Category: Military and Veterans Affairs; Brain Injury; Measurement
Objective : To examine differences in active duty service members with mTBI and healthy controls on a tactical agility test, the POWAR-TOTAL.
Design : Case control, cross-sectional.
Setting : Two military treatment facilities with intensive outpatient programs for mTBI.
Participants (or Animals, Specimens, Cadavers) : Subjects were all active duty military service member volunteers: 23 individuals with mTBI and age-matched healthy controls drawn from a convenience sample of 50.
Interventions : Individuals participated in single test session in which they completed self-report measures, POWAR-TOTAL, and the High Level Moblity Assessment Test (HiMAT).
Main Outcome Measure(s) : The POWAR-TOTAL test is performed while carrying a simulated weapon. The test begins with the service member in a prone position, transition to standing, run forward, transition to prone, combat roll to the right, stand and back pedal to the start position, followed by the same sequence with a combat roll to the left. Multiple trials reduce practice effects and examine differences in single and dual-task performance. The dual-task condition requires remembering a two word, 6 number grid coordinate used in military location descriptions. Performance of the both motor and cognitive tasks are measured in the dual-task condition. The HiMAT, requiring maximum speed mobility tasks was completed according to standard instructions.
Results : 5 subjects with mTBI could not complete all trials of the tests. Those with mTBI differed from age-matched health control performance in cognitive performance in single (p=.001), average dual-task conditions (p=.008), single task motor (p=.023), and average dual-task motor (p=.044) performance. HiMAT scores also differed significantly between groups (p=.001).
Conclusions : POWAR-TOTAL group differences were significant in cognitive and motor performance. High level mobility tests may aid in return to duty decision making for injured service members with high level mobility or vestibular impairments.