Mild Traumatic Brain Injury
Conditions
Keywords
Concussion, Vestibular, Ocular-Motor
Brief summary
The purpose of the proposed project is to determine if the VOMS is an effective screening tool to identify and track recovery of vestibular and ocular motor impairment and symptoms following mTBI, that corpsman-level medical personnel can successfully implement in combat and non-combat environments. A second purpose of the project is to determine if impairment and symptoms on the VOMS is more pronounced following blast compared to blunt mTBI.
Detailed description
Vestibular impairment and symptoms are prevalent following mild traumatic brain injury (mTBI) and may play a role in prolonged recovery. Researchers have indicated that ocular motor dysfunction and symptoms are common among personnel exposed to blast mTBI. In fact, researchers have suggested that vestibular and ocular motor outcomes such as VOR and vestibulo-spinal reflex (VSR) may be useful in identifying the effects of blast from blunt mTBI. There are currently no brief, clinical screening tools to identify vestibular/ocular motor impairment and symptoms in military personnel following mTBI. Our research team recently developed the Vestibular/Ocular Motor Screening (VOMS) tool to screen for vestibular/ocular motor impairment and symptoms following mTBI. Our preliminary research indicates that VOMS- a 5-min clinical screening tool that can be deployed by corpsman-level (i.e., Special Operation Combat Medics \[SOCM\], Special Forces Medical Sergeants \[18D\]) medical personnel with minimal training and materials- was nearly 90% accurate in identifying patients with mTBI from healthy controls. These preliminary findings suggest that VOMS may augment current clinical screening tools- such as the MACE- used by the U.S. Military. The proposed project addresses the studies to develop standardized metrics for vestibular assessment and monitoring for return to duty area in the Diagnostics subsection of the Hearing Loss/Dysfunction, Balance Disorder, and or Tinnitus section under the Clinical Trial Research Focus Area.
Interventions
DIAGNOSTIC_TESTVestibular Ocular Motor Screening Tool (VOMS)
Vestibular Ocular Motor Screening Tool (VOMS)
Sponsors
United States Department of Defense
University of Pittsburgh
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* All Participants: * Military personnel; * Age 18-40 years; * Normal or corrected normal vision * mTBI Participants: * Diagnosed with mTBI (blast, blunt, or combo) within past 7 days * Clear mechanism of injury * Glasgow Coma Scale (GCS) = 13-15 * Reported or observed signs (Loss of consciousness \[LOC\], amnesia, disorientation/confusion) at time of injury * Current reported symptoms and/or impairment (cognitive, balance, visual)
Exclusion criteria
* History of vestibular disorder; * History of neurological disorder; * History of previous moderate to severe TBI
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Reliability of US military corpsmen-level medical personnel (i.e., Special Operation Combat Medics [SOCM], Special Forces Medical Sergeants [18D]) to administer the VOMS to US military personnel in combat and non-combat environments. | 6 months | In-person and telemedicine VOMS (Vestibular Ocular-Motor Screening) training with USASOC medical personnel, followed by repeated VOMS measures to examine reliability of symptom report |
| Change in symptoms on the VOMS at acute and sub-acute time periods correlated with recovery times to return to duty (RTD) | 3 time periods: 1-7 days post injury; 8 days to 3 months post injury; return to duty (RTD-time period is variable because it is based on individual recovery-assessed up to 36 months) | — |
Countries
United States
Outcome results
None listed