Citation

Scherer M, Weightman MM, Radomski MV, Smith L, Finkelstein M, Cecchini A, Heaton KJ, McCulloch K. Arch. Phys. Med. Rehabil. 2018; 99(2S): S79-S85.

Affiliation

Division of Physical Therapy, University of North Carolina-Chapel Hill, NC.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.apmr.2017.04.012

PMID

28499856

Abstract

OBJECTIVE: To assess the discriminant validity of the Patrol-Exertion Multitask (PEMT), a novel, multi-domain, functional return-to-duty clinical assessment for Active Duty military personnel.

DESIGN: Measurement development study SETTING: Non-clinical indoor testing facility, Fort Bragg NC PARTICIPANTS: 51 healthy control (HC) Service Members and 33 military personnel with persistent post-concussive symptoms receiving rehabilitation (mTBI) INTERVENTION: Not applicable MAIN OUTCOME MEASURES: Known-groups discriminant validity was evaluated by comparing performance on the PEMT in two groups of Active Duty SM, HC and personnel with mTBI residual symptoms. Participant PEMT performance was based on responses in four sub-tasks during a 12 minute patrolling scenario: a) accuracy in identifying virtual improvised explosive device markers and responses to scenario-derived questions from a computer simulated foot patrol; b) auditory reaction time responses; c) rating of perceived exertion during stepping; and d) self-reported visual clarity (i.e., gaze stability) during vertical head-in-space translation while stepping.

RESULTS: Significant between group differences for the PEMT were observed in two of four performance domains. Post-patrol IED identification task/ question responses (p=0.179) and Rating of Perceived Exertion (p=0.133) did not discriminate between groups. Participant self-report of visual clarity during stepping revealed significant (p<0.001) between group differences. SM reaction time responses to scenario-based auditory cues were significantly delayed in the mTBI group in both early (p=0.013) and late (p=0.002) stages of the PEMT.

CONCLUSIONS: Findings from this study support the use of a naturalistic, multi-domain, complex clinical assessment to discriminate between healthy SM and personnel with mTBI residual symptoms. Based on this preliminary study, additional research to further refine the PEMT and extend its application to return-to-work outcomes in military and civilian environments is warranted.

Copyright © 2017. Published by Elsevier Inc.

Language: en

Keywords

concussion; mild traumatic brain injury; military Service Member; multitask; outcome measures; performance based assessment; return to duty; return to work; validation