Restoration and Maintenance of Physical and Neurosensory Performance (RAMP) in Naval and Marine Corps Aviation

Military aviation personnel are exposed to high physical demands related to their mission sets and training. These occupational demands heighten the risk for both musculoskeletal injuries (MSKI) and mild traumatic brain injuries (mTBI). Rates of MSKI and mTBI within the military continue to rise and represent a significant threat to operational readiness across all military services. Due to the significant clinical limitations encountered within an active military training environment, health professionals may not have the time or resources to support additional clinical data acquisition procedures. The inability to assess physical and neurosensory function precisely and routinely throughout training is a major barrier to maintaining warfighter health and returning the warfighter to their preinjury capabilities. Many conventional military groups are investing in an increasing amount of performance and rehabilitation technology to achieve elite performance and sustained wellness of their warfighters and support personnel. Although many of these tools and data platforms may be on the cutting edge, they may lack the evidence to suggest their use will provide operational or health benefit to the warfighter. A key component of any rehabilitation program is the ability to personalize the regimen and precisely monitor treatment response. However, access to innovative clinical assessment technologies needed to maximize efficiency and information being collected is rare during active military training. These technologies often require specialized training, thus limiting their practical application. Therefore, rehabilitation within an active military training environment currently lacks the precision and personalization expected from an effective exercise regimen. Indeed, the ability to measure patient status and tailor treatments to the warfighter—regarded as essential in much of rehabilitation and medicine—is functionally missing. Our overall objective for this project is to expand current Naval and Marine Corps rehabilitative clinical capabilities and improve the translation of these capabilities through continued integration of new clinical assessment technologies. We hypothesize that the integration of new clinical assessment technologies will continue to expand current rehabilitation capabilities and extend patient monitoring by improving multi-disciplinary collaborations across the different HSS components. This work will identify and overcome barriers that impede the utilization of technologies within this environment, further streamlining the translation of these clinical measures to tactical training application. Specific Aim 1: Optimize RAMP biomechanical and neurosensory screening capabilities to more accurately identify the physical and neurosensory stressors specific for the applicable aviation Naval Officer Designators, Navy Enlistment Classifications (NECs) and Military Occupation Specialties (MOS), aviation platforms, and the different aviation training environments. Specific Aim 2: Examine how previous injuries and the physical stressors specific to aviation training influence RAMP biomechanical and neurosensory outcomes. Specific Aim 3: Improve clinical and/or physical performance outcomes through the integration of RAMP biomechanical and neurosensory outcomes into human performance and rehabilitative programs within active aviation training environments. This proposed work will continue developing state-of-the-art clinical rehabilitative strategies and building upon the multi-disciplinary collaborations that are needed to support effective clinical programs focused on the needs of Naval and Marine Corps aviators, air crew, and support personnel. The aims of this study focus on how to improve the feasibility of integrating new technologies in this complex environment, to help establish data driven collaborative networks, and developing streamlined pathways for the translation of data-driven evidence-based rehabilitation strategies. Although this research is focused on addressing needs within the aviation community and various aviation platforms, the findings and applications have a broad impact to other specialized groups and conventional forces at large. Little has been done to systematically learn how these technologies can be implemented within an active military training environment to make an impactful change on the recovery from injury, the prevention of future injury, and ultimately on overall readiness.