WASHINGTON (AFP) - The US military on Friday decorated dozens of troops and civilians who were wounded in a 2009 shooting rampage at Fort Hood in Texas, after a long campaign to change the rules for awarding the Purple Heart.
The solemn ceremony followed a move by Congress to redefine the criteria for the medal, allowing the shooting to be deemed an act of international "terrorism".
The Purple Heart is traditionally awarded only to troops killed or wounded in combat.
After the legal change, the US Army in February announced it would award the Purple Heart and the civilian equivalent, the Defence of Freedom medal, to all those injured in the shooting and to relatives of those killed.
The former commander at the Fort Hood base, retired general Robert Cone, praised activists and lawmakers who lobbied for the amended rules for "making sure our government has done the right thing by these great patriots."
Thirteen people were killed and more than 30 wounded in the shooting rampage at Fort Hood by army major Nidal Hasan.
He was convicted of the killings in 2013 and sentenced to death. He remains behind bars while his case is reviewed by appeals courts.
US military authorities concluded there was evidence to show Hasan was "in communication" with Al-Qaeda before the attack and that his acts could "reasonably" be considered to have been inspired by the group.
That met the new criteria for the medal, which applies to an attack if the perpetrator was in communication with or inspired by foreign terrorists.
Before the assault, Hasan was in contact with Anwar al-Awlaki, an American-born cleric and operative in Al-Qaeda's branch in Yemen.
Awlaki was killed in a US drone strike in 2011.
"It is our sincere hope that today, we will in some small way help to heal the wounds that you have suffered," Lieutenant-General Sean MacFarland, the current commanding general at Fort Hood, said at the ceremony.
Medals were given to 47 troops and civilians at the Fort Hood ceremony, which was webcast by the Pentagon.
The Purple Heart, which dates back to 1782 and bears a likeness of George Washington, is among the country's most revered military honours.
Veterans groups were divided over the proposed change, with some arguing against altering the criteria.
Soldiers given the Purple Heart qualify for combat-related compensation after retirement and are eligible for burial at Arlington National Cemetery outside Washington.