Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.
General Dynamics Information Technology, Falls Church, VA, USA.
NeuroRehabilitation. 2024;55(3):347-356. doi: 10.3233/NRE-230269.
Concussion, also known as mild traumatic brain injury (mTBI), is a condition with unique ties to military service. Service members (SMs) are inherently at a higher risk for concussive injuries due to the intense physical training environment and combat operational tempo required to serve. The Traumatic Brain Injury Center of Excellence (TBICoE) is the US Department of Defense authority on this condition and provides a thorough approach to management of concussion and associated symptom sequela.
This article seeks to review the TBICoE approach to the management and rehabilitation of military SMs with mTBI, and highlight resources available to military medical providers.
The authors reviewed evidence and TBICoE resources to provide this comprehensive overview of the TBICoE approach to management and rehabilitation of concussion in military SMs.
A progressive return to activity protocol in conjunction with symptom-guided management of common post-concussive sequelae, including headache, vestibular and oculomotor issues, sleep dysfunction, cognitive rehabilitation, and behavioral health comorbidities are essential for concussion management in the acute, post-acute and chronic phases of injury.
The TBICoE approach to the rehabilitation of military SMs is comprehensive, and includes initial management with a stepwise return to duty protocol and an objective return to duty screening. The mainstays of treatment for SMs with post-acute and chronic post-concussion symptoms are headache management, vestibular and oculomotor rehabilitation, sleep interventions, cognitive rehabilitation, and early intervention for behavioral health comorbidities. These evidence-based strategies may be applied in the treatment of SMs in the US and internationally.
脑震荡，也称为轻度创伤性脑损伤（mTBI），与军事服务有着独特的联系。由于高强度的体能训练环境和战斗行动节奏，军人（SM）固有地面临更高的脑震荡风险。创伤性脑损伤卓越中心（TBICoE）是美国国防部对此类疾病的权威机构，提供了一种全面的方法来管理脑震荡和相关症状后遗症。
本文旨在回顾 TBICoE 对患有 mTBI 的军人 SM 的管理和康复方法，并强调为军事医疗提供者提供的资源。
作者回顾了证据和 TBICoE 资源，为军事 SM 脑震荡的 TBICoE 管理和康复方法提供了全面概述。
与常见脑震荡后后遗症的症状指导管理相结合的逐步恢复活动方案，包括头痛、前庭和眼动问题、睡眠功能障碍、认知康复和行为健康合并症，对于脑震荡在损伤的急性期、亚急性期和慢性期的管理至关重要。
TBICoE 对军人 SM 的康复方法是全面的，包括初始管理采用逐步恢复工作方案和客观的恢复工作筛查。急性和慢性脑震荡后症状军人的主要治疗方法是头痛管理、前庭和眼动康复、睡眠干预、认知康复以及行为健康合并症的早期干预。这些基于证据的策略可能适用于美国和国际上的军人治疗。
