Relation Between Cognitive Assessment and Clinical Physical Performance Measures After Mild Traumatic Brain Injury.

Objectives: To investigate the relation between cognitive and motor performance in individuals with mild traumatic brain injury (mTBI) and examine differences in both cognitive and motor performance between adults after mTBI and healthy controls.

Design: Multi-center, cross-sectional study.

Setting: Three institutional sites (Courage Kenny Research Center, Minneapolis, MN, Oregon Health & Science University, Portland, OR, and University of Utah, Salt Lake City, UT).

Reconsidering Vestibular/Ocular Motor Screening Cutoff Scores for Concussion.

Introduction: Vestibular/Ocular Motor Screening (VOMS) is often part of a comprehensive evaluation to identify acute mild traumatic brain injury. Most of the reports describe the use of the VOMS in adolescents/young adults and not in older adults or military service members. The purpose of this study was to describe VOMS findings in healthy civilians and active duty military service members up to the age of 50 years.

Quantifying Turning Tasks With Wearable Sensors: A Reliability Assessment.

Objective: The aim of this study was to establish the test-retest reliability of metrics obtained from wearable inertial sensors that reflect turning performance during tasks designed to imitate various turns in daily activity.

Methods: Seventy-one adults who were healthy completed 3 turning tasks: a 1-minute walk along a 6-m walkway, a modified Illinois Agility Test (mIAT), and a complex turning course (CTC). Peak axial turning and rotational velocity (yaw angular velocity) were extracted from wearable inertial sensors on the head, trunk, and lumbar spine.

A Hybrid Assessment of Clinical Mobility Test Items for Evaluating Individuals With Mild Traumatic Brain Injury.

Background And Purpose: The Functional Gait Assessment (FGA) and High Level Mobility Assessment Tool (HiMAT) are clinical batteries used to assess people with mild traumatic brain injury (mTBI). However, neither assessment was specifically developed for people with mTBI; the FGA was developed to evaluate vestibular deficits, and the HiMAT was developed for individuals with more severe TBI. To maximize the sensitivity and reduce the time burden of these assessments, the purpose of this study was to determine the combination of FGA and HiMAT items that best discriminates persons with persistent symptoms from mTBI from healthy controls.

Exploring Vestibular Ocular Motor Screening in Adults With Persistent Complaints After Mild Traumatic Brain Injury.

Objective: The purpose of this study was to (1) explore differences in vestibular ocular motor screening (VOMS) symptoms between healthy adults and adults with persistent symptoms after mild traumatic brain injury (mTBI), and (2) explore the relationships between VOMS symptoms and other measures (self-reported vestibular symptoms, clinical measures of balance and gait, and higher-level motor ability tasks).

Setting: Research laboratory setting.

Participants: Fifty-three persons with persistent symptoms (>3 weeks) following mTBI and 57 healthy controls were recruited.

Between-site equivalence of turning speed assessments using inertial measurement units.

Background: Turning is a component of gait that requires planning for movement of multiple body segments and the sophisticated integration of sensory information from the vestibular, visual, and somatosensory systems. These aspects of turning have led to growing interest to quantify turning in clinical populations to characterize deficits or identify disease progression. However, turning may be affected by environmental differences, and the degree to which turning assessments are comparable across research or clinical sites has not yet been evaluated.

Objective Dual-Task Turning Measures for Return-to-Duty Assessment After Mild Traumatic Brain Injury: The ReTURN Study Protocol.

Determining readiness for duty after mild traumatic brain injury (mTBI) is essential for the safety of service members and their unit. Currently, these decisions are primarily based on self-reported symptoms, objective measures that assess a single system, or standardized physical or cognitive tests that may be insensitive or lack ecological validity for warrior tasks. While significant technological advancements have been made in a variety of assessments of these individual systems, assessments of isolated tasks are neither diagnostically accurate nor representative of the demands imposed by daily life and military activities.

Control of Linear Head and Trunk Acceleration During Gait After Unilateral Vestibular Deficits.

Objective: To use clinically available inertial measurement units to quantify the control of linear accelerations at the head and trunk during gait in different sensory conditions in individuals with unilateral vestibular loss.

Design: Observational study.

Setting: Outpatient research laboratory.

Reduced Purposeful Head Movements During Community Ambulation Following Unilateral Vestibular Loss.

Background: Individuals with unilateral vestibular hypofunction (UVH) alter their movement and reduce mobility to try to stabilize their gaze and avoid symptoms of dizziness and vertigo.

Objective: To determine if individuals with UVH 6 weeks after surgery demonstrate altered head and trunk kinematics during community ambulation.

Methods: A total of 15 vestibular schwannoma patients with documented postoperative unilateral vestibular loss and 9 healthy controls with symmetrical vestibulo-ocular reflexes participated in this cross-sectional study.

Characterization of Head-Trunk Coordination Deficits After Unilateral Vestibular Hypofunction Using Wearable Sensors.

Importance: Individuals with vestibular hypofunction acutely restrict head motion to reduce symptoms of dizziness and nausea. This restriction results in abnormal decoupling of head motion from trunk motion, but the character, magnitude, and persistence of these deficits are unclear.

Objective: To use wearable inertial sensors to quantify the extent of head and trunk kinematic abnormalities in the subacute stage after resection of vestibular schwannoma (VS) and the particular areas of deficit in head-trunk motion.

Feasibility and Validity of Discriminating Yaw Plane Head-on-Trunk Motion Using Inertial Wearable Sensors.

A consequence of vestibular loss is increased coupling of head-on-trunk motion, particularly in the yaw plane, which adversely affects community mobility in these patients. Inertial sensors may provide a means of better understanding normal decoupling behaviors in community environments, but demonstration of their validity and responsiveness is needed. This paper examined the validity and measurement sensitivity of inertial sensors in quantifying yaw plane head-trunk decoupling during unrestricted and restricted cervical motion conditions in healthy adults.

Adaptation of postural recovery responses to a vestibular sensory illusion in individuals with Parkinson disease and healthy controls.

Background: The ability to adapt postural responses to sensory illusions diminishes with age and is further impaired by Parkinson disease. However, limited information exists regarding training-related adaptions of sensory reweighting in these populations.

Methods: This study sought to determine whether Parkinson disease or age would differentially affect acute postural recovery or adaptive postural responses to novel or repeated exposure to sensory illusions using galvanic vestibular stimulation during quiet stance.

Influence of upper extremity positioning on pain, paresthesia, and tolerance: advancing current practice.

Loss of upper extremity motion caused by axillary burn scar contracture is a major complication of burn injury. Positioning acutely injured patients with axillary burns in positions above 90° of shoulder abduction may improve shoulder motion and minimize scar contracture. However, these positions may increase injury risk to the nerves of the brachial plexus.

Effect of specific short-term physical training on fitness measures in conditioned men.

Physical training programs that enhance battlefield-related fitness needs have been increasingly advocated as operational demands on the US military have increased, but few studies have evaluated program effectiveness. The purpose of this study was to compare a novel 7-week physical training program with traditional army physical fitness training in improving the selected measures of physical fitness and military task performance. One hundred and eighty subjects performed a 30-m rush wearing a fighting load, a simulated casualty recovery wearing a fighting load, a 1-repetition maximum bench press, a maximum repetition pull-up test, a medicine ball put, a vertical jump, and a T-test agility drill to establish test-retest reliability and normative reference values.

Clinical utility of tibial motor and sensory nerve conduction studies with motor recording from the flexor hallucis brevis: a methodological and reliability study.

Background: Standard tibial motor nerve conduction measures are established with recording from the abductor hallucis. This technique is often technically challenging and clinicians have difficulty interpreting the information particularly in the short segment needed to assess focal tibial nerve entrapment at the medial ankle as occurs in posterior tarsal tunnel syndrome. The flexor hallucis brevis (FHB) has been described as an alternative site for recording tibial nerve function in those with posterior tarsal tunnel syndrome.

Effect of a 13-month deployment to Iraq on physical fitness and body composition.

This investigation evaluated the effects of a 13-month deployment to Iraq on body composition and selected fitness measures. Seventy-three combat arms soldiers were measured pre- and postdeployment. Body composition was assessed by dual X-ray absorptiometry (DXA).

Influence of exercise mode and osteogenic index on bone biomarker responses during short-term physical training.

Prescribing exercise based on intensity, frequency, and duration of loading may maximize osteogenic responses in bone, but a model of the osteogenic potential of exercise has not been established in humans. In rodents, an osteogenic index (OI) has been used to predict the osteogenic potential of exercise. The current study sought to determine whether aerobic, resistance, or combined aerobic and resistance exercise programs conducted over eight weeks and compared to a control group could produce changes in biochemical markers of bone turnover indicative of bone formation.

Identification of cutaneous functional units related to burn scar contracture development.

The development of burn scar contractures is due in part to the replacement of naturally pliable skin with an inadequate quantity and quality of extensible scar tissue. Predilected skin surface areas associated with limb range of motion (ROM) have a tendency to develop burn scar contractures that prevent full joint ROM leading to deformity, impairment, and disability. Previous study has documented forearm skin movement associated with wrist extension.

Burn rehabilitation and research: proceedings of a consensus summit.

Burn rehabilitation is an essential component of successful patient care. In May 2008, a group of burn rehabilitation clinicians met to discuss the status and future needs of burn rehabilitation. Fifteen topic areas pertinent to clinical burn rehabilitation were addressed.

Injury reduction effectiveness of selecting running shoes based on plantar shape.

Popular running magazines and running shoe companies suggest that imprints of the bottom of the feet (plantar shape) can be used as an indication of the height of the medial longitudinal foot arch and that this can be used to select individually appropriate types of running shoes. This study examined whether or not this selection technique influenced injury risk during United States Army Basic Combat Training (BCT). After foot examinations, BCT recruits in an experimental group (E: n = 1,079 men and 451 women) selected motion control, stability, or cushioned shoes for plantar shapes judged to represent low, medium, or high foot arches, respectively.

Physical fitness and body composition after a 9-month deployment to Afghanistan.

Purpose: To examine change in physical fitness and body composition after a military deployment to Afghanistan.

Methods: One hundred and ten infantry soldiers were measured before and after a 9-month deployment to Afghanistan for Operation Enduring Freedom. Measurements included treadmill peak oxygen uptake (peak VO2), lifting strength, medicine ball put, vertical jump, and body composition estimated via dual-energy x-ray absorptiometry (percent body fat, absolute body fat, fat-free mass, bone mineral content, and bone mineral density).