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Technical Reports

A technical report is a technical document that records and disseminates methods and results from research studies and research, development, test, and evaluation (RDT&E) activities. Technical reports are USAARL's principal method of in-depth reporting on technical subjects that are of interest not only to the department, agency, or command sponsoring the work, but also to external groups and laboratories in government, academia, and industry. Technical reports may vary in type, to include technical reports that present the findings of research or analyses or that provide guidance or instruction on matters important to the DoD, journal articles (open access and embargoed text) that have been published under an open access agreement with the publisher or published under a Creative Commons license, conference proceedings that include whole collections of papers presented at a symposium or workshop, and conference papers that could include an individual paper, briefing charts, or a poster presented at a workshop or symposium. For inquiries related to USAARL's technical report(s), contact usarmy-usaarl-library@health.mil.

Featured Reports

For more reports, please visit the technical reports archive page.

DTIC #:AD1219902
TITLE:Evaluation of a Transparent Seat Back for Motion Capture of the Thoracolumbar Spine on the Multi-Axis Ride Simulator
AUTHOR(s):Ballard, M., Hasapes, S., Robinette, A., Stewart, A., Perkins, S. M., Prusia, M., Shumate, S., Madison, A., & Chancey, V. C.
ABBREVIATED ABSTRACT:Low back pain is a pervasive health problem in a range of military occupations. A knowledge gap exists regarding spinal movement in operational ride environments due to limitations in data collection caused by equipment impeding motion capture data collection. This involves the development and validation of a novel transparent seat back (TSB) for the USAARL multi-axis ride simulator (MARS) to develop a standard methodology to quantify seated spinal motion response to whole-body vibration (WBV) and jolt during simulated operational transport environments. The TSB was fabricated and affixed to the standard MARS chair instead of the aluminum seat back. Volunteers were instrumented and asked to perform torso movements within all three planes. Vicon motion capture was used to observe visual distortions through the transparent seat back. Data were collected for a 35th percentile female and capture was used to observe visual distortions through the transparent seat back. Data were collected for a 35th percentile female and 95th percentile male, and x-, y-, and z-positional data were analyzed. Results indicate that the retroreflective markers can be tracked regardless of TSB configuration with minimal error or distortion. The TSB will add to vibration research capabilities.
KEYWORDS:low back pain, LBP, military back pain, whole-body vibration, WBV, motion capture, Vicon, transparent seat back, seated spinal kinematics, spinal motion, spinal motion capture, thoracolumbar spine
DTIC #:AD1219898
TITLE:Efficacy of Medical Device Alarm Integration into a Simulated H-60 Integrated Communication System
AUTHOR(s):Kroening, L., Kinsler, R., Molles, J., & Lloyd, A.
ABBREVIATED ABSTRACT:Introduction: This study sought to examine the efficacy of integrating medical device alarms into the intercommunication set of a simulated HH-60, allowing medics to hear the alarms over the ambient noise of the aeromedical environment. Materials and Methods: U.S. Army critical care flight paramedics were recruited as subjects for this study. Subjects participated in two testing scenarios: one with patient monitor alarms integrated into their communication lines and one without integrated alarms (the control condition). Testing took place in a simulated HH-60 interior with two priority-level patients per testing scenario, one on either side of the interior. Subjects provided care to these two patients for 30 minutes per scenario. After both scenarios were complete, the subjects were given a questionnaire to obtain their feedback on alarm integration. Results: Six subjects took part in this study, so the results do not have sufficient power to represent the population. No statistically significant results were found. Looking at the trends in the data, implementing alarm integration showed the indications of reducing reaction time to alarms, decreasing or matching the amount of time spent with the patient monitor, and equivalent amounts of time dedicated to patient treatment when compared to the nonintegrated scenario. The feedback obtained from the subjects provided a list of perceived benefits, drawbacks, and improvements related to the integration of medical device alarms into the intercommunication set. Conclusions: Although the study was underpowered, the trends in the data indicate a benefit to the medics when integrating medical device alarms. When coupled with strongly favorable end-user feedback, the results provide justification for pursuing the effort of integrating alarms and performing future studies with improved integration systems to optimize the potential of the system.
KEYWORDS:integrated communication set, ICS, communication ear plugs, CEPs, U.S. Army, helicopter, HH-60, baseline medical interior, BMI, medical evacuation, MEDEVAC, patient care, medical device, monitor, vital signs
DTIC #:AD1219895
TITLE:Methodology and Considerations for Combining Historic Accelerative Loading Research to Update the U.S. Army Aeromedical Research Laboratory Head-Supported Mass Injury Curve Using Survival Analysis
AUTHOR(s):Brozoski, F., Duemmler, M., McGovern, S., Rhodes, D., Vasquez, K., Johnson, B., Beltran, C., Madison, A., & Chancey, V. C.
ABBREVIATED ABSTRACT:Military helmets are multi-functional tools that provide blunt and ballistic impact protection and are frequently used as a mounting platform for life support and operational enhancement technologies. The frequent use of these helmet-mounted technologies can increase the risk of cervical spine injury, both acute and chronic, to Warfighters due to the increase in head-supported mass (HSM) and changes in the location of the combined center of mass (CM) of the helmet and helmet-mounted technologies. Evidence of an increased neck injury risk was provided through epidemiological research. This evidence led the U.S. Army Aeromedical Research Laboratory (USAARL) to investigate and develop HSM requirements for Army rotary-wing helmets in 1997 (McEntire & Shannahan, 1997). Over the 25 years since the introduction of the USAARL HSM Curves, additional research has been conducted into the effects of HSM and HSM CM location.
KEYWORDS:head-supported mass, HSM, retrospective review, survival analysis, center of mass
DTIC #:AD1218341
TITLE:Evaluation of a Multisensory Cueing System on Aviators' Performance: Impact of Tactile and Auditory Cueing Sensitivity Levels
AUTHOR(s):Feltman, K., Mackie, R., McAtee, A., Aura, C., Noetzel, J., Wilkins, J., Yue, X., McCormick, R., Alcock, S., & Gerstner, J.
ABBREVIATED ABSTRACT:The present study sought to evaluate the utility of a multisensory cueing system on aviators' ability to maintain performance, their experience of workload, and its impact to their situation awareness. Four combinations of cueing sensitivities were evaluated: high auditory/low tactile, high auditory/high tactile, low auditory/low tactile, and low auditory/high tactile. From this study it was concluded that cueing configurations featuring low auditory sensitivity were preferred in terms of performance. Additionally, the majority of participants indicated preference of the configuration featuring low auditory/high tactile cueing, which was also reflected in their workload ratings and performance data.
KEYWORDS:aviation, multisensory cueing, flight performance
DTIC #:AD1219889
TITLE:Instrumented Mouthguard Laboratory Evaluation using Two Anthropometric Test Device Headforms
AUTHOR(s):Brown, B., Daniel, R., & Rooks, T.
ABBREVIATED ABSTRACT:This study is in support of the Human Head Impact Dose Concussion Risk Functions and Sensor-Based Military-Specific Environmental Monitoring System project (BA150149, W81XWH-17-1-0019). Test methods and results comparing the measured kinematics using a boil-and-bite instrumented mouthguard with reference kinematics from two ATD headforms under multiple exposure types and severities are provided. Mouthguard performance was comparable to prior literature; however, there was an increase in variability due to fitting. The Mandible Load Sensing Headform resulted in poor comparisons between the mouthguard and the reference due to several issues with jaw movement and interactions with the mouthguard. A modified NOCSAE headform resulted in good comparisons between the mouthguard and reference data. Increased variability in mouthguard response compared to the reference was primarily attributed to the use of boil-and-bite versus fully custom-molded mouthguards commonly used in the literature. While increased, when compared to custom-molded mouthguards, the variability was still minimal.
KEYWORDS:environmental sensor, concussion, traumatic brain injury, TBI, mTBI, wearable sensor, concussion monitor, head impact sensor, ESiT
DTIC #:AD1219887
TITLE:Environmental Sensors in Training: Head Acceleration Dose Response
AUTHOR(s):Rooks, T. F., Kelley, A. M., Duffy, M., & Chancey, V. C.
ABBREVIATED ABSTRACT:Within the military, it has been estimated that nearly 20 percent of Service Members deployed to Iraq or Afghanistan have sustained at least one mild Traumatic Brain Injury (mTBI). While concussion management and education have significantly improved in recent years, there is still a concern over the possibility of Soldiers with mTBI being missed for evaluation, diagnosis, and treatment. Over the past two decades, civilian and military researchers and clinicians have attempted to leverage environmental sensors, providing the capability to monitor head impact exposures in vivo, to develop a dose-response model for mTBI and concussion. The Environmental Sensors in Training (ESiT) research program evaluated the ability of available devices to identify potentially concussive events resulting from head acceleration events (HAEs) in the military. The present report summarizes the results of the U.S. Army Aeromedical Research Laboratory (USAARL)-led accelerative exposure arm of the ESiT Research Program aimed at developing a dose-response relationship for identifying PCEs with wearable device data.
KEYWORDS:ESiT, environmental sensors in training, head impact, head acceleration event, concussion threshold, concussion, mild traumatic brain injury, mTBI
DTIC #:AD1217068
TITLE:Measuring Trust in Automation in Operational Aeromedical Settings: A Systematic Review of the Literature
AUTHOR(s):Ranes, B., Wilkins, J., Kenser, E., & Caid-Loos, M.
ABBREVIATED ABSTRACT:As military environments integrate more complex technological systems, operators increasingly require more assistance in the form of automation. When used properly, automation has the potential to significantly enhance performance; however, proper use is predicated on the operator's trust in the automation (TIA). TIA, like trust among people, is a complex construct that is influenced by biological, psychosocial, and behavioral aspects that affect (and are affected by) how a user feels about a system. While options for measuring TIA have rapidly expanded in the past decade, there has been little consideration for how well these measures can perform in operational environments. The purpose of this review was to explore the literature produced over the previous ten years to identify all means of measuring TIA, evaluating the quality of the studies that used each measure, and rating how well each measure would perform in an operational aeromedical environment. A recommendation of 28 behavioral, physiological, and user-reported TIA measures is provided, as well as a list of 23 measures with a cautious recommendation (including caveats for use) and six TIA measures that are not recommended. While these recommendations offer a starting point for testing TIA in aeromedical settings, further research is required to test how well these recommended measures actually perform in an operational aeromedical environment.
KEYWORDS:trust, automation, aviation, performance, trust measurements, operational environment, TIA
DTIC #:AD1217055
TITLE:Evaluation of Litter Carriage Performance and Post-Carry Fatigue Effects in Prolonged Combat Field Care Environments (Part 2): Effects of Assistive Device Use During Simulated Litter Transport
AUTHOR(s):Ballard, M. T., Madison, A. M., Novotny, B., McGovern, S., Robinette, A., Stewart, A., Hasapes, S., Williams, S. T., Brozoski, F. T., & Chancey, V. C.
ABBREVIATED ABSTRACT:Litter carriage transport is a standard procedure for initial casualty evacuation from the point of injury to the medical aid or evacuation zone and is generally done on foot. Using an assistive device during litter transport could decrease fatigue and increase the litter bearer's ability to carry the litter, provide critical care, and sustain Warfighter tasks. Improvements in these capabilities are critical with upcoming large scale combat operations (LSCO) and multi-domain operations (MDO), which could extend distance and duration away from medical evacuation zones or definitive medical treatment. We examined the effects of commercial-off-the-shelf (COTS) assistive device use (i.e., shoulder harness and wrist hooks) on litter bearer performance and post-carry fatigue during simulated prolonged care and transport scenarios. Assistive device usage resulted in positive benefits to litter carry distance, grip strength, and spinal posture during the litter carriage task. The use of an assistive device also demonstrated limited benefit to muscular fatigue.
KEYWORDS:litter transport, litter carriage, military casualty evacuation and transport, assistive devices, shoulder harness, wrist hooks, dismounted, operational fatigue, operational performance
DTIC #:AD1217052
TITLE:Environmental Sensors in Training: Lessons Learned
AUTHOR(s):Rooks, T. F., Novotny, B., Winegar, A., & Chancey, V. C.
ABBREVIATED ABSTRACT:Between 2000 and the fourth quarter of 2022, the number of reported traumatic brain injury (TBI) diagnoses totaled 472,785 for all military branches; of those, 82.3% are classified as mild TBI (mTBIs) (Traumatic Brain Injury Center of Excellence, 2022). Recent estimates indicate that as many as 80% of these mTBIs were diagnosed in garrison (potentially during training), as opposed to during combat operations (Helmick et al., 2015). In response, the Environmental Sensors in Training (ESiT) research program was initiated to evaluate wearable sensors designed to detect and quantify head acceleration exposures. The present report summarizes lessons learned through multiple studies conducted between 2015 and 2018 under the ESiT research program informing future device development and continued research involving wearable devices.
KEYWORDS:environmental sensor; concussion; TBI; mTBI; wearable sensor; concussion monitor; head impact sensor; ESiT
DTIC #:AD1214367
TITLE:Efficacy of Donepezil to Enhance Cognitive and Functional Performance in Healthy, Rested Soldiers
AUTHOR(s):Kelley, A. M., Persson, I., Mackie, R., & Wolf, S.
ABBREVIATED ABSTRACT:We evaluated the cognitive enhancement effects of a single dose (5 mg) of donepezil in healthy, rested Soldiers using a randomized, placebo-controlled, within-subjects, double-blind experimental design. The independent variable was drug (donepezil 5 mg, placebo) and abstract reasoning ability was included as a moderator variable. The primary outcomes were cognitive ability (attention, visual information processing, memory), marksmanship performance, and flight performance on a subset of aviators. Participants were 23 male, U.S. Army active-duty Soldiers. Eight participants were rated aviators and completed three simulated flights. Out of 9 tasks (including 3 simulated flights), only one significant difference between drug conditions was found. The effect was seen on one of the simulated flights, which were only completed by rated aviators, approximately 36 percent of participants who completed the study (n = 8). Further research, particularly that focused on the role cognitive workload and intrinsic motivation may play, is required prior to recommendations regarding donepezil and its enhancement properties.
KEYWORDS:Cognitive enhancement, rotary-wing aviation, marksmanship

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Last Modified Date: 2023-04-14