Advancing the Evidence Base in Rehabilitation for Military Personnel and Veterans

Worldwide interest in the unique health needs of military personnel and veterans increased following the 1991 Persian Gulf War, when military members from countries around the world returned home with numerous health concerns. The Gulf War also marked the beginning of an era of difficult military operations and an accelerated rate of deployments to the heart of many of the world's most complex conflicts, including Rwanda, Somalia, Kosovo, the former Yugoslavia, Iraq, Afghanistan, Haiti, and Libya. Since 2003, the United States has been at war simultaneously in Iraq, Afghanistan, and elsewhere around the world in what has been termed the “Global War on Terrorism.” Fortunately, there has been much progress in medicine since the Vietnam War. As just one example, advancements in the acute management of massive bleeding—and in our ability to rapidly air evacuate wounded soldiers out of harm's way—have saved the lives of many soldiers who previously would have died on the battlefield. With this dramatic improvement in survival rates from battle-related injuries comes an ever-pressing need to address the rehabilitation needs of our nation's wounded soldiers. Many soldiers sustain extremely debilitating injuries—limb loss, traumatic brain injury, and posttraumatic stress disorder, among others—each of which has profound implications for our nation's post-war rehabilitation, infrastructure, and research needs. Even when war ends, the health issues arising from it do not. Veterans come forward 10, 20, or even 50 years later with service-related illnesses and injuries. Injury and illness among military personnel are not necessarily different from those among civilians, but the context of military health issues is unique and requires focused study. Ultimately, this research can benefit all populations. Historically, military and veteran health research has produced many innovations for civilian health care, including advanced, effective surgical techniques; new medications for infections; and advancements in prosthetic limbs. Military and veteran health research also has served as the incubator for entirely new professions (physical therapy emerged as a profession from the Reconstruction Aides during World War I). Increasing our rehabilitation evidence base will ensure that we provide our military members and veterans with the care and support they need and will help bring rehabilitation innovations to civilian health care that will have an impact long into the future. We are pleased to announce that PTJ is preparing a special issue devoted to research and perspectives on the topic of “Advancing the Evidence Base in Rehabilitation for Military Personnel and Veterans.” The aim of this special issue is to capture the latest thinking on topics related to this important domain of practice. Toward that end, we seek to aggregate and disseminate high-quality disability research on topics such as: Evaluation of existing rehabilitation programs for military personnel and veterans to determine their effectiveness, efficacy, and broad applicability Evaluation of new technologies for the purposes of prevention, rehabilitation, and reintegration Epidemiological surveys on the types of injuries sustained during war and the associated sequelae related to health and disability Case reports on the innovative use of technology to care for military members and veterans The role of rehabilitation in the transition from military to civilian life Novel rehabilitation strategies and their effect on functional outcomes Perspective papers on the history of military physical therapy and the implications of recent wars on funding for health research on military and veteran populations We invite original contributions to this special issue, which is scheduled to be published in late 2012. We encourage submissions that include international perspectives on the implications of rehabilitation issues affecting military and veteran health outside the United States and Canada. The special issue will provide a global forum for authoritative empirical research, theoretical development and perspectives, clinical cases, and innovations. We anticipate a very thought-provoking special issue on physical therapy in the military and specifi cally on the implications of the recent wars in Iraq and Afghanistan for the physical therapy and rehabilitation professions. If you are interested in contributing to the special issue, please forward an outline of your proposed topic for consideration to militaryrehabevidence@apta.org no later than October 31, 2011.

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