Chief, Amputee Patient Care Service
Walter Reed National Military Medical Center
Enables combat amputees to lead active lives and potentially return to duty, through an internationally recognized rehabilitation program that uses a novel sports medicine approach.
The building in a Washington, D.C. suburb where young athletes are engaged in intensive training activities is not an Olympic workout facility, but an advanced center for military amputees—part of a unique rehabilitation program designed and developed by Charles Scoville.
The internationally recognized program combines traditional medical and counseling services with a novel sports medicine regime for catastrophically wounded service members, an approach that strives to give amputees back their lives, restore their sense of self-worth and keep them physically active.
“It’s an interdisciplinary approach to patient care that looks at our patients as tactical athletes,” said Scoville, chief of the Amputee Patient Care Service and a former Army physical therapist. “They do things they never did before and reach more high level activities than in the past.”
Scoville oversees the staff that currently is working with about 170 amputees and has helped drive the research into advances in prostheses.
Some of the 1,450 injured service members who have been through the program have gone on to complete triathlons, climb Mt. Everest and compete in gymnastics, skiing, rowing and other sports.
“Our wounded warriors have been out running, on a bear hunt or scuba diving in Guantanamo Bay,” Scoville said. “It continually reinforces that everything is going to be okay.”
More than 300 have gone back into military service, and 53 have redeployed into Iraq or Afghanistan, including one individual with an above-the-knee amputation who went on to lead 350 Marines overseas.
A decade ago, the military was equipped mainly for treating a small number of active-duty amputees and older amputees who had lost limbs due to diabetes or vascular problems, not in combat. Care consisted mainly of getting patients mobile enough to be discharged or transferred to the Department of Veterans Affairs (VA) for care.
After 9/11, the Office of Surgeon General of the Army, where Scoville was working, began planning for the possibility of war and a rise in the number of combat amputees.
Scoville had run a sports physical therapy program at West Point in the 1990s, and developed the concept for a military facility for amputee patients with the goal of returning the injured to active lives or continued military service if they chose.
He helped with the design, development and staffing for a temporary center at the Walter Reed Army Medical Center in Washington, D.C. that opened in 2007. After Walter Reed closed in 2011, a new facility opened in Bethesda, Md. with state-of-the-art equipment and a range of rehabilitation specialists to help with patients’ physical, psychological and emotional well-being.
“The old blueprint for amputee medical care has totally changed due to Scoville’s work,” said Dr. Paul F. Pasquina, chief of orthopedics and rehabilitation at Walter Reed National Military Medical Center. He said the new model “improves the quality of care for all those who suffer from the ill effects of war worldwide.”
At the facilities, which have expanded to sites in San Antonio and San Diego, nurse practitioners, orthopedic surgeons, nurse case managers and occupational, physical and recreation therapists work with amputees injured in Iraq and Afghanistan. Peers also visit with the newly injured as they go through the acceptance process.
“Those peers have thrived in life, they listen to and mentor our patients through common experiences, often leading to lifelong friendships,” said Scoville.
Scoville has collaborated on and overseen the three military amputee care facilities, an extremity trauma center at the Naval Medical Hospital in Portsmouth, Va., as well as seven regional VA amputee care centers.
In addition, his evidence-based research has led to advances in clinical care and contributed to publication of a textbook and corresponding patient education handbook on care of the combat amputee. He also has collaborated with developers of motorized knees and ankles and an advanced prosthetic knee for active duty use.
“He gives folks new hope that they can function and strive for independence,” said Brigadier General Joseph Caravalho. “Chuck will go down as one of the leaders in the care of amputees.”
Dr. Hans Dietl, managing director and chief technology officer at Otto Bock Healthcare Products GmbH, a manufacturer of prosthetic devices, said Scoville defined requirements that had never previously been achieved, such as the ability to climb stairs, avoid obstacles and walk backwards.
He said Scoville also pushed for longer battery life and a water-tight limb that could function in the sea as well as in the desert, leading to advances in sensors, mechanics, electronics, software and materials.
“It is rare to see so many positive outcomes in such a short time, none of which would have been possible without Chuck’s single-minded and persistent determination to get concrete results for those in his care,” Dietl said.
In addition, Scoville’s work with charity organizations has led to greater awareness of people with disabilities and their ability to participate in recreational sports and community activities.
“What we aim for is the soldiers to make the decision of what they will do with the rest of their lives, and take it away from the person who set the improvised explosive device or fired the rocket-propelled grenade or the rifle,” said Scoville.