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The Defense Health Agency Extremity Trauma and Amputation Center of Excellence, or EACE, held its Federal Advanced Skills Training earlier this summer. The seminar focused on the holistic connection between mental health and limb loss or limb trauma. Speakers addressed how the mind-body connection is a tool for managing severe, chronic pain, with potential to heal and function in daily life.
“FAST always has had some element of mental health, but mental health emerged as the next clear priority topic based on an emphasis in the clinical practice guidelines and clinician input,” said Andrea Crunkhorn, the EACE chief of clinical affairs who holds a doctorate in physical therapy.
EACE, part of the DHA Research and Engineering Directorate, is advancing the science of trauma-related and patient-centered care. EACE is a joint operation of the Department of Defense and Department of Veterans Affairs.
DOD and VA have jointly published 28 clinical practice guidelines based on current best practices and the most up-to-date, evidence-based research. DOD-VA have published two limb loss clinical resources:
• Rehabilitation of Lower Limb Amputation
• Management of Upper Limb Amputation Rehabilitation
Functional recovery speaker captures meeting themes
Dr. Ajay Manhapra, who works at the Hampton VA Medical Center, encapsulated the mind-body connection in his presentation, “Enabling physical and psychosocial recovery among veterans with debilitating chronic pain: Can lessons learned help people with limb loss experiencing chronic pain?”
“A chronic pain syndrome diagnosis means that the pain has become a separate problem … and is not a symptom of some other physical disorder,” Manhapra said.
Manhapra is a pioneer of the care model where patients establish a “trauma narrative” to reframe their trauma and help make sense of their experience. Patients build a timeline linking their injuries with subsequent behavioral challenges, such as PTSD or opioid addiction.
With a trauma narrative, provider and patient build a goal-oriented recovery plan to develop a “new normal with good functioning, but not the prior normal without pain,” Manhapra said. Patients learn to gradually increase their physical function with their existing pain. He also advocated for limited-time use of pain management medication.
Keynotes highlight amputees’ recovery and lessons for attendees
Three military amputees were FAST keynote speakers. All were treated at Walter Reed National Military Medical Center, and discussed their experiences with their injuries. They emphasized physical rehabilitation paired with mental health care helped them feel whole and healthy again.
Retired U.S. Army Sgt. 1st Class Daniel Metzdorf lost his right leg to a roadside bomb in Iraq in January 2004. He told the audience: “If I could go back in time and talk to that 2004 me, I would ask the hospital to make my mental health care therapy the same tempo as my physical therapy.”
U.S. Marine Corps Lt. Col. Erik Melanson, a former intelligence officer in the special operations community, suffered a traumatic dislocation of his left knee and subsequent paralysis below the knee in a recreational accident. Melanson credits his physical and mental therapy as the main reason he’s been able to stay active duty. “It's not the injury itself. The greatest threat to you is going to be isolation,” he said. “If you're struggling, just find some meaning in your struggle.”
Retired U.S. Army 1st Sgt. Christopher Roseberry lost his right leg above the ankle and suffered serious back and arm fractures in a hit-and-run accident. He spent two years recovering and returned to active duty for another 12 years. He reinjured his leg in Afghanistan and had another amputation.
From training to practice
Crunkhorn said the meeting’s interactive sessions on evidence-based imagery, visualization, music, dance/movement, and creative arts therapy were beneficial because “many therapists know of these techniques but haven’t tried to implement them in clinical practice.”
| Date Taken: | 08.05.2025 |
| Date Posted: | 08.05.2025 15:01 |
| Story ID: | 544818 |
| Location: | US |
| Web Views: | 33 |
| Downloads: | 0 |
This work, Mental health effects of traumatic limb injuries focus of recent military medical training, by Janet A. Aker, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright.
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