Military Operational Medicine Research Program (MOMRP)
Mission
The mission of the Military Operational Medicine Research Program (MOMRP) is to develop effective countermeasures against stressors and to maximize health, performance, and fitness. Our mission is protecting the Soldier from head to toe, inside and out, at home, and on the battlefield. Science to Soldier is our focus.
Background and Environment
MOMRP, U.S. Army Medical Research and Development Command (USAMRDC), conducts biomedical research to deliver products and solutions to the Warrior that address health and fitness throughout the deployment cycle. MOMRP is centered on cutting-edge scientific research and bringing Science to the Soldier on the battlefield in a relevant, timely manner. MOMRP depends on a phenomenal cadre of dedicated scientists and engineers who continuously and tirelessly work to protect the nation's most valuable asset - the Warrior.
Goals and Objectives
MOMRP is divided into four research focus areas:
Biomedical basis for countermeasures that prevent and mitigate Warrior injury
MOMRP Injury Prevention and Reduction research develops models to predict the degree of injury from known threats, develops design guidelines and performance specifications for protective equipment, and identifies countermeasures to prevent or mitigate injury to the Warrior. Key threats addressed by this research area include blast overpressure, blunt and penetrating trauma, musculoskeletal and training injuries, and neurosensory injury. This program addresses thoracic and pulmonary injury protection through modeling blast and blunt trauma, protection that prevents or reduces neurosensory injury, validated standards for performance to assess return to duty, and training doctrine based on physiological mechanisms that underlie musculosketal injury that identify and mitigate injury risks.
Strategies and interventions that build psychological resilience and optimize psychological health and emotional fitness among Soldiers and families
MOMRP Psychological Health and Resilience research is focused on prevention, treatment, and recovery of Soldiers - and families - behavioral health, which are critical to force health and readiness. Research is necessary to guide policy and ensure optimal delivery of behavioral health training and services across the continuum of care and deployment cycle. Threats addressed by this research component include post-traumatic stress disorder (PTSD), suicide, family separation, and family violence.
Current psychological health research topic areas include:
Biomedical countermeasures to sustain Warrior health and operational effectiveness
MOMRP Physiological Health research focuses on developing medical standards, predictive models, and countermeasures to prevent or mitigate the effects of physiological stressors on the performance and fitness of Warriors. These stressors include inappropriate nutrition, poor physical fitness, sleep loss, sleep deprivation, fatigue, and burnout. The focus is on threats and stressors in both the garrison and operational environments. Current research addresses advanced biomedical modeling and networked physiological status monitoring capabilities, a comprehensive sleep and performance management system based on effects of chronic sleep restriction and acute total sleep deprivation, individual physiological differences in sleep loss resilience, nutritional health surveillance and dietary supplement use, and interventions to mitigate threats to operational health.
Assess and sustain Warrior health and performance in extreme environments
MOMRP Environmental Health and Protection research develops medical standards, predictive models, and countermeasures to prevent or mitigate the effects of extreme environments and toxic material exposure in the military. Threats addressed by this program include extremes of heat/cold and hydration, high altitude, and toxic industrial chemicals and materials. Current research projects focus on methods that sustain operational performance in extreme heat and cold and at high altitudes to prevent and manage heat, cold, altitude sickness, and hydration-related injuries. This research also includes detecting, monitoring, and assessing the risk of the Warrior's exposure to toxic chemicals and materials during operations.
Key Themes and Messages
Injury Prevention and Reduction
Warriors are susceptible to physical, sometimes debilitating, injuries. Head and neck injuries, including severe brain trauma, have been reported in one-fourth of all evacuated service members. In the past 5 years, Walter Reed Army Medical Center alone has surgically treated approximately 700 Warriors with moderate-to-severe visual injuries. Nearly 70,000 combat troops are collecting disability for tinnitus and more than 58,000 for hearing loss. Medical disability discharge rates have increased with 78% due to musculoskeletal injury. MOMRP research helps prevent physical injuries through development of injury prediction models, equipment design specifications and guidelines, health hazard assessment criteria, and strategies to reduce musculoskeletal injuries.
Psychological Health and Resilience
Psychological health problems are the second leading cause of evacuation during prolonged and/or repeated deployments. Of returning Warriors, 20 - 40% have behavioral health problems post-deployment, mostly related to PTSD, depression, and interpersonal conflict. MOMRP researchers develop strategies and advise policy makers to enhance and sustain mental fitness throughout a service member's career. These include validated prevention and treatment interventions that address psychological health issues, enhanced screening and identification of concussion-related health concerns, and improved clinical guidelines for health care providers.
Physiological Health
The rapid pace of operations and the need for repeated deployments have a profound effect on the physiological health and performance of Warriors. MOMRP develops novel nutritional strategies that maintain and sustain optimal health and readiness, a comprehensive sleep and performance management system that predicts Warrior physiological degradation, and a real-time medical status monitoring and situational awareness informational system enabling commanders to ensure mission success.
Environmental Health and Protection
Warriors train and fight while exposed to a range of harsh environmental conditions, such as extreme heat and cold temperatures and high terrestrial altitude. These harsh environmental conditions, alone or combined with other operational stressors, degrade military physical and cognitive performance. MOMRP provides guidelines to mitigate performance degradation from these environmental extremes. Warriors also are susceptible to exposure to toxic chemicals and materials in the operational environment. MOMRP develops biomarkers to detect toxic exposures and methods to assess their impact on health risk.
Questions and Answers
What are some examples of Injury Prevention research?
The Thoracic and Pulmonary Injury Protection task area addresses the internal and external damage inflicted by blast trauma, blunt forces to the thorax, and acute physiological consequences caused by blunt impact, blast, and inhaled toxic gases. It captures injury responses in mathematical models that support health hazard and survivability assessments and design of protection systems.
The focus of the Neurosensory Injury Protection task area is to prevent or reduce neurosensory injury and promote Warrior capabilities to continue to move, shoot, and communicate. Areas to be protected from combat, training, and accident-related injuries include the head, brain, eyes, ears, cranial nerves, face, neck, spine, and spinal cord.
Injury Return-to-Duty Standards and Strategies will address the need to develop validated standards and strategies for measuring performance levels in military occupations. It is specifically tailored to provide the basis for consistently accurate, safe, and rapid decisions to return a Warrior to military duty after neurosensory, cognitive, or musculoskeletal injury.
MOMRP Physiological Mechanisms of Musculoskeletal Injury research will provide an enhanced understanding of physiological mechanisms that underlie musculoskeletal injury to help identify countermeasures to mitigate injury risks. It also could be used in revising Army training doctrine.
Why is Psychological Health and Resilience important to the military?
The inability to remain psychologically resilient during training and in operational environments can completely disable a Warrior. More than one-third of enlisted Warriors fail to complete their first term of enlistment, often due to mental, psychosocial, or behavioral problems. Even those Warriors considered psychologically hardened can be affected by traumatic events common on the modern battlefield. MOMRP's Psychological Health and Resilience research program area develops criteria to identify vulnerable Warriors and targets factors that predict mental disorders. In addition, field tests of biomedical strategies are designed to reduce attrition rates and psychiatric morbidity associated with poor mental health.
What are some examples of products from the Psychological Health program area?
- Unit Behavioral Health Needs Assessment
- Mental Health Advisory Team
- Post-Deployment Health Assessment and Post-Deployment Health Reassessment
- Army Suicide Event Report System
- Doctrine and Training: Research findings and recommendations that led to the revision of combat and operational stress control doctrine and medic training courses
What is meant by mission reset and recovery?
Sustained combat operations such as those in Iraq and Afghanistan cause physical and mental fatigue due to the physically demanding work as well as lack of sleep. "Mission reset" and "recovery" are terms that are used to describe the need for adequate rest, nutrition, and fitness to ensure that Warriors are functioning at their highest possible level of physical readiness and mental alertness.
What are some examples of products from the Physiological Health program area?
The SPARNET-Spartan Sensor Network is a system of mobile, networked wearable sensors that will provide real-time medical status and situational awareness information to commanders in training scenarios. This product currently is being tested in Ranger Training Brigade with future implementation planned for Basic Combat Training and Advanced Individual Training.
A wrist-worn digital signal-processing device, the Sleep Watch Actigraph, provides real-time quantitative estimates of Warrior physical and cognitive readiness and performance based on sleep/wake history. The actigraph is a risk assessment decision aid for commanders.
The First Strike Ration (FSR) is a lightweight, efficient ration that provides optimal nutrition to sustain the cognitive and physical performance of Warriors. In conjunction with the FSR, a new liquid-based Nutrient Delivery System will improve on-demand access to essential nutrients.
An effort called 21st Century Fueling is an integrated research program that promotes optimal health and fitness; prevents degraded performance; prevents and treats obesity, injury, and disease; and supports post-deployment health reset over the military career. The goal is to establish holistic community-based nutrition programs for Warriors and their families.
What are some examples of products from the Environmental Health program area?
Products from the Environmental Health Program area include:
Heat/Cold, Altitude and Hydration Products
- Enhanced Fluid Delivery System - Improves water consumption and provides supplemental nutrition
- Water Use Modeling - Provides a water needs prediction model and a real-time heat injury prediction model
- Microclimate Cooling System - Will prevent overheating in extreme heat
- Microclimate Heating System - Will enhance dexterity in extreme cold High-Altitude Products
- Altitude Readiness Management System - Will enhance operational capability in high altitude environments
- Hypoxic Training Guidelines - Provides pre-deployment rapid acclimatization methods
- Acquired Cross-Tolerance - Will potentially provide a mechanism to enhance resistance to all environmental injuries and develop improved medications for treatment of heat, cold, and altitude-related injury and illness
Toxic Chemical Exposure Products
- Aquatic Biomonitor/Environmental Sentinel Biomonitor - Provides biological detection of toxic materials in water supplies
- Coliform Analyzer - Provides rapid detection of bacterial contamination in drinking water
- Biomarkers of Toxic Exposure - Will determine susceptibility to toxic exposure and indicate effects of exposure
What are some key MOMRP products supporting current operations?
- Battlemind Training programs, focusing on stress and psychological resilience, help Warriors transition from combat to home
- Operational guidelines prevent heat-stress casualties among Warriors deployed to Iraq
- Operational guidelines prevent altitude-induced injuries among Warriors operating in the mountains of Afghanistan
- TGAS (Toxic Gas Assessment Software), a Warrior survivability assessment tool, predicts vehicle crew incapacitation from toxic fire gas exposures behind defeated armor
- ESB (Environmental Sentinel Biomonitor), a novel biomonitoring system, continuously monitors drinking water sources for toxic chemicals, which is currently protecting military and civilian communities
- A body armor blunt trauma performance standard and testing method will enable the development of lightweight body armor
- INJURY, a software tool, predicts lung injuries from exposure to blast overpressure from high-powered weapon systems
- Guidelines for nutritional supplements in rations sustain performance and health
Where can I find more information about MOMRP?
Additional information about MOMRP can be found at https://momrp.health.mil.