title: Blast exposure and dual sensory impairment: an evidence review and integrated rehabilitation approach.
abstract: Combat exposures to blast can result in both peripheral damage to the ears and eyes and central damage to the auditory and visual processing areas in the brain. The functional effects of the latter include visual, auditory, and cognitive processing difficulties that manifest as deficits in attention, memory, and problem solving--symptoms similar to those seen in individuals with visual and auditory processing disorders. Coexisting damage to the auditory and visual system is referred to as dual sensory impairment (DSI). The number of Operation Iraqi Freedom/Operation Enduring Freedom Veterans with DSI is vast; yet currently no established models or guidelines exist for assessment, rehabilitation, or service-delivery practice. In this article, we review the current state of knowledge regarding blast exposure and DSI and outline the many unknowns in this area. Further, we propose a model for clinical assessment and rehabilitation of blast-related DSI that includes development of a coordinated team-based approach to target activity limitations and participation restrictions in order to enhance reintegration, recovery, and quality of life.
authors: National Center for Rehabilitative Auditory Research, Department of Veterans Affairs, Rehabilitation Research and Development Service, Portland VA Medical Center, Portland, OR 97239, USA. gabrielle.saunders@va.gov
authors: Gabrielle H
authors: GH
authors: Saunders
authors: Katharina V
authors: KV
authors: Echt
mesh_terms: D055826:Afghan Campaign 2001-; D001308:Auditory Perceptual Disorders / Q000534:rehabilitation*; D001753:Blast Injuries / Q000150:complications* / Q000523:psychology; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D012048:Correction of Hearing Impairment; D005107:Explosions; D006311:Hearing Disorders; D006801:Humans; D054542:Iraq War, 2003-2011; D008889:Military Personnel; D014728:Veterans / Q000523:psychology; D014786:Vision Disorders / Q000534:rehabilitation*