Neuromotor changes in participants with a concussion history can be detected with a custom smartphone app.

Neuromotor dysfunction after a concussion is common, but balance tests used to assess neuromotor dysfunction are typically subjective. Current objective balance tests are either cost- or space-prohibitive, or utilize a static balance protocol, which may mask neuromotor dysfunction due to the simplicity of the task. To address this gap, our team developed an Android-based smartphone app (portable and cost-effective) that uses the sensors in the device (objective) to record movement profiles during a stepping-in-place task (dynamic movement).

Chronic Effects of Breaching Blast Exposure on Sensory Organization and Postural Limits of Stability.

Objective: The goal of this effort to investigate if experienced breachers, professionals with a career history of exposure to repeated low-level blasts, exhibited postural instability.

Methods: Postural data were examined using traditional tests of means and compared to normative data.

Results: Breachers had significantly lower NeuroCom Sensory Organization Test (SOT) visual scores (within normative limits), prolonged Limits of Stability (LOS) test reaction time (30% of breachers and 7% of controls testing abnormal), and slower LOS movement velocity (21% of breachers and 0% of controls testing abnormal) compared to controls.

Functional and Structural Neuroimaging Correlates of Repetitive Low-Level Blast Exposure in Career Breachers.

Combat military and civilian law enforcement personnel may be exposed to repetitive low-intensity blast events during training and operations. Persons who use explosives to gain entry (i.e.

Relationships Between Sleepiness, Mood, and Neurocognitive Performance in Military Personnel.

Neurocognitive computerized assessment tools (NCATs) were developed to assist military clinicians with the tracking of recovery from injury and return to full duty decisions with a recent focus on the setting of post-concussion evaluations. However, there is limited data on the impact of deployment on neurocognitive functioning, sleepiness, and mood in healthy, non-concussed Service members. Automated Neuropsychological Assessment Metrics version 4 TBI Military (ANAM) data was obtained for a sample of active duty deployed personnel ( = 72) without recent history of mild traumatic brain injury (mTBI).

Acute neurocognitive deficits in active duty service members following subconcussive blast exposure.

Military service members are frequently subjected to subconcussive blast events during training and deployment. Emerging evidence suggests blast exposures of these magnitudes may have long-term consequences for dimensions of cognitive function. Less is known about cognitive sequelae acutely following deployment-related subconcussive blast events.

Using Rates of Low Scores to Assess Agreement between Brief Computerized Neuropsychological Assessment Batteries: A Clinically-based Approach for Psychometric Comparisons.

Objective: To assess agreement between four brief computerized neurocognitive assessment tools (CNTs), ANAM, CogState, CNS Vital Signs, and ImPACT, by comparing rates of low scores.

Methods: Four hundred and six US Army service members (SMs) with and without acute mild traumatic brain injury completed two randomly assigned CNTs with order of administration also randomly assigned. We performed a base rate analysis for each CNT to determine the proportions of SMs in the control and mTBI groups who had various numbers of scores that were 1.

Effects of sleep and fatigue on teams in a submarine environment.

Successful submarine operations rely on the performance of tactical teams who must work under conditions of physiological and cognitive fatigue. Sleep loss and circadian disruption contribute to fatigue in this setting and, although the effects of this fatigue have been studied extensively in individuals, little is understood about how fatigue impacts team performance Рespecially in a submarine environment. The present review provides an overview of the fatigue on submarine teams and is divided into four main sections: 1) A discussion of factors that should be considered in team fatigue research.

Changes in Posture Following a Single Session of Long-Duration Water Immersion.

Transitioning between different sensory environments is known to affect sensorimotor function and postural control. Water immersion presents a novel environmental stimulus common to many professional and recreational pursuits, but is not well-studied with regard to its sensorimotor effects upon transitioning back to land. The authors investigated the effects of long-duration water immersion on terrestrial postural control outcomes in veteran divers.

Cardiac and gait rhythms in healthy younger and older adults during treadmill walking tasks.

Background: Aging and pathology result in changes in the dynamics of several physiological subsystems. Often, these changes are concurrent, altering the dynamics between subsystems. Cardiac and gait rhythms are one example in which patterns change during physical activity.

Healthy Active Duty Military with Lifetime Experience of Mild Traumatic Brain Injury Exhibits Subtle Deficits in Sensory Reactivity and Sensory Integration During Static Balance.

Postural control and stress reactivity were investigated in active duty coast guard personnel to determine whether they are sensitive to lifetime effects of mild traumatic brain injury (mTBI). A custom-designed and validated virtual reality-based computerized posturography device was used to assess postural stability, whereas emotional reactivity was assessed using the acoustic startle response (ASR), and neurocognitive performance was assessed using the defense-automated neurobehavioral assessment (DANA). It was hypothesized that residual and subtle postural control imbalance and deficits in cognitive and sensory reactivity would be evident in those reporting multiple lifetime mTBI.

Recovery from Mild Traumatic Brain Injury Following Uncomplicated Mounted and Dismounted Blast: A Natural History Approach.

Objective: The purpose of this study is to utilize a natural history approach to describe and understand symptom recovery in personnel diagnosed with a blast-related mild traumatic brain injury (mTBI) resulting from an improvised explosive device blast.

Participants And Design: The population included military personnel who experienced a blast mTBI while mounted (vehicle; n = 176) or dismounted (on foot; n = 37) (N = 213). Patients had no co-morbid psychiatric or muscle-skeletal issues and were treated within 72 h of injury.

Effects of prolonged and repeated immersions on heart rate variability and complexity in military divers.

Background: The influence of prolonged and repeated water immersions on heart rate variability (HRV) and complexity was examined in 10 U.S. Navy divers who completed six-hour resting dives on five consecutive days.

Validity and reliability of smartphone orientation measurement to quantify dynamic balance function.

Objective: Postural control is frequently compromised after sub-concussive and concussive head trauma, and balance testing is an integral part of neuromotor assessment and management. The main objective of this paper is to develop a novel smartphone-based neuromotor assessment protocol for screening of dynamic balance decrements stemming from head trauma.

Approach: Experiments 1 and 2 compared Android smartphone orientation detection algorithms to a biomechanics laboratory motion capture system using a pendulum (i.

Intraindividual Cognitive Variability: An Examination of ANAM4 TBI-MIL Simple Reaction Time Data from Service Members with and without Mild Traumatic Brain Injury.

Objectives: The Automated Neuropsychological Assessment Metrics 4 TBI-MIL (ANAM4) is a computerized cognitive test often used in post-concussion assessments with U.S. service members (SMs).

Effect of concussion and blast exposure on symptoms after military deployment.

Objective: To examine whether blast exposure alone and blast-associated concussion result in similar neurologic and mental health symptoms.

Methods: A 14-item questionnaire was administered to male US Marines on their return from deployment in Iraq and/or Afghanistan.

Results: A total of 2,612 Marines (median age 22 years) completed the survey.

RETRACTED - Intra-individual Cognitive Variability: An Examination of ANAM4 TBI-MIL Simple Reaction Time Data from Service Members with and without Mild Traumatic Brain Injury.

The Automated Neuropsychological Assessment Metrics 4 TBI-MIL (ANAM4) is a computerized cognitive test often used in post-concussion assessments with U.S. service members (SMs).

Development of a Portable Tool for Screening Neuromotor Sequelae From Repetitive Low-Level Blast Exposure.

Blast exposure is a prevalent cause of mild traumatic brain injury (mTBI) in military personnel in combat. However, it is more common for a service member to be exposed to a low-level blast (LLB) that does not result in a clinically diagnosable mTBI. Recent research suggests that repetitive LLB exposure can result in symptomology similar to symptoms observed after mTBI.

Assessing subacute mild traumatic brain injury with a portable virtual reality balance device.

Purpose: Balance impairment is a common sensorimotor symptom in mild traumatic brain injury (mTBI). We designed an affordable, portable virtual reality (VR)-based balance screening device (Virtual Environment TBI Screen [VETS]), which will be validated relative to the Neurocom Sensory Organization Test (SOT) to determine if it can replace commonly used postural assessments.

Methods: This preliminary study examines healthy adults (n = 56) and adults with mTBI (n = 11).

Performance on the Defense Automated Neurobehavioral Assessment across controlled environmental conditions.

Neurocognitive assessment tools (NCAT) are commonly used to screen for changes in cognitive functioning following a mild traumatic brain injury and to assist with a return to duty decision. As such, it is critical to determine if performance on the Defense Automated Neurobehavioral Assessment (DANA) is adversely affected by operationally-relevant field environments. Differences in DANA performance between a thermoneutral environment and three simulated operationally-relevant field environments across the thermal stress continuum were calculated for 16 healthy U.

Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment.

Primary Objective: To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI).

Research Design: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls.

Methods And Procedures: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline.

Sensitivity of the Balance Error Scoring System and the Sensory Organization Test in the Combat Environment.

This study evaluated the utility of the Balance Error Scoring System (BESS) and the Sensory Organization Test (SOT) as tools for the screening and monitoring of Service members (SMs) with mild traumatic brain injury (mTBI) in a deployed setting during the acute and subacute phases of recovery. Patient records (N = 699) were reviewed for a cohort of SMs who sustained a blast-related mTBI while deployed to Afghanistan and were treated at the Concussion Restoration Care Center (CRCC) at Camp Leatherneck. On initial intake into the CRCC, participants completed two assessments of postural control, the BESS, and SOT.

Reliable Change Estimates for Assessing Recovery From Concussion Using the ANAM4 TBI-MIL.

Objective: To establish the reliable change parameters for the Automated Neuropsychological Assessment Metrics (ANAM) using a healthy normative sample of active duty service members (SMs) and apply the parameters to sample of recently deployed SMs.

Methods: Postdeployment neurocognitive performance was compared in 1893 US Marines with high rates of combat exposure during deployment. Of the sample, 289 SMs had data for 2 predeployment assessments and were used as a normative subsample and 502 SMs had data for predeployment and postdeployment assessments and were used as a deployed subsample.

Interpretation of postural control may change due to data processing techniques.

Postural control is commonly assessed by quantifying center of pressure (CoP) variability during quiet stance. CoP data is traditionally filtered prior to analysis. However, some researchers suggest filtering may lead to undesirable consequences.

Fractal gait patterns are retained after entrainment to a fractal stimulus.

Previous work has shown that fractal patterns in gait can be altered by entraining to a fractal stimulus. However, little is understood about how long those patterns are retained or which factors may influence stronger entrainment or retention. In experiment one, participants walked on a treadmill for 45 continuous minutes, which was separated into three phases.

A new measure of the CoP trajectory in postural sway: dynamics of heading change.

The maintenance of upright stance requires the simultaneous control of posture in both the anterior-posterior (AP) and medial-lateral (ML) dimensions. Postural sway is typically measured by quantifying the movement of the center of pressure (CoP) in the AP and ML dimensions independently. Metrics such as path length and 95% ellipse area have been developed to take into account movement in both the AP and ML directions, but these metrics only quantify the magnitude of the CoP movement.