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Tuesday, January 20, 2015

USA - Military gets new guidelines for post-concussion return to duty

Research has continued to shed new light on the compounding and long-lasting effects of concussions.

WASHINGTON, Jan. 8 (UPI) -- The military is updating its protocol for treatment and return to active duty following concussions and traumatic brain injuries. The new guidelines dictate a six-step process of progressive activity, which must be completed before military personnel are allowed back on active duty. The new guidelines were compiled by the Progressive Activity Working Group, which was assembled by officials at the Defense and Veterans Brain Injury Center. The ad hoc group consisted of experts in neuroscience and brain injuries, as well as Department of Defense representatives from throughout the military. Research shedding new light on the compounding and long-lasting effects of concussions have moved leaders in a variety of fields and industries to rethink treatment and recovery guidelines for traumatic brain injuries.
While this development has garnered the most attention within the context of sports, especially football, the military's decision to revamp TBI protocol was, in fact, an effort to personalize rest and recovery guidelines for soldiers and other military personnel -- to update research heavily reliant on sports-related studies.
"Although service members share similarities with athletes," lead researcher Dr. Karen L. McCulloch, a neuroscientist at the University of North Carolina-Chapel Hill, wrote in an introduction to the new guidelines, "guidance for sports-related concussion is not always relevant to military contexts and does not incorporate the complexities of military demands, decision making under stressful conditions, and multitasking in extreme environments."
The new guidelines mandate a 24-hour rest period following a concussion. After the initial rest period, if the patient should show symptoms once returned to activity, then the six-step treatment should be followed. The treatment walks patients through a six-day recovery, progressing from "rest, to light routine activity, to light occupation-oriented activity, to moderate, intensive, and unrestricted activity."
"These recommendations will further improve and standardize the care provided to patients with mild TBI and offer them useful information to become more actively involved in their recovery," Captain Richard Stoltz, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury for the Navy, said in a press release.
The new guidelines were published this week in the Journal of Head Trauma Rehabilitation.