Weightman Margaret M, McCulloch Karen L, Radomski Mary V, Finkelstein Marsha, Cecchini Amy S, Davidson Leslie F, Heaton Kristin J, Smith Laurel B, Scherer Matthew R
Courage Kenny Research Center, Abbott Northwestern Hospital, Minneapolis, Minnesota, United States of America.
Division of Physical Therapy, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America.
PLoS One. 2017 Jan 5;12(1):e0169104. doi: 10.1371/journal.pone.0169104. eCollection 2017.
The Assessment of Military Multitasking Performance (AMMP) is a battery of functional dual-tasks and multitasks based on military activities that target known sensorimotor, cognitive, and exertional vulnerabilities after concussion/mild traumatic brain injury (mTBI). The AMMP was developed to help address known limitations in post concussive return to duty assessment and decision making. Once validated, the AMMP is intended for use in combination with other metrics to inform duty-readiness decisions in Active Duty Service Members following concussion. This study used an iterative process of repeated interrater reliability testing and feasibility feedback to drive modifications to the 9 tasks of the original AMMP which resulted in a final version of 6 tasks with metrics that demonstrated clinically acceptable ICCs of > 0.92 (range of 0.92-1.0) for the 3 dual tasks and > 0.87 (range 0.87-1.0) for the metrics of the 3 multitasks. Three metrics involved in recording subject errors across 2 tasks did not achieve ICCs above 0.85 set apriori for multitasks (0.64) and above 0.90 set for dual-tasks (0.77 and 0.86) and were not used for further analysis. This iterative process involved 3 phases of testing with between 13 and 26 subjects, ages 18-42 years, tested in each phase from a combined cohort of healthy controls and Service Members with mTBI. Study findings support continued validation of this assessment tool to provide rehabilitation clinicians further return to duty assessment methods robust to ceiling effects with strong face validity to injured Warriors and their leaders.
军事多任务表现评估（AMMP）是一组基于军事活动的功能性双任务和多任务，旨在针对脑震荡/轻度创伤性脑损伤（mTBI）后已知的感觉运动、认知和运动能力弱点。开发AMMP是为了帮助解决脑震荡后重返工作岗位评估和决策中已知的局限性。一旦经过验证，AMMP旨在与其他指标结合使用，为现役军人脑震荡后的任务准备情况决策提供参考。本研究采用了反复进行评分者间信度测试和可行性反馈的迭代过程，以推动对原始AMMP的9项任务进行修改，最终形成了一个包含6项任务的版本，其中3项双任务指标的组内相关系数（ICC）> 0.92（范围为0.92 - 1.0），3项多任务指标的ICC > 0.87（范围为0.87 - 1.0），在临床上可接受。涉及记录2项任务中受试者错误的3项指标，多任务的ICC未达到预先设定的> 0.85（实际为0.64），双任务的ICC未达到预先设定的> 0.90（实际为0.77和0.86），因此未用于进一步分析。这个迭代过程包括3个测试阶段，每个阶段测试13至26名年龄在18 - 42岁之间的受试者，这些受试者来自健康对照组和患有mTBI的军人组成的联合队列。研究结果支持对该评估工具进行持续验证，以便为康复临床医生提供更强大的重返工作岗位评估方法，该方法对天花板效应具有稳健性，对受伤的军人及其领导具有很强的表面效度。
