on every day at NHRC and how we are uniquely positioned with cutting-edge tools and seasoned experts to do some exciting and ground-breaking work."

    Computer Assisted Rehabilitation Environment (CAREN) was installed at NHRC in 2008 and originally used for rehabilitation research to support the recovery of combat-injured service members, particularly those with lower-limb amputations and traumatic brain injuries (TBI). The CARENs initial configuration incorporated a 6 degree of freedom motion platform with integrated instrumented treadmill, multiple motion capture cameras, and a large curved screen with 180-degree projection creating a virtual environment mirroring real-world situations.

    "Over the last three years, my team has enhanced the CARENs capabilities with a programmable scent system, three dimensional projection and environments, improved surround sound system, accurate laser shooting system, and a high-performance treadmill capable of high accelerations for simulating trips," said Pinata Sessoms, Ph.D., senior biomedical engineer with NHRCs PhyCORE team.

    Additional improvements include a unique driving cab developed in house by NHRC scientists that can be placed on the CAREN platform. Service members are challenged as they drive through customizable simulated driving scenarios to assess awareness, speed infractions, driving violations and other errors. 

    The PhyCORE team designed additional performance measurement tools and incorporated them into the CAREN allowing researchers and clinicians a host of different quantitative physiological measures to support the recovery and rehabilitation of injured service members. These include surface electromyography (SEMG) for measuring muscle activation and fatigue, eye-tracking and gaze-tracking for attention and symptom measurement in patients with TBI and mobile electroencephalography (EEG) systems to measure increased cognitive workload and differences in brain activity while service members perform different tasks. 

    "The PhyCORE team has invested over 1,000 hours of clinical investigation and therapy, treating over 100 patients within the virtual environment," said Sessoms. "We work closely with our collaborators at the Naval Medical Center San Diego to treat our wounded warriors and our research has led to improved therapies and capabilities such as walking, balancing, and cognitive performance that allow injured service members to return to their daily activities and, in many cases, full function. The work we've done to expand the CAREN system beyond its original configuration was actually the genesis of what we now call the Physiological and Cognitive Operational Research Environment, or PhyCORE."

    Part of what led to the PhyCORE team's success in expanding the CARENs capabilities and furthering of their research is the interdisciplinary nature of the team. The group of researchers and clinicians includes physical therapists, kinesiologists, biomechanists, biomedical engineers, software and hardware engineers, sleep physiologists, an aerospace experimental psychologist and a neurophysiologist.

    Due to the enhancements the team developed for the CAREN, it is now much more than a rehabilitation tool. It can also measure the physical performance of service members using operator-specific tasks. The CAREN is now ideal for testing the effects of new protective gear, carriage loads and equipment on warfighter performance. 

    "The use of one system for so many different capacities maximizes the resources of the Navy and has led to the creation of a multifaceted team of experts who can study multiple performance metrics at one time, in one place," said Sessoms. "For example, instead of just measuring cognitive load, fatigue, or movement, we can measure the correlation between each of these factors. We've created a tool that isn't just for rehabilitation-it's now capable of promoting injury prevention and resilience."

    The PhyCORE team shares information with other Department of Defense CAREN sites to promote best practices, collaboration and cost savings.

    As the DoD's premier deployment health research center, NHRC's cutting-edge research and development is used to optimize the operational health and readiness of the nation's armed forces. In proximity to more than 95,000 active-duty service members, world-class universities, and industry partners, NHRC sets the standard in joint ventures, innovation and translational research.

    PhyCORE Team.jpg

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