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40 www.army.mil/publications 90-degree turns. The final focused on polishing up to give the men smooth- ness of motion. They were taught to dance and practiced getting in and out of a mock streetcar built specially for their therapy. “Advancements in (physical and occupational therapy) have been real- ized during and immediately after each major war of the 20th century,” said Dr. Jeffrey S. Reznick, former senior curator of the National Museum of Health and Medicine and director of the Institute for the Study of Occupa- tion and Health. “Fortunately or un- fortunately—depending on one’s point of view, of course—war can be ‘good’ for medicine in the sense that it pushes new innovation, and speeds innovation that might already be underway before a war begins.” Like prosthetics, the rehabilitation methods used with amputees are evolv- ing, and Walter Reed continues to seek the best treatments and technologies for its patients. The Warrior Clinic, with its Ameri- cans with Disabilities Act-compliant restrooms, doublewide doors and lower examining-room tables, was specifically designed for wounded warriors and their families. Its comfortable seating, warm amber lighting, and 50-inch flat- screen televisions invite relaxation. Shar is here to see his primary care physician, Capt. Ingrid Pacowski. In the examining room, Pacowski calls up Shar’s electronic medical record using the Armed Forces Health Longitudi- nal Technology Application. She goes through routine questions, asking about his recovery and looking for any new problems. “Any allergies?” “Yeah, I.E.D.s,” he replies. Pacowski is part of the Triad of Care, a concept initiated by the Army Medical Action Plan. It calls for a primary care physician; a nurse case manager, who handles the administra- The process of making prosthetics is an essential part of helping patients return to their normal lives. In this World War I-era photo, technicians are shown re-creating limbs lost in battle. National Museum of Health and Medicine (Below and two right photos) Cristin Loeffler, a Walter Reed physi- cal therapist, monitors Staff Sgt. Brian Shar’s walking motion in the Military Advanced Training Center and uses an elastic band to put Shar through resisted abduction. 40 www.army.mil/publications uneven ground went through different methods of physical therapy. Before World War II, amputees used an obstacle course, where patients were required to jump from box to box and climb clumsily over obstacles. It was eliminated once therapists found patients would see better results by receiving instructions and practice on everyday tasks they would face in civil- ian life. “War changes everything in the military,” said Sherman Fleek, WRAMC command historian. “The doctors realized we have to do more than just heal these guys. Let’s give them a skill.” The new method focused on easy- walking gaits, balance, turns, sitting and picking up objects. The first step in the new three-step program required exercises in balance, climbing stairs, and 180-degree turns. The second practiced sitting, getting up, bending, walking around curves, and 45- and Craig Coleman Craig Coleman