Radomski Mary Vining, Weightman Margaret M, Davidson Leslie Freeman, Finkelstein Marsha, Goldman Sarah, McCulloch Karen, Roy Tanja C, Scherer Matthew, Stern Erica B
Sister Kenny Research Center, 800 East 28th Street @ Chicago Avenue, Minneapolis, MN 55407, USA.
Mil Med. 2013 Mar;178(3):246-53. doi: 10.7205/MILMED-D-12-00144.
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.
轻度创伤性脑损伤（mTBI）是伊拉克和阿富汗战争中的主要损伤类型，可导致显著的发病率。为了对患有mTBI的士兵做出准确的重返岗位决策，军事医务人员需要敏感、客观且与职责相关的数据，以描述细微的认知和感觉运动损伤后遗症。一个军民研究团队回顾了现有文献，并从利益相关者、最终用户和专家那里获取了意见，以明确这一概念并制定初步评估方案来满足这一需求。文献回顾结果表明基于双重任务和多任务评估方法的测试具有潜在效用。33名代表各种军事和民用利益相关者/专家的人员参与了访谈。访谈数据表明，可靠性/有效性、临床可行性、在各治疗机构的可用性、军事表面效度以及挑战关键任务mTBI易损性的能力对于最终采用至关重要。该研究团队开发了军事多任务表现评估工具，这是一种由八个双重和多任务测试任务组成的工具。对10名受试者进行的概念测试表明了初步的表面效度，并为评分和设计提供了改进依据。还需要进一步验证。军事多任务表现评估可能填补了利益相关者所确定的复杂认知/运动测试方面的空白，以协助对患有mTBI的军人做出重返岗位决策。
