Document Detail

Returning Service Members to Duty Following Mild Traumatic Brain Injury: Exploring the Use of Dual-Task and Multitask Assessment Methods.
MedLine Citation:
PMID:  23766395     Owner:  NLM     Status:  Publisher    
Within the last decade, over 220,000 Service Members (SM) have sustained traumatic brain injury (TBI) in support of military operations in Iraq and Afghanistan. Mild TBI may result in subtle cognitive and sensorimotor deficits that adversely affect Warfighter performance, creating significant challenges for SM, Commanders and clinicians. In recent conflicts, physical and occupational therapists have played an important role in evaluating SM readiness to return-to-duty (RTD) incorporating research and best practices from the sports concussion literature. Because pre-morbid (baseline) performance metrics are not typically available for deployed SM as for athletes, clinicians commonly determine duty readiness based upon the absence of post-concussive symptoms and return to "normal" performance on clinical assessments not yet validated in the military population. While practices described in the sports concussion literature guide "return to play" determinations, resolution of symptoms or improvement of isolated impairments may be inadequate to predict readiness in a military operational environment. Existing clinical metrics informing RTD decision-making are limited because they fail to emphasize functional, Warrior Task demands and lack versatility to assess the effects of co-morbid deficits. Recently, a number of complex task-oriented RTD approaches have emerged from DoD laboratory and clinical settings to address this gap. Immersive virtual reality environments, field-based scenario-driven assessment programs, and militarized dual- and multitask based approaches have all been proposed for the evaluation of sensorimotor and cognitive function following TBI. There remains a need for clinically feasible assessment methods which can be used to verify functional performance and operational competence in a variety of practice settings. Complex and ecologically valid assessment techniques incorporating dual- and multitask methodologies may prove useful in validating return-to-activity requirements in civilian and military populations.
Matthew R Scherer; Margaret M Weightman; Mary V Radomski; Leslie F Davidson; Karen L McCulloch
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-13
Journal Detail:
Title:  Physical therapy     Volume:  -     ISSN:  1538-6724     ISO Abbreviation:  Phys Ther     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
M.R. Scherer, PT, PhD, NCS, Military Performance Division, US Army Research Institute of Environmental Medicine, 15 Kansas St, Natick, MA 01760 (USA).
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