Lower Limb Disability: Present Military and Civilian Needs

Lower limb dysfunction can occur from a variety of acquired or congenital etiologies. Conditions such as cerebral vascular accident, spinal cord injury, traumatic brain injury (TBI), cancer, amputation, musculoskeletal injury, or neuromuscular diseases may result in impaired lower limb function and lead to considerable temporary or permanent disability. Over the past decade, the Department of Defense (DoD) and Department of Veterans Affairs (VA) have cared for thousands of service members with combat-related injuries associated with military operations in Iraq and Afghanistan. A significant number of these injuries have resulted from exposure to blast and have disproportionately affected the musculoskeletal system, including the lower limb(s). In response, significant investments have been made by many federal and non-federal organizations to improve medical, surgical, and rehabilitative care for the injured. In addition, substantive improvements have been made in the field of assistive technology, including prosthetics, orthotics, and wheelchairs. Despite these technological advances, much work is still needed to mitigate the negative consequences of lower limb loss and dysfunction in order to improve overall quality of life.