FORT DETRICK, Md. – The Congressionally Directed Medical Research Programs’ Traumatic Brain Injury and Psychological Health Research Program recently awarded a $3.4 million grant to a team of Cleveland Clinic researchers to develop an innovative augmented reality tool for assessing whether Warfighters recovering from concussion are ready to return to duty. The new tool, called Troop Readiness Evaluation with Augmented Reality Return-to-Duty, or Troop READY, promises to provide answers more quickly and reliably than existing methods.

Concussion, also referred to as mild traumatic brain injury or mTBI, is a relatively common injury in the military. According to the DOD Traumatic Brain Injury Center of Excellence, over 80% of the TBI injuries sustained by Service Members between 2000 and 2024 were classified as mTBI. Service Members can experience an mTBI while on deployment, during training, and even when participating in a sport. Most injured Service Members are able to return to duty within two weeks. Military doctors currently follow a six-step protocol called the Progressive Return to Activity for safely returning an injured Service Member to duty, but the PRA has some shortcomings.

“The PRA is not 100% objective,” explains Dr. Dwayne Taliaferro, CDMRP’s TBIPHRP program manager. “While a medical professional guides the Service Member through the protocol, progress is dependent on the Service Member’s self-assessment of the mildness or severity of their symptoms. Troop READY offers an opportunity to provide more objectivity in the PRA protocol.”

Troop READY uses a Microsoft HoloLens 2 augmented reality headset and simulated M4 carbine assault rifle to generate a series of realistic and increasingly intensive scenarios that a patient must complete in order to simultaneously assess their cognitive and physical readiness. The exercises involve marching, shooting while standing and kneeling, and breaching and clearing a room. The patient’s cognitive, motor, and task performance capabilities are then analyzed using specially trained machine learning algorithms to determine the severity of any detected symptoms.

Dr. Jay Alberts, director of Cleveland Clinic’s Concussion Center, is leading the three-year project to further refine Troop READY, which he originally developed and tested under a previous CDMRP grant. In partnership with Microsoft Federal, Alberts and his team will use the new grant to improve the tool’s ability to detect signs of mTBI and to recommend personalized treatment plans for patients that streamline their return to duty.

Under the TBIPHRP grant, Alberts and his team will conduct a usability study with volunteers to refine the simulation modules, which will then be tested on a larger cohort of volunteers to identify baseline performance levels. Those baseline data will be used to train the machine learning algorithms to ensure a high degree of accuracy when assessing a patient’s current condition and guiding their continued treatment.

Taliaferro says that Troop READY offers several potential advantages over existing methods for assessing mTBI recovery in Service Members. For example, doctors use a battery of neurocognitive tests called Automated Neuropsychological Assessment Metrics to assess a Service Member’s readiness to return to duty. The computer-based ANAM assesses changes to a Service Member’s attention, reaction time, memory, and decision-making abilities based on their answers to a series of survey questions. However, as a sit-down multiple-choice test, ANAM lacks the fidelity of an active 3D simulation.

“The Computer Assisted Rehabilitation Environment Laboratory at the National Intrepid Center of Excellence blends virtual reality with a treadmill, immersive video, surround sound, and even smells,” Taliaferro says. “It is very powerful, but it’s in a fixed location and not very portable. Whereas with Troop READY, you can deploy the goggle set and the mock weapon anywhere quickly.”

In addition to helping Warfighters return to duty, the Troop READY tool has the potential to be adapted for use in other fields where mTBI is a risk, such as professional sports, construction, and law enforcement, says Taliaferro.

Before it can be deployed with the military or other users, Troop READY will need to be assessed by both the U.S. Food and Drug Administration and the DOD for its safety and readiness for use.

“CDMRP’s role is to accelerate the development of products like Troop READY so that they can be properly evaluated to determine how, when, and where they can be deployed,” explains Taliaferro. “We do not always put things directly in the hands of Warfighters at the end of a study, but we get them as close as we can. That is a great use of taxpayer dollars.”

By Paul Lagasse, USAMRDC Public Affairs Office

FORT GREELY, Alaska — Members of the U.S. Army Reserve’s 307th Forward Resuscitative and Surgical Detachment recently conducted annual training during the Joint Pacific Multinational Readiness Center 25-02 rotation in early 2025.

JPMRC 25-02 is designed to challenge roughly 10,000 joint, multi-component and multinational partners in remote and extreme Arctic winter conditions. The large-scale combat scenarios help refine tactics, techniques, and procedures.

Medical readiness is a critical component of combat effectiveness and JPMRC 25-02 provided an opportunity for the 307th FRSD to spread their knowledge and enhance their capabilities in a harsh environment.

During the exercise, the 307th FRSD augmented with Charlie Company, 725th Brigade Support Battalion, 2nd Infantry Brigade Combat Team (Airborne), 11th Airborne Division as a training enabler and allowed surgical capability to Role 2, or advanced medical care.

“This increased the fidelity of the simulated exercise by offering an additional level of patient care. It provided the C-Med team with additional training on patient triage, movement, and high-acuity patient hold scenarios,” said Capt. David Bold, commander of the FRSD.

By simulating real-world casualty scenarios, the 307th FRSD tested and stressed the Role 2 facility while displaying the full spectrum of military healthcare capabilities. Their presence emphasized that “a surgical element is a high functioning and mission capable unit but comes at the cost of being extremely resource heavy,” explained Bold. “The resources required are sourced and provided by C-Med/BSB. Our presence helped to emphasize this fact and provided critical training and education for the support battalion.”

Operating in the Arctic presents challenges beyond combat tactics.

“Being a unit from Wisconsin, we have experience training in the cold, but not to this degree,” Bold admitted. The extreme cold is both a physical and mental drain, impacting movement, equipment functionality, and patient care. For the 307th FRSD, training in Alaska was an invaluable opportunity to prepare for the realities of warfighting in subzero conditions.

“It is important for the FRSD to be here to display various levels of care that military healthcare provides,” said Bold.

The exercise provided ample educational opportunities. The FRSD’s subject matter experts in trauma surgery, orthopedic surgery, critical care and anesthesia conducted hands-on training for medics and junior officers. Topics covered included advanced trauma care, airway management, trauma operative care and care for brain-injured patients.

Sgt. Alexandria Schroeder, an operating room specialist shared that her last unit was a hospital augmentation detachment providing Roles 3 and 4 medical care, said, “they deal with more down the line surgery and capabilities. So yeah, this is new to me. The whole being this close to the front lines.”

Schroeder joined the FRSD a few months prior to coming to Alaska and noted the effective training. “It’s definitely a lot of the Army warrior tasks training that we all do but never really implement. So I feel like coming out here, we actually get to implement a lot of those trainings.”

Not only did the FRSD focus on medicine, one of the highlights both Bold and Schroeder mentioned was the cold weather training they received by the 11th Airborne Soldiers before being sent to the notional battlefield.

“I thought that was cool. Learning how to use the snowshoes, setting up those tents and learning how to get the heaters going,” said Schroeder.

Another highlight for Bold was the collaboration between the FRSD and the Role 2 facility, demonstrating the necessity of seamless coordination between echelons of medical care in combat scenarios.

One notable aspect of the exercise was the exclusion of the FRSD from the initial airborne assault at the drop zone. This decision reflected real-world operational considerations, as a surgical element would not typically be deployed ahead of the initial assaulting force.

Instead, the FRSD’s integration into JPMRC 25-02 focused on later-stage battlefield medical support, reinforcing logistical planning and patient evacuation procedures.

As the 307th FRSD refined their ability to provide life-saving care under the harshest conditions, JPMRC 25-02 stands as a testament to the power of deliberate training, adaptability, and joint force collaboration in securing the future of warfare in the world’s coldest and most challenging battlefields.

By SSG Mikayla Fritz

FORT GREELY, Alaska — On a frigid early morning along the Alaskan frontier, the 25th Brigade Support Battalion, 1st Infantry Brigade Combat Team and the 1-52nd General Support Aviation Battalion, Arctic Aviation Command — both of the 11th Airborne Division, — conducted a medical evacuation rehearsal ahead of Joint Pacific Multinational Readiness Center 25-02, near Delta Junction, Alaska, Jan. 18, 2025.

The MEDEVAC rehearsal comes only days before the start of JPMRC 25-02, the Army’s newest Combat Training Center, focusing on large scale combat operations in remote and extreme Arctic winter conditions, where the ability to reach and treat casualties is key.

“Rehearsal is very important,” said 2nd Lt. Allen Sanchez, a platoon leader assigned to Charlie Company, 25th Brigade Support Battalion, 1st Infantry Brigade Combat Team, 11th Airborne Division. “We have to practice our skills because, at the end of the day, we have to be prepared for things that may change in real-life situations.”

The Donnelly Training Area and its extreme cold temperatures, high winds and ever-changing conditions presents challenges, but learning to operate in that environment is vital for building soldiers that live up to the division’s motto: Arctic tough.

“This rehearsal is essential because we are in an Arctic environment, where resources are limited,” said Spc. Brandon Martinez Segura, a combat medic assigned to Charlie Company, 25th BSB, 1st IBCT, 11th Airborne Division. “So we need to practice getting all casualties out of this environment and to safety.”

With mere hours of daylight during the winter months, rehearsing in darkness is nearly unavoidable, but is critical to ensuring combat medics are prepared to treat any injury, no matter the conditions.

“It is crucial that we practice how to properly aid a patient in the cover of night; we hope to gain experience and learn from our mistakes,” Sanchez said.

By PFC Makenna Tilton, 27th Public Affairs Detachement