Prim Julianna H, Favorov Oleg V, Cecchini Amy S, Scherer Matthew R, Weightman Margaret M, McCulloch Karen L
Curriculum in Human Movement Science, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, 3070 Bondurant Hall, 321 S. Columbia St. Chapel Hill, NC.
Department of Biomedical Engineering, University of North Carolina at Chapel Hill, NC.
Mil Med. 2019 May 1;184(5-6):e268-e277. doi: 10.1093/milmed/usy425.
The Assessment of Military Multitasking Performance (AMMP1) consists of six dual-task and multitask military-relevant performance-based assessments which were developed to provide assistance in making return-to-duty decisions after concussion or mild traumatic brain injury (mTBI.) The Run-Roll-Aim (RRA) task, one component of the AMMP, was developed to target vulnerabilities following mTBI including attention, visual function, dynamic stability, rapid transition, and vestibular function. One aim of this study was to assess the known-group and construct validity of the RRA, and additionally to further explore reliability limitations reported previously.
A cross-sectional study consisting of 84 Active Duty service members in two groups (healthy control - HC and individuals experiencing persistent mTBI symptoms) completed neurocognitive tests and the RRA. The RRA task requires a high level of mobility and resembles military training activities in a maneuver that includes combat rolls, fast transitions, obstacle avoidance, and visual search. Observational and inertial sensor data were compared between groups and performance across four trial times was compared within groups. Correlations between RRA results and neurocognitive test scores were analyzed.
Simple observational measures (time, errors) did not differ between groups. Spectral power analysis of the inertial sensor data showed significant differences in motor performance between groups. Within group one-way ANOVAs showed that in HC trial 1, time was significantly different than trials 2,3 and 4 (F(3,47) = 4.60, p < 0.01, Tukey HSD p < 0.05) while the mTBI group showed no significant difference in time between trials. During testing individuals with mTBI were less likely to complete the multiple test trials or required additional rest between trials than HCs (χ2 = 10.78, p < 0.01). Small but significant correlations were seen with two neurocognitive tests of attention and RRA performance time.
While observational scores were not sensitive to group differences, inertial sensor data showed motor performance on the forward run, combat roll, and backward run differed significantly between groups. The RRA task appeared challenging and provoked symptoms in the mTBI group, causing 8 of 33 mTBI participants to stop the task or require additional rest between trials while none of the HC participants had to stop. Individuals with mTBI demonstrated slower learning of the complex motor sequence compared to HCs who had significant improvement after one trial of RRA. Complex novel training maneuvers like RRA may aid clinicians in informing return to duty decisions.
军事多任务表现评估（AMMP1）由六项基于军事相关任务表现的双重任务和多任务评估组成，旨在为脑震荡或轻度创伤性脑损伤（mTBI）后重返工作岗位的决策提供帮助。AMMP的一个组成部分“跑-滚-瞄准（RRA）”任务，旨在针对mTBI后的易损性，包括注意力、视觉功能、动态稳定性、快速转换和前庭功能。本研究的一个目的是评估RRA的已知组效度和结构效度，并进一步探讨先前报道的可靠性局限性。
一项横断面研究，由两组共84名现役军人组成（健康对照组-HC和有持续性mTBI症状的个体），他们完成了神经认知测试和RRA。RRA任务需要高水平的机动性，类似于军事训练活动，包括战斗翻滚、快速转换、避障和视觉搜索。比较了两组之间的观察数据和惯性传感器数据，并比较了组内四个试验时间的表现。分析了RRA结果与神经认知测试分数之间相关性。
简单的观察指标（时间、错误次数）在两组之间没有差异。惯性传感器数据的频谱功率分析显示两组之间的运动表现存在显著差异。组内单因素方差分析显示，在HC组中，试验1的时间与试验2、3和4有显著差异（F(3,47)=4.60，p<0.01，Tukey HSD p<0.05），而mTBI组试验之间的时间没有显著差异。在测试过程中，与HC组相比，mTBI组个体完成多次测试试验的可能性较小，或者试验之间需要额外休息（χ2=10.78，p<0.01）。在两项注意力神经认知测试与RRA表现时间之间发现了小但显著的相关性。
虽然观察分数对组间差异不敏感，但惯性传感器数据显示，两组之间在向前跑、战斗翻滚和向后跑的运动表现上存在显著差异。RRA任务对mTBI组来说似乎具有挑战性，并引发了症状，导致33名mTBI参与者中有8人停止任务或试验之间需要额外休息，而HC组参与者无人需要停止。与HC组相比，mTBI组个体学习复杂运动序列的速度较慢，HC组在一次RRA试验后有显著改善。像RRA这样复杂的新型训练动作可能有助于临床医生做出重返工作岗位的决策。
