Skip to main content

Military Health System

NICoE, NHRC Team Up To Make CAREN Technology Portable

Image of A person walks in front of a large virtual reality screen. The Computer Assisted Rehabilitation Environment (CAREN) at the National Intrepid Center of Excellence (NICoE) offers clinicians a VR-based tool to assess and treat patients with TBI and PTSD. (Photo by Linsey Pizzulo, National Intrepid Center of Excellence)

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | The National Intrepid Center of Excellence

Since the National Intrepid Center of Excellence opened in 2010, Biomedical Engineer Sarah Kruger has operated the center’s Computer Assisted Rehabilitation Environment (CAREN).

The CAREN is a large-scale virtual-reality system used to evaluate and treat NICoE patients with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD).

Now, her team is collaborating with researchers at the Naval Health Research Center (NHRC) to scale the technology down to a mobile system, with the long-term goal of making the novel therapy more attainable throughout both the Military Health System and the Defense Intrepid Network for TBI and Brain Health.

“Head-mounted display technology has become more affordable and accessible over the past couple of years,” said Kruger. “It’s also portable. So we want to leverage what we’ve learned about the [CAREN] system and see if we can make it possible to use similar treatments without committing the space or funding to a CAREN.”

In the CAREN, the patient stands or walks on a treadmill in the middle of a circular platform while interacting with virtual environments projected in front of them onto a 9-foot-tall, 180-degree screen. The platform can tilt in all directions to mimic a rocking boat, an uphill climb, or other scenarios as a ring of motion-capture cameras track movement, allowing for real-time modifications to the environment.

Monitoring the patient’s behavior, physical therapists can assess and treat conditions such as vestibular dysfunction - one of the most common complaints following a TBI - and PTSD.

In initial discussions about using head-mounted displays for treatment, NICoE physical therapists expressed concern that the devices might be too heavy for their many patients with neck pain. So the NICoE and NHRC teams evaluated several different headsets and, after positive feedback from clinicians, chose an augmented-reality (AR) based head-mounted display which has a lightweight visor that allows digital content to be layered over the existing real-world environment.

A person wearing a virtual reality headset
Researchers at the National Intrepid Center of Excellence (NICoE) and the Naval Health Research Center (NHRC) are using their CARENs to test similar technology on an AR headset, which would be more accessible and less costly for military medical treatment facilities than a CAREN. (Photo by Sarah Kruger, National Intrepid Center of Excellence)

Application developers then worked to transition some of the CAREN’s most frequently utilized virtual environments over to a cross-platform game engine that allows for improved graphics, physics, and user control. The new environments are compatible on both the CAREN and AR headset.

These systems are currently being evaluated in two IRB-approved research protocols for a multisite vestibular physical therapy project, where data is being collected at both NICoE and NHRC.

Last month, the research team provided an overview of the development process in a symposium presentation at the International Conference on Virtual Rehabilitation. Kruger, physical therapist Kathleen Delpy, and research scientist Kerry Rosen represented the NICoE; with NHRC physical therapist Dawn Bodell and biomedical engineers Pinata Sessoms, Vrajeshri Ordek, and Jacob Van Dehy. 

While there are some clear differences between the CAREN and the head-mounted display - for instance, the CAREN makes it easier for patients to find real-world anchors and use their peripheral vision - Kruger does not consider them to be dealbreakers.

“There are obviously limitations to using [the mobile system],” she said, “but if I can get a 75% solution that clinicians will use, I’ll take it.”

The key to this health innovation is that the head-mounted displays are portable and can potentially be used at multiple locations without requiring a full-size CAREN. There are pros and cons to the new technology, but in the end, they may help make TBI and PTSD care more accessible to MHS patients.

You also may be interested in...

Traumatic Brain Injury Family Caregivers Panel Update

Presentation
12/15/2008

Traumatic Brain Injury Family Caregivers Panel Update presented to the Defense Health Board Dec. 15, 2008

Recommended Content:

Traumatic Brain Injury Center of Excellence

Traumatic Brain Injury Family Care Givers Panel Update

Presentation
9/4/2008

Traumatic Brain Injury Family Care Givers Panel Update presented to the Defense Health Board Sept. 4, 2008

Recommended Content:

Traumatic Brain Injury Center of Excellence

Traumatic Brain Injury External Advisory Subcommittee Update

Presentation
9/4/2008

Traumatic Brain Injury External Advisory Subcommittee Update presented to the Defense Health Board Sept. 4, 2008

Recommended Content:

Traumatic Brain Injury Center of Excellence

Trauma and Injury Subcommittee Update Combat Casualty Care

Presentation
9/4/2008

Trauma and Injury Subcommittee Update Combat Casualty Care presented to the Defense Health Board Sept. 4, 2008

Recommended Content:

Traumatic Brain Injury Center of Excellence

DCoE and NICOE for Psychological Health and TBI

Presentation
4/23/2008

DCoE and NICOE for Psychological Health and TBI presented to the Defense Health Board April 23, 2008

Recommended Content:

Traumatic Brain Injury Center of Excellence

TBI External Advisory Subcommittee

Presentation
4/23/2008

TBI External Advisory Subcommittee presented to the Defense Health Board April 23, 2008

Recommended Content:

Traumatic Brain Injury Center of Excellence

TBI Family Caregivers Panel Update

Presentation
4/23/2008

TBI Family Caregivers Panel Update presented to the Defense Health Board April 23, 2008

Recommended Content:

Traumatic Brain Injury Center of Excellence

Mild Traumatic Brain Injuries in US Soldiers Returning From Iraq

Presentation
4/23/2008

Mild Traumatic Brain Injuries in US Soldiers Returning From Iraq presented to the Defense Health Board April 23, 2008

Recommended Content:

Traumatic Brain Injury Center of Excellence

Traumatic Brain Injury External Advisory Committee Report

Presentation
12/11/2007

Traumatic Brain Injury External Advisory Committee Report presented to the Defense Health Board December 11, 2007

Recommended Content:

Traumatic Brain Injury Center of Excellence

Traumatic Brain Injury Psychological Health DoD Response Plan

Presentation
9/19/2007

Traumatic Brain Injury Psychological Health DoD Response Plan presented to the Defense Health Board September 19, 2007

Recommended Content:

Traumatic Brain Injury Center of Excellence

DoD Traumatic Brain Injury Treatment and Prevention Initiatives

Presentation
5/23/2007

DoD Traumatic Brain Injury Treatment and Prevention Initiatives briefing to the Defense Health Board May 23, 2007

Recommended Content:

Traumatic Brain Injury Center of Excellence

ASD (HA) Memo "TBI Questions for the Post Deployment Health Assessment"

Policy
<< < ... 16 17 > >> 
Showing results 241 - 252 Page 17 of 17
Refine your search
Last Updated: September 01, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery