Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury.

Objective: Physical therapy following traumatic brain injury (TBI) can be negatively impacted by psychological symptoms, atypical symptom reporting, and response bias. We examined rates of Symptom Validity Test (SVT) failure in active duty military service members with a history of mild-moderate TBI and its impact on gait speed.

Setting: Intensive Outpatient Program at the National Intrepid Center of Excellence at Walter Reed National Military Medical Center.

Examining the Relationship Between Conventional Outcomes and Immersive Balance Task Performance in Service Members With Mild Traumatic Brain Injury.

Introduction: Mild traumatic brain injury (mTBI) is associated with significant financial cost and reduced military readiness and impacts quality of life for active duty service members (SMs). Post-concussive symptoms can include vestibular impairments, such as chronic dizziness and postural instability, which can be compounded by psychological comorbidities like PTSD. Comprehensive vestibular evaluations are required to assess symptoms and guide clinical decision-making.

The Effect of Walking on Auditory Localization, Visual Discrimination, and Aurally Aided Visual Search.

Objective: The present study was designed to examine the impact that walking has on performance in auditory localization, visual discrimination, and aurally aided visual search tasks.

Background: Auditory localization and visual search are critical skills that are frequently conducted by moving observers, but most laboratory studies of these tasks have been conducted on stationary listeners who were either seated or standing during stimulus presentation.

Method: Thirty participants completed three different tasks while either standing still or while walking at a comfortable self-selected pace on a treadmill: (1) an auditory localization task, where they identified the perceived location of a target sound; (2) a visual discrimination task, where they identified a visual target presented at a known location directly in front of the listener; and (3) an aurally aided visual search task, where they identified a visual target that was presented in the presence of multiple visual distracters either in isolation or in conjunction with a spatially colocated auditory cue.

Expanding Clinical Assessment for Traumatic Brain Injury and Comorbid Post-Traumatic Stress Disorder: A Retrospective Analysis of Virtual Environment Tasks in the Computer-Assisted Rehabilitation Environment.

The objective of this study was to determine whether physical performance during virtual environment (VE) tasks in the Computer-Assisted Rehabilitation Environment (CAREN) could differentiate between service members (SMs) with a history of traumatic brain injury (TBI) with and without comorbid post-traumatic stress disorder (PTSD). Data were obtained by independent review of clinical notes, objective outcomes, and validated questionnaires from 214 SMs (208 males) with a history of TBI assessed in the CAREN from 2010 to 2015. Three preliminary VEs acclimatized patients to the CAREN: Balance Balls, weight shifting on a static platform (timed); Balance Cubes, step shifting with and without platform motion (timed); and Continuous Road, flat ambulation (self-selected speed).

If You Build It, They Will Come, But What Will Wounded Warriors Experience? Presence in the CAREN.

Military service members (SMs) are surviving complex battlefield injuries at higher rates than ever before. Cutting-edge technologies are increasingly being employed to improve assessment and treatment of these complex injuries. The Computer Assisted Rehabilitation Environment (CAREN) is a comprehensive immersive environment, featuring a treadmill, curved panoramic screen, audio array, and infrared cameras to capture movement.