The impact of traumatic brain injuries on community life
A soldier at Joint Base Elmendorf-Richardson’s traumatic brain injury clinic in Alaska takes a cognitive hand-eye coordination test on a driving stimulator. Cognitive tests, in addition to monitoring physical and emotional symptoms, help practitioners develop a treatment plan best suited for an individual with TBI. (Courtesy photo)
APproximately 350,000 service members have sustained a traumatic brain injury (TBI) in the past 16 years. While the majority of those cases are mild, TBIs have presented a lot of challenges for experts to discuss.
The Defense Health Agency’s Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury is bringing together experts from across the Department of Veterans Affairs, Military Health System and academia to talk about care for service members and veterans with these injuries and some of the challenges they face when settling back into their communities.
Although more than 80 percent of TBI cases are not diagnosed in deployed settings, the impact of this injury can affect everything from unit readiness to quality of life during and after deployment. Bryant Seamon, rehabilitation research fellow at the VA Medical Center in Washington, D.C., said a TBI diagnosis can be associated with decreased quality of life, social interaction and community involvement, among other things. A veteran may not show physical limitations but the cognitive impairments associated with this injury can lead to sedentary lifestyles or poor habits, he warned.
“These types of impairments, if veterans have them, they’re not getting out there [and] they’re not engaging in their community,” said Seamon, using physical exertion, balance, coordination and agility issues as examples. “They’re avoiding things they did before while they were very active.”
Physical activity can help lower the incidence of other long-term health issues, such as cardiovascular disease, hypertension and diabetes, and increase cognitive function, Seamon said. However, little research has been done on fitness and wellness programs for TBI patients, he said.
“Service members and veterans tend to be more reserved and isolated when they suffer this injury,” said Seamon. “Because of that social isolation, we tend to see reduced community integration, sometimes heightened family dysfunction and sedentary lifestyle.”
Aside from staying physically and socially active, healthy reintegration includes community participation, such as employment, individual living and activities. At a recent DCoE Summit held at DHA headquarters, experts said rehabilitation services and vocational training are valuable assets for all severities of TBI, especially if they focus on cognitive and emotional challenges. For example, a pilot program, hosted by the Camp Lejeune Intrepid Spirit Center, simulates a college classroom and uses technology to help active-duty service members return to school.
Doris Davis, speech language pathologist at the Intrepid’s Concussion Recovery Center, said some service members receiving treatment were also enrolled in college classes but struggled with managing symptoms, adjusting to the social environment and using cognitive strategies in the classroom.
“We’re only in the preliminary stages of collecting data […] and even though we don’t have a large sample of service members, some of them – so far – appear to be quite promising,” said Davis.
Over the course of this six-week program, service members set goals to describe and implement ways to manage their symptoms time and resources, mitigate stressors, complete academic-related tasks, identify their learning styles in conjunction with technology and improve skills, such as note taking, studying and test taking.
Since May, 12 service members have graduated from the pilot program. A few of the findings from those graduates reveal that 57 percent reported improvement in symptom management, 50 percent reported decreased anxiety, and 75 percent reported improved ability to focus and concentrate.