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Post-Concussion Tools to Assist with Assessment, Treatment, and Return to Duty

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Technical Report,28 Sep 2009,27 Sep 2014

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Henry M. Jackson Foundation for the Advancement of Military Medicine Bethesda United States

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Dizziness and instability are common outcomes of concussion and mild Traumatic Brain Injury mTBI. Such problems decrease functional ability and patient safety, while adversely affecting cognition and affect. The latest objective tests of balancedizziness are not routinely used to aid assessment and diagnosis, nor to monitor recovery. This project intends to fill these gaps. We will develop an enhanced quantitative test battery for evaluating neurophysiological balance dysfunction associated with concussive events or mTBI. This project will deliver a portable initial screening instrument for immediate field assessment after injury, and a battery of sensitive clinic-based tests for monitoring results of therapy during the recovery period. Test sensitivity will be established on groups of military personnel who have or have not been exposed to blast without concussion or concussion without blast. Specificity for differential diagnosis will be established by comparing to individuals diagnosed with PTSD and normal subjects attempting to malinger. This project will be coordinated with another funded effort to assist patients through the entire period of injury and recovery, allowing for initial assessment to aid diagnosis, objective monitoring of recovery, the establishment of criteria for deciding about fitness for returning to duty, and the development of an enhanced program of rehabilitation. A treatment program will be developed in coordination with our other funded effort, which emphasize individualized, automated training to decrease sway under conditions of enhanced balance feedback, to coordinate head-eye movement reflexes normally again, and to balance normally while cognitively engaged in a challenging mental task.

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