Adaptive Reconditioning Adaptive Reconditioning

What is Adaptive Reconditioning?

The Soldier Recovery Units (SRUs) offer Adaptive Reconditioning (AR) Programs to help Soldiers in the SRUs achieve success in their recovery journey. Adaptive Reconditioning Programs offer a wide variety of activities that can supplement a Soldier’s rehabilitation and help improve mental, emotional, and physical well-being. All Soldiers in SRUs will participate in some type of adaptive reconditioning activity within the limits of their profile to work towards their short-term and long-term comprehensive recovery program (CRP) goals.

The 5 W's of Adaptive Reconditioning

WHO: All eligible Soldier Recovery Unit (SRU) Soldiers. RM2 Soldiers are not eligible for AR.

WHAT: All Soldiers in Recovery cleared by an SRU Physical Therapist participate in a mandated adaptive reconditioning program individualized for each Soldier in Recovery. Adaptive Reconditioning consists of modified physical exercises, adaptive sports, and therapeutic activities designed to meet the individual needs and goals of the wounded, ill, and injured Soldiers in the SRU to assist with recovery and improve readiness.

WHEN: Each SRU has an Adaptive Reconditioning team that provides a wide variety of safe adaptable AR events throughout the duty week. Approximately 60 different types of activities are being offered across the SRUs (approximately 2,000 activity sessions/month across the enterprise). About 60% of offerings are moderate intensity activities and 40% are therapeutic recreational activities.

WHERE: All SRUs.

WHY: Allow Soldiers in Recovery a wide array of activities to engage in to enhance the recovery process. Participating in moderate intensity physical activities and therapeutic recreation encourages safe return to physical activity and engagement in activities that encourage mental and emotional well-being to assist with returning to an active and productive lifestyle.

Benefits of Adaptive Reconditioning

  • Participation in therapeutic recreation and adaptive sports improves athletic identity, balance/coordination, and perceived competence (Greer et al).
  • Low/no harm associated with participation in therapeutic recreation and adaptive sports (Greer et al).
  • Adaptive sports participation can be used as a bridge to complement rehabilitation (Diaz et al).
  • Participation in group exercise demonstrates substantial improvements in self-reported physical activity, aerobic outcomes, and functional outcomes (Hall et al).
  • Exercise and therapeutic activities boost mood (Wheeler et al).
  • Therapeutic recreation can help reduce tension, depression, and anger and can improve perceived quality of life, vigor, and perceived personal competence (Wheeler et al, Bettman et al).
  • Participation in music therapy bolsters physical and neurological functioning, functional and expressive communication, and social and emotional wellbeing (Bradt et al, Bronson et al).
  • Creativity expressed through art therapy can assist with understanding and communicating internal processes (Jones et al).
  • Evidence supports the connection between art making and changes in the brain for military service members with TBI and posttraumatic stress.
  • Veterans with various medical conditions report higher quality of life with participation in muli-sport adaptive sporting programs (Greer et al).
  • Adaptive reconditioning participation creates a “team atmosphere”, an environment which is accepting, normalizing, and non-judgmental (Gettings et al).
  • Peer support through participation utilizes the strength of the military and veteran communities; its sense of brother/sisterhood. Peer support helps participants re-engage and re-motivate each other and take a lead in their own respective recovery journeys. (Gettings et al).
  • Socialization fosters growth and engagement through the conduit of group cohesion, togetherness, and connectedness (Gettings et al).
  • Participants in Veteran adaptive sports offered by the Veterans Administration report “increased friends” and the ability to be competitive as areas most affected by participating in adaptive sporting events (Greer et al).
  • Veterans participating in adaptive sports report that participating in the National Veteran Wheelchair Games had a positive impact on employment (Greer et al).

Balancing Adaptive Reconditioning and a Busy Schedule

  • The Adaptive Reconditioning (AR) program is individualized and focused on Soldiers' needs and goals. The SRU Physical Therapist and Soldier in Recovery work together to determine a balanced, safe, individualized AR plan.
  • AR offers a large variety of activities - there is something for everyone!
  • Since the AR program is individualized, it is easy to balance AR participation with medical appointments, career, and education requirements, etc.
  • The majority of Soldiers in Recovery are eligible to participate.
  • Participation in AR keeps Soldiers engaged, active, and occupied in a positive way throughout the recovery process. Participation in AR programming decreases boredom and gives Soldiers goals to strive to achieve (e.g., Warrior Games, learning new lifelong hobbies and activities).

Activities Offered at SRUs

Why are adaptive sports offered as a part of the Adaptive Reconditioning Program?

  • Injury and recovery can make Soldiers in Recovery feel like they will never be athletes again. Getting involved in adaptive sports during the recovery process helps Soldiers in Recovery make goals, connect with their athletic identities, and bond with other athletes on their recovery journey. Competition, teamwork, and purpose fuels the inner athlete and inspires Soldiers to set goals and excel. Being a part of a team and connection with others makes a tremendous impact on Soldiers in the recovery process. Participating in Army adaptive sports allows Soldiers in Recovery to connect with their team and be competitive.
  • While in the SRU setting, SRs are offered many opportunities to participate in safe adaptive sporting events led by the Adaptive Reconditioning Team, a team of professionals that get recovering Soldiers involved in sports early and safely.
  • Since the AR program is individualized, it is easy to balance AR participation with medical appointments, career, and education requirements, etc.
  • MANY adaptive sports are offered at the SRUs, but 11 adaptive sports are featured in adaptive sporting events offered to SRs that participate in the Adaptive Reconditioning program.

11 adaptive sporting events are featured at Army Trials, Warrior Games, and Invictus Games.

  • 3 Team Sports: Wheelchair rugby, Wheelchair basketball, and Sitting Volleyball
    • Why do we do wheelchair sports and sitting volleyball? They are inclusive and easily adaptive; Most people can play at any stage in their recovery; Gives athletes perspective; They give athletes of all abilities a chance to play together on a team; and THEY ARE FUN!
  • Individual Sports:
    • Track (and track chair events)
    • Field (and seated field events)
    • Swimming
    • Cycling (upright bike, hand cycle, recumbent)
    • Indoor Rowing
    • Powerlifting (Adaptive Bench Press)
  • Precision Air Sports:
    • Air Pistol/Air Rifle
    • Archery (Recurve and Compound Bows)

Do the sports change?

Sometimes! Adaptive Tennis, Adaptive Table Tennis, Adaptive Winter Sports, and Adaptive Golf events have also been featured in adaptive sporting events!

A wide variety of adaptive sports are offered in the community and VA setting in addition to the sports featured here. Recovering Soldiers that are introduced to adaptive sports while in the SRU setting can get involved and continue to excel in these activities once they transition out of the SRU. Some examples of large-scale adaptive sporting events are Valor Games, Texas Regional Games, National Veterans Wheelchair Games, and more!

Moderate Intensity Physical Activities offered in the SRU

The 14 SRUs offer a wide variety of exciting moderate intensity physical fitness programming led by an experienced team to help recovering Soldiers meet their goals. New offerings are featured regularly; however, the extensive list below is a snapshot of the programming offered across the adaptive reconditioning programs in the 14 SRUs:

  • Hiking
  • Spin
  • Strength Training
  • Adaptive Functional Fitness
  • Dance
  • Football/Kickball/Dodgeball
  • Combatives/Martial Arts/Boxing
  • Pilates/Barre
  • Tennis
  • Pickleball
  • Kayaking/Paddle Boarding/Surfing
  • Core/Lower Back Class
  • Aquatics
  • Balance Class
  • Cardio/HIIT Class
  • Mountain Biking
  • Skiing/Water Skiing/Snowboarding
  • Ice Skating
  • Racquetball
  • Yoga
  • Run Walk Group
  • Return to Duty Specific Training

Therapeutic Activities

Recovery is not all about physical conditioning! Recovery also encompasses the mental and spiritual domains and therapeutic activities offer opportunities for recovering Soldiers to have fun trying something new while socializing with fellow Soldiers. In addition to interacting with social groups, participating in therapeutic activities assists with cognitive recovery, motor skills, and life skills.

Adaptive reconditioning programs offer a wide variety of therapeutic activities to include:

  • Gardening
  • Art
  • Music
  • Mindfulness
  • Walking Group
  • Yoga
  • Tai Chi
  • Stretching
  • Fishing/Kayak Fishing
  • Table Games
  • Table Tennis/Billiards/Darts
  • Knitting/Crochet
  • Golf
  • Cooking
  • Wellness Class
  • Spirituality
  • Equine Therapy
  • Disc Golf
  • SCUBA
  • Book Club
  • Woodworking
  • Coffee Group

 

Role of ARCP Adaptive Reconditioning Branch

  • Communications with Medical Readiness Commands regarding Soldier Recovery Unit Adaptive Reconditioning programming.
  • Policy development, oversight, and guidance of Soldier Recovery Unit Adaptive Reconditioning Programming.
  • Standardization of documentation, AR team roles, and AR equipment sets.
  • Contract Management.
  • Plan and execute large-scale adaptive reconditioning events to include Army Trials, Warrior Games, Invictus Games, Team Sports Camps, Bring on the Bands, Wellness Events, and Posttraumatic Growth Training (Struggle Well Training).

Mandates and Regulations

  • Army Regulation 40-58. Army Recovery Care Program. 12 May 2020.
  • MEDCOM OPORD 20-17, Army Recovery Care Program Restructure.
  • NDAA 2012, Establishment of Military Adaptive Sports Program.
  • TRADOC EXORD, DoD Warrior Games and Invictus Games.
  • For detailed program guidance: ARCP Processes and Procedures Guide.
  • FM 7-22, Health and Holistic Fitness October, 2020.

Supporting References

  • Greer, N., Balser, D., McKenzie, L., Nicholson, H., MacDonald, R., Rosebush, C., Senk, A., Tonkin, B., & Wilt, T. J. (2019). Adaptive sports for disabled veterans (VA ESP Project #09-009). U.S. Department of Veterans Affairs.
  • Diaz, R., Miller, E., Kraus, E., & Redericson, M. (2019). Impact of adaptive sports participation on quality of life. Sports Medicine and Arthroscopy Review, 27(2).
  • Hall, K. S., Morey, M. C., Beckham, J. C., Bosworth, H. B., Sloane, R., Pieper, C. F., & Pebole, M. M. (2020). Warrior Wellness: A randomized controlled pilot trial of the effects of exercise on physical function and clinical health risk factors in older military veterans with PTSD. The Journals of Gerontology: Series A, 75(11), 2130–2138. https://doi.org/10.1093/gerona/glz255.
  • Wheeler, M., Cooper, N. R., Andrews, L., Hacker Hughes, J., Juanchich, M., Rakow, T., & Orbell, S. (2020). Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial. PLOS ONE, 15(11), Article e0241763. https://doi.org/10.1371/journal.pone.0241763.
  • Bettmann, J. E., Prince, K. C., Ganesh, K., Rugo, K. F., Bryan, A. O., Bryan, C. J., Rozek, D. C., & Leifker, F. R. (2021). The effect of time outdoors on veterans receiving treatment for PTSD. Journal of Clinical Psychology, 77(9), 2041–2056. https://doi.org/10.1002/jclp.23139.
  • Bradt, J., Biondo, J., & Vaudreuil, R. (2019). Songs created by military service members in music therapy: A retrospective analysis. The Arts in Psychotherapy, 62, 19–27. https://doi.org/10.1016/j.aip.2018.11.004.
  • Bronson, H., Vaudreuil, R., & Bradt, J. (2018). Music therapy treatment of active duty military: An overview of intensive outpatient and longitudinal care programs. Music Therapy Perspectives, 36(2), 195–206. https://doi.org/10.1093/mtp/miy006.
  • Jones, J., Drass, J., & Girija, K. (2019). Art therapy for military service members with post-traumatic stress and traumatic brain injury: Three case reports highlighting trajectories of treatment and recovery. The Arts in Psychotherapy, 63, 18–30.
  • Gettings, R. D., Kirtley, J., Wilson-Menzfeld, G., Oxburgh, G. E., Farrell, D., & Kiernan, M. D. (2022). Exploring the role of social connection in interventions with military veterans diagnosed with post-traumatic stress disorder: Systematic narrative review. Frontiers in Psychology, 13, Article 873885. https://doi.org/10.3389/fpsyg.2022.873885.