Brain Injury
Military and Veterans Affairs
Measurement
Oral Presentation
Amy Cecchini, DPT
Research Physical Therapist
The Geneva Foundation
Fayetteville, North Carolina
Oleg Favorov, PhD
Research AssociateProfessor
UNC-Chapel Hill
Chapel Hill, North Carolina
Julianna Prim, MS
Doctoral student
UNC-Chapel Hill
Chapel Hill, North Carolina
Karen McCulloch, PT, PhD, MS, NCS(E), FAPTA
Professor
Univ of NC Chapel Hill
Chapel Hill, North Carolina
Active duty servicemembers with mTBI were studied in a pre- post-intervention design, demonstrating improvements in performance on a test of tactical agility, the POWAR-TOTAL, in addition to improvements in concurrent measures of mobility, balance and dynamic visual acuity. This tactical agility test may be useful in return to duty decision making for individuals who are injured in military service.
Objective : Assess the ability of a performance-based agility task to aid in post-concussion readiness for return to duty assessment of active duty service members (ADSM).
Design : Longitudinal, pre- and post-intervention assessment
Setting : Outpatient clinic on a military base serving ADSM diagnosed with concussion.
Participants (or Animals, Specimens, Cadavers):
13 male subjects: average age of 28.3 years (SD 5.8), 7.6 years (SD 5.7) in service, and 2.5 deployments (SD 2.8).
Interventions : Subjects were seen a median of 6.9 weeks for individualized therapy.
Main Outcome Measure(s) : Intake/self-report measures were collected within one week of initial physical therapy evaluation and again after discharge from therapy. Measures included High level Mobility Assessment Test (HiMAT), Sensory Organization Test (SOT), Dynamic Visual Acuity Test (DVAT), and POWAR-TOTAL agility task. POWAR-TOTAL is a military-specific multi-task assessing visual stability, working memory, balance and tactical agility. The agility task includes rapid prone to stand transition, forward and backward running and combat rolls to the right and left while carrying a simulated weapon. Movement is measured with smartphone tri-axial accelerometers and gyroscopes attached at the lumbar and occipital region
Results:
Participants showed statistically significant improvements in HiMAT, SOT, DVAT and the visual stability and movement components of the POWAR-TOTAL task (p < .05). Improvements were also noted in self-reported dizziness, sleep, and readiness to deploy, however these improvements did not reach statistical significance (p=0.11, 0.12 and 0.12 respectively).
Conclusions:
The POWAR-TOTAL task demonstrates functional improvement on a complex, military specific task after physical therapy rehabilitation for impairments associated with concussion. This improvement may serve as an indicator of recovery and of service member readiness for full return to duty.
