Back to Top Skip to main content

Improving training of healthcare providers boosts post-concussion care

Elizabeth Fuentes (left), physical therapist assistant, Fort Bliss Traumatic Brain Injury Clinic, William Beaumont Army Medical Center, provides information and educates medical professionals about TBI symptoms, treatments and assessments, during the TBI Clinic’s open house event, in observance of Brain Injury Awareness Month. (U.S. Army photo by Marcy Sanchez) Elizabeth Fuentes (left), physical therapist assistant, Fort Bliss Traumatic Brain Injury Clinic, William Beaumont Army Medical Center, provides information and educates medical professionals about TBI symptoms, treatments and assessments, during the TBI Clinic’s open house event, in observance of Brain Injury Awareness Month. (U.S. Army photo by Marcy Sanchez)

Recommended Content:

Traumatic Brain Injury

What happens when the Defense and Veterans Brain Injury Center disseminates a new clinical recommendation? Is it adopted by practitioners? Does training health care providers lead to improved patient outcomes?

DVBIC scans the latest research about TBI findings, and then recruits TBI experts from the scientific community who meet regularly to develop clinical guidelines to inform health care decisions. This specialized function supports the Military Health System’s objectives of improving warfighter care and readiness. DVBIC is a division of the Defense Health Agency Research and Development Directorate.

These questions are at the heart of a recent study by DVBIC who asked whether teaching providers about state-of-the-science tools for concussion treatment improves patient care and rehabilitation. A concussion is a blow or jolt to the head that disrupts the normal function of the brain. Most traumatic brain injuries in the military are mild and most service members return to duty after recovering from their injuries.

The study compared two groups of TBI patients: those treated after primary care managers at various military hospitals received an interactive two-hour training, and those treated before providers received instruction. At the end of the study, patients completed a questionnaire that asked how soon they began to engage in physical and mental activity.

DVBIC found that patients in the group cared for by providers who had received the intensive training reported an overall reduction in symptoms after one week, one month and at three months, when compared to patients who were treated by the providers who had not yet received the intensive training.

This study highlights the importance of integrating research, clinical affairs, and education activities at DVBIC.

“One of the things that DVBIC has done, of late, is take many of our clinical tools . . . and actually study them,” Navy Captain Scott Pyne, DVBIC division chief. “The tools are based on the state-of-the-science, which is current research. Not only do we create the tool, but we throw it out there for the providers to use, and then we evaluate the effectiveness of its use. That's been very helpful.”

The “Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury” clinical recommendation is focused on a six-stage approach to manage recovery.

The first stage involves rest, followed by light routine activity, light work-related activity, moderate activity, intensive activity, and finally unrestricted activity.

Each stage lasts a minimum of 24 hours and the service member should be re-evaluated each day. Patients with a mild TBI, often described as a concussion, should begin with less physical and mental activity and gradually move from one stage to the next.

“We have been able to show two critical things for military medicine,” said Jason Bailie, DVBIC’s senior clinical research director at Camp Pendleton. “Our frontline medical practitioners need to be taught how to treat concussed patients with a progressive return to activity approach” and “we can enhance our force readiness by helping our warfighters get better faster following a concussion.”

In addition to improved health among patients, the study finds more consistent treatment options offered by the trained physicians – including giving their patients special brochures focused on different parts of their rehabilitation. As one physician said in a post-study survey, “It’s been a pretty big difference, not only in my comfort with treating these patients, but educating them as well.”

Dr. Keith Stuessi, a DVBIC subject matter expert who provided the two-hour training sessions, underscored the implications of these findings for DVBIC’s future training efforts. “By doing this study, in this way,” Stuessi said, “we showed the effectiveness of this educational intervention.”

These findings could not be timelier. In June 2019, the U.S. Army directed medical personnel who would be treating patients with concussions use updated management tools designed by DVBIC, including the progressive return to activity process.

The progressive return to activity clinical suite is designed to help primary care managers, rehabilitation providers, and service members.

You also may be interested in...

TBI Champions Roxana Delgado & Victor Medina

Video
11/17/2020
TBI Champions Roxana Delgado & Victor Medina

While he was deployed, retired Army Sgt. 1st Class Victor Medina was in a vehicle that was hit by an explosive device. He sustained a traumatic brain injury (TBI) that severely impaired some of his physical functions and ability to speak. Medina’s wife, Roxana Delgado, continued her pursuit of a Ph.D. in health sciences and became his caregiver. As they adjusted to a life neither one of them had imagined, their marriage became a new kind of partnership.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Patient and Family Resources | A Head for the Future | Traumatic Brain Injury

TBI Champion Gary Moran

Video
11/17/2020
TBI Champion Gary Moran

SGM Gary D. Moran shares his TBI recovery story, and tips for talking to kids about TBI.

Recommended Content:

Traumatic Brain Injury Center of Excellence | A Head for the Future | Patient and Family Resources | Traumatic Brain Injury

TBI Champion Micah Norgard

Video
11/16/2020
TBI Champion Micah Norgard

After 12 years as an infantryman, Norgard's biggest battle was recognizing the cumulative effects of multiple TBIs.

Recommended Content:

Traumatic Brain Injury | Traumatic Brain Injury Center of Excellence | A Head for the Future

TBI Champion Beth King

Video
11/16/2020
TBI Champion Beth King

Army veteran Beth King was on a routine mission when her helicopter was struck by an RPG, ultimately resulting in a traumatic brain injury (TBI). In this video, Beth shares the impact of her TBI and how she discovered her new passion along the way — recumbent biking.

Recommended Content:

Traumatic Brain Injury Center of Excellence | A Head for the Future | Traumatic Brain Injury

Find Your Story: TBI Champions

Video
11/16/2020
Find Your Story: TBI Champions

In this video, A Head for the Future’s TBI Champions share their experiences with traumatic brain injury and resources that helped them through recovery. They can help you too.

Recommended Content:

Traumatic Brain Injury | Traumatic Brain Injury Center of Excellence | A Head for the Future

Talking TBI: Talking to Kids

Video
11/16/2020
Talking TBI: Talking to Kids

While on patrol in Iraq, former U.S. Marine Corps Sgt. Maj. Gary Moran was knocked unconscious by an improvised explosive device, resulting in a traumatic brain injury (TBI). Gary and his son discuss how TBI affected their relationship early on and ultimately brought them closer together.

Recommended Content:

Traumatic Brain Injury | Traumatic Brain Injury Center of Excellence | Patient and Family Resources | A Head for the Future

Talking TBI: Going Back to School

Video
11/16/2020
Talking TBI: Going Back to School

Marine Corps veteran Chris shares his experience going back to school following his TBI.

Recommended Content:

Traumatic Brain Injury Center of Excellence | A Head for the Future | Patient and Family Resources | Traumatic Brain Injury

TBI Champion Dalton Mask

Video
11/16/2020
TBI Champion Dalton Mask

Facing a long road to recovery following his TBI, Dalton remained positive and participated in the 2019 Warrior Games.

Recommended Content:

Traumatic Brain Injury Center of Excellence | A Head for the Future | Traumatic Brain Injury

TBI Champion Derek Poor

Video
11/16/2020
TBI Champion Derek Poor

While instructing hand-to-hand combat training, U.S. Army Special Forces veteran Derek Poor slammed his head against a wall and sustained a traumatic brain injury (TBI). Seeing stars and unable to shake his persistent, daily headaches, Poor sought help.

Recommended Content:

Traumatic Brain Injury Center of Excellence | A Head for the Future | Traumatic Brain Injury

Talking TBI: Connect with Others

Video
11/16/2020
Talking TBI: Connect with Others

Navy veteran Amanda Burrill and Army veteran Elana Duffy had a few things in common: They both lived in New York City, experienced traumatic brain injuries (TBI) while in service and were coping with the injuries alone. Until they met each other.

Recommended Content:

Traumatic Brain Injury Center of Excellence | A Head for the Future | Patient and Family Resources | Traumatic Brain Injury

MACE 2 Provider Training Video

Video
9/29/2020
MACE 2 Provider Training Video

This video illustrates how to conduct a MACE 2 training event. This video supports the MACE 2 and its training materials created by the Traumatic Brain Injury Center of Excellence.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury | Provider Resources

Concussion: Know the Symptoms

Video
3/12/2019
Concussion: Know the Symptoms

A racquetball game goes wrong when one player slips and hits his head. He thinks he's OK and his partner isn’t sure what to do about it.

Recommended Content:

Traumatic Brain Injury

Defense and Veterans Brain Injury Center Celebrates 25 Years

Video
3/12/2018
Defense and Veterans Brain Injury Center Celebrates 25 Years

Katherine Helmick, DVBIC acting national director, discusses DVBIC achievements and goals to advance service members' health care. DVBIC honors 25 years of military health care by continued dedication to research and treatment of traumatic brain injury.

Recommended Content:

Traumatic Brain Injury

Technician Discusses TBI Research

Video
5/20/2016
Photo of an Edgerton Shadowgraph, a technique which allows researchers to visualize shockwaves in a transparent medium so they can see the shockwaves in the air. Upon visualizing the shockwaves, researchers can measure their locations and use the timing from high-speed video cameras to determine a velocity, which is critical in indicating the shockwave’s pressure. Once researchers have all this information, they can tell the pressure impacted on the test subject. (DoD photo)

Richard Benjamin, lead physical science technician at the Army Research Laboratory at Aberdeen Proving Ground, Md., discusses using technology to better understand traumatic brain injuries.

Recommended Content:

Traumatic Brain Injury

A Head for the Future: Randy Gross

Video
3/25/2016
Randy Gross

When he was 23, Randy Gross was riding in a car with his seat belt off. The former Army staff sergeant sustained a TBI when the vehicle crashed. He sought help immediately, making a full recovery from his TBI and continuing to serve in the Army until 2006. Now, Gross helps those in the military with TBI as a regional education coordinator for DVBIC.

Recommended Content:

Traumatic Brain Injury
<< < 1 2 > >> 
Showing results 1 - 15 Page 1 of 2

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.