NFAM is engaged in a strong effort to find and evaluate treatments that benefit active personnel, veterans, and their families. Areas for study have included management of acute and chronic pain and wound healing. In 2006, The MILCAM focus expanded to include health concerns that confront active personnel and veterans.  Cancer, cardiovascular disease, neurological problems, and infectious diseases have also been included in the scope of investigations for MILCAM.

Current Activities/Research

Objective: Parkinson's disease (PD) is a progressive, degenerative neurological condition potentially leading to significant disability and morbidity.  It is characterized by the clinical triad of bradykinesia, rigidity, and resting tremor. Currently, there is no cure or proven neuroprotective therapy for PD. With PD typically diagnosed at middle age due to progressive symptoms, the disease is prominent in the population of patients served by the Department of Veteran’s Affairs. Current research seeks to provide a drug free, noninvasive and non-toxic therapy for PD through transcranial magnetic stimulation in the form of picoTesla magnetic therapy (pTMT). 

Research Design: This double-blind, randomized sham-controlled study (n = 20) will test the efficacy of pTMT to reduce motor and neuropsychiatric symptoms in PD patients at the PVAMC.

Methodology: Evaluations will include the Unified Parkinson’s Disease Rating Scale (UPDRS), magnetoencephalogram (MEG), a neuropsychological battery (including global assessments of cognitive function, specific assessments of language, attention, executive function, learning and memory, and assessments of neuropsychiatric symptoms including depression, anxiety, apathy and psychosis), a PD specific assessment of quality of life (QOL) and computer automated assessment of gait. These assessments will be performed at baseline and at three months with the UPDRS and MEG being performed in the "on-state" (on medications) as well as in a functional “off-state” (no anti-Parkinsonian medications for the previous 12 hours). Participants will also be examined at one month with an "on-state" UPDRS and MEG.

Objective: Ankle injuries, typically ankle inversion injuries, are the most common orthopaedic condition treated in clinical practice. Among military personnel, these injuries result in significant lost duty time and impact military readiness. In addition, these injuries may lead to prolonged ankle pain, chronic ankle laxity, and potential re-injury.  In the battlefield, they may be a detriment to survival. Research has demonstrated the efficacy of electronic devices in reducing edema and pain of sprained ankles.  The Electro Pressure Regeneration Therapy (EPRT) is a non-invasive, ultra-low electrical current device that stimulates regeneration of injured tissue, reduces inflammation, and enhances an immune response in the treatment of pain, wound healing, and cellular regeneration.  The ultimate goal of this research is to identify portable, non-pharmaceutical therapies for ankle sprains to reduce the lost duty time of military personnel. 

Research Design: This double-blind, randomized sham-controlled study (n=40) will evaluate the efficacy of standard care plus active or sham EPRT on pain intensity, swelling, quality of life, and function for patients with acute grade 2-3 ankle injuries.

Methodology: Outpatients who present to Mount Sinai Hospital in New York City and who meet the eligibility criteria and consent, will undergo pre and post test assessments of pain intensity, swelling, quality of life and function.  After the initial post treatment assessment, participants will be followed by telephone to monitor swelling and pain on days 1, 3, 7, and a final clinical visit between days 10 to 12, when they will be evaluated for quality of life and function.  Medication use will be self reported (diary) daily until the final assessment. 

Objective: Burn injuries pose a continuous threat to the military community. The ever-present threat of thermal injuries to military personnel makes them common, accounting for up to 20% of conventional warfare casualties. Silver coated wound dressings have been shown to reduce bacterial growth, limit nosocomial infection, and reduce the frequency of secondary bacteremia; the application of microcurrent and silver nylon has promising clinical implications.

Research Design: This single-center, prospective, randomized sham-controlled study (n=30) will evaluate the efficacy of a silver-coated dressing with active or sham microcurrent on wound-closure time for autogenous skin donor sites.

Methodology: The primary endpoint is wound-closure time, defined as re-epithelialization of 90% or more of wound surface. Dressings will be checked at least once per day beginning 24 hours after surgery while the patient is hospitalized, and thereafter at the discretion of the surgeon, until healing occurs. Secondary endpoints include pain and infection. Exploratory assessments of clinical outcomes, including inflammation and pain medication (type, dosage, route, timing) will also be conducted.

In 1997, CAM use in the US increased to 42% and out-of-pocket expenditures on alternative therapies reached at least 27 billion dollars.1 In the military subset, approximately 27.3% of veterans with cancer or chronic pain used CAM within the past year.2 Other research showed that nearly half of southwestern US veterans used CAM.3 Data for individuals in the active military is limited, however, among active Navy and Marine Corps service members, 37% used at least one CAM therapy within the past year.4 Although there is widespread use of CAM, the efficacy of many therapies has not been confirmed. In the following section, we describe two potential projects for the military population. 

Continued