Independent evaluation and review of ARCHANGEL ARMOR IFLBA
Dr. Richard M. Kuhns, III
Executive Summary: Current IOTV and MBAV cause postural changes
and spinal compression that lead to accelerated fatigue and injury of
the spine and its supporting structures when compared with a nonload bearing system such as the IFLBA.
I. General Education
A. In General, the scenario that results in making a human physically
tired throughout a normal day is the result of expending energy via
all bodily systems to perform a given task or set of tasks within
and/or during a certain period of time.
The details of this as they relate to fatigue are somewhat individual
in nature as they correlate to the current conditioning level of the
person doing the work and how efficient their body is at performing
said tasks. Certain factors affect this and create some variability
such as nutritional status, past injury status, how well rested is the
person, etc. However, spinal loading will eventually affect everyone
in a detrimental manner regardless of the individual conditioning
level.
B. The body systems that are impacted during a normal day that
contribute to a person being physically tired are basically every
system in the body.
The musculoskeletal system (bones, ligaments, muscles, tendons,
intervertebral discs, etc.) is tasked with keeping a person physically
moving and supported in a healthy capable posture and set of
movement patterns. The circulatory and respiratory system must
provide the entire body with blood, oxygen and vital nutrients to all
cells of the body. The endocrine system works with the central
nervous system to balance the body’s delicate balance of chemicals,
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hormones, enzymes, etc. The brain must keep the person focused
and alert to perform tasks and minimize mistakes that prolong the
tasks and increase chances of injury and unneeded repetition.
C. The average soldier has an increased need, compared to most
civilians, to be fit and injury free to perform all the necessary
requirements of their job especially as they relate to the safety and
protection of themselves, their fellow soldiers and our country.
The daily duties of physical training, to include the increased
emotional and physical stress their bodies must endure, are more
traumatic on a daily basis than the average civilian encounters. The
occurrence of most injuries, (acute, sub acute, and chronic) are
increased significantly. A major source of such injuries is increased
physical load bearing on the spine and its supporting structures,
along with the associated structural compensations that are the result
of functional changes in body mechanics. The long-term effect of
these being the chronic disability of the soldier.
D. In terms of the acute affects on the body of increased spinal
loading, especially using the current IOTV and MBAV, the most
common injuries are those affecting the spinal tissues. These injuries
are mostly due to excessive strains on biologic tissues in the spine
that require less than 5% deformation to cause microfailure.
Microfailure of tissues that generally begins as fatigue then
progresses to injury. (See Attached Fig. 2.4 and 2.5).1
If there is repeated or prolonged loading, which can sometimes be
just a few minutes, tissue damage in the form of rearrangement of
collagen fibers, proteoglycans (vital components of cartilage tissue),
and water in the ligaments and joint capsule can occur. Following
these changes the tissues have difficulty returning to their original
length. This then leads to hysteresis, which is the energy lost after
repeated or prolonged loading. Usually the person is now aware of
acute pain and dysfunction.
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Pain and dysfunction are noticed usually first in the muscles.
Myofascial trigger points have direct and referred pain patterns that
are commonly seen in soldiers carrying the current IOTV and MBAV.
The common affected muscles are upper trapezius, levator scapulae,
scalenes, sternocleidomastoids, quadratus lumborum. The most
common joint injuries and their referral patterns are cervical spine
joints and lumbar spine joints. (See attached Fig. 10A.6, 10A.7,
10A.9, 10A.10, 10A.14, 10A.15).2
Even mild strains can cause microdamage which if repeated will
frequently result in tissue deformation. Various studies have
concluded that fatigue causes failure. According to Bogduk and
Twomey, hysteresis makes fatigued tissues more vulnerable to
injury.3 According to Andersson, repetitive loading of various tissues
causes fatigue which leads to failure.4
E. The long term or chronic affects on the body are basically the
result of the acute injuries not being treated (due to mission status
and availability of proper treatment modalities), and continued
actions that initiated the injury to begin with. The above mentioned
acute injury scenario is magnified and becomes chronic with each
successive attempt to continue performing the same job with the
same equipment.
The more impaired the soft tissue site is, the less stress required to
attain the soft tissue fatigue/failure point. The articular surfaces,
joint capsules and ligaments contain the most nociceptors in the body
and are likely the most common pain generators. Activation of these
sites and any other pain generators will cause a compensatory
reaction in the entire motor system that will cause adaptive patterns
to remain for extended periods of time after the injury has occurred.
This is the foundation of chronic injury.
F. The easiest way to mitigate and interfere with acute and chronic
injury patterns, as they relate to the soldiers and the use of the
current IOTV and MBAV, is to remove as much spinal load bearing
as possible and add spinal support.
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For instance, the current use IOTV and MBAV causes the soldier to
lean forward to balance the pack on the spine. This body position
creates a forward head carriage that mimics adding weight to the
head. For every inch the head moves forward of its normal posture
(See attached: normal posture references viewed in Fig. 7.1 and
7.2),5 the weight of the compressive forces on the lower neck
increases by the additional weight of the entire head. (See attached
Fig. 10a.19).6
I see these injuries on a daily basis for treatment and they always
involve the recruitment of other spinal muscles, joints and supporting
structures due to compensation factors that the body performs
instinctively in response to fatigue and trauma.
Changing the load bearing dynamics of the current IOTV and MBAV
to something that has little or no negative effects on the spine and its
supporting structures is an ideal way to decrease fatigue and injury,
and will thereby increase performance, endurance and tactical
readiness. The ARCHANGEL IFLBA does this easily.
By utilizing the ARCHANGEL IFLBA, the load bearing focus is redirected to the sacrum and iliac crests. These are much stronger
bodily structures, ideally suited for carrying heavy loads with less
fatigue and less potential for injury to a majority of spinal structures.
In my opinion the ARCHANGELL IFLBA completely satisfies the two
goals of a) completely removing gear related spinal loading and b)
providing improved support to the spine. These factors, individually
and cumulatively, increase endurance while reducing fatigue and
injury.
II. Device Evaluation
*Evaluation was performed in both clinical and non-specific outdoor
settings. Evaluation included fitting and general body movement
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observations, with myself, and numerous volunteer soldiers as test
subjects. The soldiers involved where veterans and active duty
personnel who are very familiar with currently used IOTV and MBAV
systems. The evaluation was with IFLBA loaded with armor.
A. The ARCHANGEL IFLBA’s purpose of decreasing spinal loading
and re-directing the load to a more stable structure of the body is
successful. The current IOTV and MBAV places all of it’s loading on
the spine and the supporting structures in such a way as to not only
cause increased occurrence of injury but also increased fatigue,
limited range of motion and alterations of body mechanics to account
for the load being supported, and to balance that shifting load.
The ARCHANGEL IFLBA re-directs the load bearing to a stronger,
more secure area of the body, which will reduce injuries to the spine
and its supporting structures. It allows greater range of motion in
the head/neck/shoulder area regardless of loads carried. The
nominal changes in total measured weight are negligible especially in
light of the idea that the ARCHANGEL IFLBA creates less fatigue
which will equate to greater levels of job performance and decreased
injury occurrence.
The ARCHANGEL IFLBA also provides ergonomic support for the
spine. The added benefit of this will be evident with prolonged
periods of standing, sitting, walking, running, laying prone and laying
supine.
B. Since 2001 I have treated over a thousand soldiers for various
injuries. In order to understand how to rehabilitate an injury, we
must also understand how and why the injury occurred. In roughly
three quarters of these cases, the injuries could be reduced with
changes that reduce strain. Strain that occurs because of spinal load
bearing packs is a major problem. The current use IOTV and MBAV
requires the soldier to alter body mechanics to endure many hours
carrying equipment, supplies, etc.
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If a soldier is required to change body mechanics while carrying a
large amount of weight, then to reduce fatigue and injury the soldier
must either reduce weight significantly or re-direct the way the
weight is being loaded on the body. The lumbosacral, gluteal, and
leg musculoskeletal structures are much stronger than the neck,
shoulder region and can carry significantly more weight with less
fatigue.
The overall result here is greater support for the spine, less fatigue
for the body structures and the entire body, greater endurance on
mission tasks, enhanced mobility, decreased rate of fatigue and
injury.
C. Simply stated, less fatigue has enormous implications on overall
body function. Less fatigue means the body organs and systems
have to work less and expend less energy to maintain homeostasis.
Overall body strength is preserved for longer consecutive periods of
time. Fewer calories are burned which means nutritional intake is
reduced. Circulatory and respiratory systems are less taxed which
means less need for rest to regain energy. Hydration needs are
minimized due to less caloric expenditure and a reduced rate of
energy usage.
D. The ARCHANGEL IFLBA also has the unique quality of providing
support for the body due to a specific lumbar support that enables
proper engagement of lumbosacral musculature throughout most
movements.
This acts as a guard to again prevent injury in the event of an
unexpected incident or accident that may usually compromise the
integrity of the spine. This is accomplished by the kyphotic thoracic
support piece that stabilizes the upper spine and again by the lumbar
support pad and cumber bun that stabilizes and protects the
lumbosacral spine.
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It is also my professional opinion that the marked reduction in spinal
load bearing, and the increase in spinal support provided by the
ILFBA will have noticeable secondary effects of increased endurance,
tactical readiness, protection, and freedom of movement.
E. Whether sitting or standing, the effect of the ARCHANGEL IFLBA’s
posture support system on the soldier is evident. While sitting, the
load is removed from the shoulders and neck which enables greater
freedom to use the arms more effectively to handle a weapon or to
maneuver a vehicle. All of this while the rest of the spine is naturally
supported in a proper position to reduce fatigue and injury.
While standing, the same effects are noted with the use of the arms
having notably more freedom to carry out required actions. While
lying in the prone position, the soldier also has the same freedoms of
motion and is better able to arise quickly due to the positioning of
the IFLBA on the hips. This is an easier fulcrum point than the
shoulders and neck, which carry most of the weight in the current
use IOTV and MBAV.
Most of the time when arising from a prone position, the hips arise
first to establish footing to raise the upper body. If the weight is
raised first with hips (as it is with the ILFBA), the upper body arises
with less effort, enabling this particular task to be performed multiple
times with much less effort, especially when compared with the IOTV
and MBAV systems that tend to ride up higher onto the soldiers neck
area further increasing spinal strain and fatigue.
It is also my opinion that that the advantages of the IFLBA are going
to be more pronounced in areas of high altitude or high temperature.
These are the conditions observed in the current theatre of
operations of the U.S. The reason for this is the combination of high
temperatures and hydration needs, as well as the rugged terrain,
high altitudes and decreased oxygen experienced by our soldiers,
acts to accelerate fatigue. It is therefore imperative to minimize that
fatigue by using the ILFBA, rather than continuing to compound the
fatigue levels as I observe fro the current IOTV and MBAV.
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It is also important to realize that the load lifting and spinal
supporting behavior of the ILFBA further reduces fatigue by reducing
escalation of body temperature by allowing some air circulation to
reach the dorsal surface of the soldier to diminish perspiration. In
doing this, blood flow is improved along with hydration needs being
reduced.
The higher temperature, and altitude are both factors that must be
factored in to the equation that requires our soldiers to perform at
their best. The IFLBA enables the soldier to utilize all of the skills,
training and conditioning to a much higher level than currently
experienced.
This is an advantage to our soldiers that should be in place in all
branches for the reason of safety, protection and tactical readiness.
Less fatigue means a soldier can go further and faster in a much
more profound way. The tactical advantage will be evident to all
who use this system.
Yours in Health,
Dr. Richard M. Kuhns, III
Bio: Dr. Kuhns is a Chiropractic Physician in private practice in
Fayetteville, NC. Since 2001, his practice has been treating soldiers
from all branches that are stationed and or training at Ft. Bragg.
This report is an independent evaluation for which no compensation
was received. The IFLBA evaluation was conducted on self and
individual soldiers, with armor plates attached, and in various body
mechanical positions, in a non-combat scenario. These views and
opinions are based on visual exam as well as clinical experience.
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References
1. Liebenson, Craig: Rehabilitation of the Spine: A Practitioner’s Manual. Williams
and Wilkins, 1996, pg. 16.
2. Liebenson, Craig: Rehabilitation of the Spine: A Practitioner’s Manual. Williams
and Wilkins, 1996, pg. 171-175.
3. Bogduk N, Twomey LT: Clinical Anatomy of the Lumbar Spine. 2nd Ed.
Churchhill Livingston, Melbourne 1991
4. Andersson GBJ: Occupational Biomechanics. In Weinstein JN, Weisel SW (eds):
The Lumbar Spine: the International Society for the Study of the Lumbar Spine.
Philadelphia, WB Saunders, 1990, p 172.
5. Liebenson, Craig: Rehabilitation of the Spine: A Practitioner’s Manuel. Williams
and Wilkins, 1996, pg.114.
6. Liebenson, Craig: Rehabilitation of the Spine: A Practitioner’s Manuel. Williams
and Wilkins, 1996, pg. 177.
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