title: Development of a measure to inform return-to-duty decision making after mild traumatic brain injury.
abstract: Mild traumatic brain injury (mTBI), a principal injury of the wars in Iraq and Afghanistan, can result in significant morbidity. To make accurate return-to-duty decisions for soldiers with mTBI, military medical personnel require sensitive, objective, and duty-relevant data to characterize subtle cognitive and sensorimotor injury sequelae. A military-civilian research team reviewed existing literature and obtained input from stakeholders, end users, and experts to specify the concept and develop a preliminary assessment protocol to address this need. Results of the literature review suggested the potential utility of a test based on dual-task and multitask assessment methods. Thirty-three individuals representing a variety of military and civilian stakeholders/experts participated in interviews. Interview data suggested that reliability/validity, clinical feasibility, usability across treatment facilities, military face validity, and capacity to challenge mission-critical mTBI vulnerabilities were important to ultimate adoption. The research team developed the Assessment of Military Multitasking Performance, a tool composed of eight dual and multitasking test-tasks. A concept test session with 10 subjects indicated preliminary face validity and informed modifications to scoring and design. Further validation is needed. The Assessment of Military Multitasking Performance may fill a gap identified by stakeholders for complex cognitive/motor testing to assist return-to-duty decisions for service members with mTBI.
authors.affiliation: Sister Kenny Research Center, 800 East 28th Street @ Chicago Avenue, Minneapolis, MN 55407, USA.
authors.forename: Mary Vining
authors.initials: MV
authors.lastname: Radomski
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Weightman
authors.forename: Leslie Freeman
authors.initials: LF
authors.lastname: Davidson
authors.forename: Marsha
authors.initials: M
authors.lastname: Finkelstein
authors.forename: Sarah
authors.initials: S
authors.lastname: Goldman
authors.forename: Karen
authors.initials: K
authors.lastname: McCulloch
authors.forename: Tanja C
authors.initials: TC
authors.lastname: Roy
authors.forename: Matthew
authors.initials: M
authors.lastname: Scherer
authors.forename: Erica B
authors.initials: EB
authors.lastname: Stern
mesh_terms: D001753:Blast Injuries / Q000150:complications*; D001930:Brain Injuries / Q000453:epidemiology / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D015994:Incidence; D008889:Military Personnel; D009483:Neuropsychological Tests; D062707:Return to Work / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014857:Warfare