Journal of Head Trauma Rehabilitation最新文献

{"title":"Supportive Elements and Challenges to Return to Work Following a Concussion: A Scoping Review.","authors":"Maryam Shahzad, Joyce Lo, Beatrice Yuen, Andrea Duncan, Nick Reed, Behdin Nowrouzi-Kia","doi":"10.1097/HTR.0000000000001064","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001064","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review aims to comprehensively explore the facilitators and barriers influencing the return to work (RTW) process following a concussion, with a focus on the person impacted by concussion, medical system, funder, and workplace domains.</p><p><strong>Design: </strong>A scoping review of electronic databases, including CINAHL, Embase, MEDLINE, PsycINFO and Web of Science, was conducted to identify relevant studies published up to April 6, 2024. Studies were included if they examined factors influencing RTW following a concussion and were available in English. Data extraction, numerical analysis and deductive content analysis were performed to determine key themes from the data. Reporting guidelines provided by the PRISMA-ScR were adhered to, and the protocol has been registered and can be accessed at the Open Science Framework.</p><p><strong>Results: </strong>Twenty studies met the inclusion criteria and were included in the review. Findings were organized into 4 main themes influencing the RTW process: the person impacted by concussion, medical system, funder, and workplace. These were further categorized into 2 subthemes: supportive elements and challenges. Various supportive elements within each theme were identified, such as individualized rehabilitation services, graduated return to work, and developing personal agency in the individual impacted by concussion. Challenges such as lack of patient education, delayed access to services, and isolating workplace accommodations were highlighted. These findings underscore the complex interplay of factors shaping the RTW trajectory post-concussion.</p><p><strong>Conclusion: </strong>This scoping review provides a detailed examination of supportive elements and challenges in the RTW process following a concussion. The identified themes offer valuable insights for clinicians and researchers seeking to optimize RTW outcomes and support individuals re-entering the workforce after a concussion. Future research should prioritize an examination of relevant policies and practices, assessing long-term outcomes, and explore strategies to integrate support systems to enhance the RTW experience.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of Traumatic Brain Injury and Severe Limb Injury on Death by Suicide: Concurrent Investigations Using Path Analysis.","authors":"Samuel Y Chung, Jordan A Levine, Emily A Schmied, John C Shero, Christopher L Dearth, Jennifer N Belding","doi":"10.1097/HTR.0000000000001053","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001053","url":null,"abstract":"<p><strong>Objective: </strong>Utilize path analysis to examine the concurrent associations of traumatic brain injury (TBI) and severe limb injury (SLI) with death by suicide mediated by psychological health (PH) conditions and substance use disorders (SUDs).</p><p><strong>Setting: </strong>Archival career and medical data were obtained from the Career History Archival Medical and Personnel System, the Expeditionary Medical Encounter Database, and the Defense Suicide Prevention Office Suicide Data Repository.</p><p><strong>Participants: </strong>Service members of the air force, army, marines corps, and navy who served more than 30 consecutive days between September 11, 2001, and September 30, 2016.</p><p><strong>Design: </strong>This retrospective cohort study utilized path analysis to examine associations among TBI, SLI, PH conditions, SUD, and death by suicide. Stratification by TBI was tested.</p><p><strong>Main measures: </strong>Concurrent associations of 2 focal predictors, TBI and SLI, with death by suicide were investigated, mediated by PH conditions (ie, posttraumatic stress disorder, depression, or anxiety disorder), and SUDs (ie, alcohol use disorder or other drug use disorder), adjusting for age, sex, race/ethnicity, service branch, and officer status.</p><p><strong>Results: </strong>In preliminary analyses, TBI, SLI, PH conditions, and SUD were all independently associated with death by suicide. In the first path model, neither of the direct effect of SLI or TBI on death by suicide were significant. TBI shared a stronger association with PH conditions and SUD than SLI did; the association between SLI and SUD was negative. When stratified by TBI status, the association between SUD and death by suicide was stronger among those without (vs with) TBI.</p><p><strong>Conclusions: </strong>Findings suggest complex and nuanced associations between TBI, SLI, PH conditions, SUD, and death by suicide, and underscore the importance of integrated and holistic treatment of injured military service members.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a New Program of Care for Work-Related Mild Traumatic Brain Injury on Recovery and Return to Work.","authors":"Yuriy Chechulin, Natasha Nanwa, John J Leddy, Aaron M S Thompson","doi":"10.1097/HTR.0000000000001055","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001055","url":null,"abstract":"<p><strong>Background: </strong>The Workplace Safety and Insurance Board (WSIB) in Ontario, Canada, launched a new community-based mild traumatic brain injury (mTBI) program of care (POC) in November 2020. The new program included graded exercise therapy and vestibular rehabilitation (where required). The objective of this study was to assess the impact of the new mTBI POC on recovery and return to work among patients who suffered a work-related mTBI.</p><p><strong>Methods: </strong>We identified WSIB claims that accessed the previous and new mTBI POC over a 4-year timeframe (October 1, 2017, to September 30, 2019, and July 1, 2021, to June 30, 2023). A quasi-experimental pre-post study, propensity score matching design with a difference-in-difference modelling component was applied to approximate estimation of causal effects on loss of earnings (LOE) benefit duration at 3-, 6-, and 12-months and HC costs for patients treated in the previous and new programs.</p><p><strong>Results: </strong>Over the 4-year timeframe, 5625 patients accessed the previous and new mTBI POC. The new program achieved improved 3-, 6-, and 12-month disability durations (incremental percentage difference of -11.7%, -9.3%, and -9.0%, respectively), and shorter durations of disability, reflected by decreased LOE benefit costs (incremental percentage difference of -32.6%) and decreased HC costs (incremental percentage difference of -5.6%). The overall combined savings in LOE and HC costs was 21%.</p><p><strong>Conclusions: </strong>This analysis indicates that the implementation of this new evidence based mTBI POC resulted in improved outcomes (decreased disability duration and lower health care utilization) on a per patient basis for people with work-related mTBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Response to Low- Versus High-Volume Aerobic Exercise for Sport-Related Concussion: A Pilot Randomized Controlled Trial.","authors":"Haley M Chizuk, Elizabeth Castro, Sarah Robinson, Jaffer Sayeed, Alex Rawlings, John J Leddy, Mohammad N Haider","doi":"10.1097/HTR.0000000000001061","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001061","url":null,"abstract":"<p><strong>Objective: </strong>To assess sex differences in behavior and motivation of adolescent athletes with sport-related concussion (SRC) versus controls during a 2-week individualized aerobic exercise intervention.</p><p><strong>Setting: </strong>Academic center research laboratory.</p><p><strong>Participants: </strong>Participants were enrolled within 10 days of SRC (n = 32; 15.6 ± 1.4 years, 33% female, 6.18 ± 2.21 days from injury). Twenty-eight control participants (16.0 ± 1.6 years, 33% female) were recruited.</p><p><strong>Design: </strong>Randomized control trial with a 1:1 block randomization scheme stratified by participant sex.</p><p><strong>Main measures: </strong>Clinical recovery time as determined by the study physician, heart rate threshold (HRt) on the Buffalo Concussion Treadmill Test, adherence rates (calculated as exercise volume completed/exercise volume prescribed), and behavioral assessments including the perceived competence scale (PCS) and the treatment self-regulation questionnaire (TSRQ).</p><p><strong>Results: </strong>Females achieved higher initial HRts (P = .007), ie, the maximum HR during exercise testing. Males and females with a concussion showed minimal differences in motivation and perceived competence. Although it did not reach statistical significance (P = .058), females in the low-volume group appeared to recover faster than the high-volume group. This trend was not seen in males. Seven (88%) of exercise-intolerant females had to stop an exercise bout early on 1 or more days due to more-than-mild symptom exacerbation versus 3 (17%) of exercise-intolerant males (P = .002).</p><p><strong>Conclusion: </strong>Females with a concussion prescribed a high volume of aerobic exercise treatment appeared to take longer to recover than females with a concussion who were prescribed a lower volume, which was not seen in males. Increased training heart rate prescriptions due to higher initial HRts and symptom exacerbation during at-home exercise may have affected female exercise behavior. Although aerobic exercise benefits SRC recovery, this study highlights the need for future research to optimize exercise treatment prescriptions for females after SRC.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the Common Misconceptions About Traumatic Brain Injury Scale (CM-TBI); What Does It Really Measure?","authors":"Christine Padgett, Hoang Nguyen, Peta S Cook, Olivia Hannon, Kathleen Doherty, Jenna Ziebell, Claire Eccleston","doi":"10.1097/HTR.0000000000001059","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001059","url":null,"abstract":"<p><strong>Objective: </strong>To examine the factor structure and validity of the 40-item common misconceptions in traumatic brain injury (CM-TBI) scale, and to develop and evaluate additional concussion-focussed items to broaden the instrument's scope.</p><p><strong>Method: </strong>A purposive sample of 988 participants from across all habitable continents (M age 43, range 16-90 years, 84% female) completed the CM-TBI and 5 additional concussion items at commencement of an online course on TBI.</p><p><strong>Results: </strong>Item analysis resulted in the removal of 19 items due to ambiguous wording and poor conceptual integrity, and/or low discrimination and low inter-item correlations. An exploratory factor analysis on the remaining 26 items revealed a 3-factor model had best fit, with an additional 8 items removed due to low or cross-loadings, low communalities, and/or low conceptual relevance, resulting in an 18-item revised scale.</p><p><strong>Conclusion: </strong>There is no psychometric support for the current structure of the CM-TBI. This is likely due to changes in understanding of TBI since the scale's inception, and issues of conceptual ambiguity. It is also proposed that a distinction must be made between knowledge and misconceptions, as these are 2 related but different constructs that are not clearly delineated in the current CM-TBI. Using the revised scale here offers researchers a more modern, focussed, and valid measure, but a new scale to measure knowledge and misconceptions in TBI is urgently needed.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Task-Dependent Neurophysiology During Virtual Reality Treadmill Training in Adults With Traumatic Brain Injury: A Functional Near-Infrared Spectroscopy Feasibility Study.","authors":"Jaclyn Stephens, Kaitlin Hays, Haylee Winden, Brandon Busch, Candace Tefertiller","doi":"10.1097/HTR.0000000000001057","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001057","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with traumatic brain injury (TBI) often experience residual mobility deficits that can be improved with treadmill and virtual reality interventions. However, previous studies have not measured the underlying neurophysiology during these interventions nor assessed if acquiring such data is feasible in a TBI population. Thus, the primary purpose of this study was to assess the feasibility of using portable functional near-infrared spectroscopy (fNIRS) to measure neurophysiology during a treadmill task and a treadmill with virtual reality task.</p><p><strong>Setting: </strong>Data were collected in an outpatient setting at Craig Hospital.</p><p><strong>Participants: </strong>Eight individuals with chronic moderate to severe TBI were recruited. The primary eligibility criteria include age of 18 years or older, diagnosis of moderate to severe TBI that initially required inpatient rehabilitation at least 1 year prior and could walk at least 10 feet without support from more than 1 person.</p><p><strong>Design: </strong>Cross-sectional feasibility study. Participants were assessed with fNIRS while completing a 12-minute treadmill task and a 12-minute treadmill with virtual reality task. Feasibility benchmarks were established a priori and included safety, acceptability, data acquisition and quality metrics.</p><p><strong>Main measures: </strong>Pre-determined feasibility objectives served as the primary outcome of this study. Global brain activity as measured by FNIRS was acquired during treadmill training alone and treadmill training with virtual reality in early, middle, and late epochs.</p><p><strong>Results: </strong>The fNIRS protocol used in this study was safe for all participants and acceptable to 87.5% of participants. FNIRS data acquisition and quality benchmarks were achieved for 87.5% participants. Exploratory fNIRS analyses revealed significantly greater global brain activity during the treadmill with virtual reality task compared to the treadmill task alone in late epochs. No adverse events occurred.</p><p><strong>Conclusion: </strong>All feasibility benchmarks were achieved suggesting that this fNIRS protocol can be used in future, larger-scale studies.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Undiagnosed Concussions and Their Associations With Current Symptom Reporting in Collegiate-Aged Athletes.","authors":"Hannah M Bartels, Kearnin M Van Bortel, Andrew R Mayer, Benjamin L Brett, Timothy B Meier","doi":"10.1097/HTR.0000000000001058","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001058","url":null,"abstract":"<p><strong>Objective: </strong>Determine the prevalence of undiagnosed concussions across the lifespan and their association with demographic and injury-related factors, prolonged recovery, and risk for subsequent injury. Test the hypothesis that prior diagnosed and undiagnosed concussions are associated with worse current-day concussion-related symptoms.</p><p><strong>Setting: </strong>Academic medical center.</p><p><strong>Participants: </strong>Healthy collegiate-aged athletes with varying levels of prior concussion (N = 212, age 21.00 ±1.69 years, 63% male; N = 125, age 21.05 ±1.67 years, 66% male) with at least 1 prior concussion.</p><p><strong>Design: </strong>In this cross-sectional single-visit study, semi-structured interviews were used to retrospectively collect concussion history across the lifespan, including whether concussion was diagnosed at time of injury. Generalized linear models determined association of injury-related and demographic factors with diagnosis status at time of injury. Multiple linear regression determined associations of number of diagnosed and undiagnosed concussions with current concussion-related symptom severity.</p><p><strong>Main measures: </strong>Diagnosis status, days until and number of subsequent concussions, number of days with symptoms for retrospectively identified concussions; Sport Concussion Assessment Tool symptom severity.</p><p><strong>Results: </strong>Fifty-three percent of the 308 concussions retrospectively identified were not diagnosed as concussion at time of injury. Older age (P = .045, OR = 1.08), greater number of endorsed symptoms (P <. 001, OR = 1.22), presence of post-traumatic amnesia (P = .011, OR = 2.47), and presence of retrograde amnesia (P = .012, OR = 3.19) at the time of injury increased odds of that injury being diagnosed as concussion. Injuries diagnosed as concussion at time of injury were associated with greater number of days with symptoms (B = 11.26(2.01), P < .001). A greater number of diagnosed concussions (B(SE) = 0.19 (0.06), P = .003), and to a lesser extent undiagnosed concussions (B(SE) = 0.11(.06), P = .08), were associated with current symptom severity.</p><p><strong>Conclusions: </strong>Most concussions experienced by collegiate-aged athletes throughout their life go undiagnosed. Findings do not support the hypothesis that undiagnosed concussions are associated with worse chronic symptom reporting relative to diagnosed concussions but illustrate the need to consider both when characterizing potential long-term effects.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Extreme Phenotypes for Pain Catastrophizing in Persons With Chronic Pain Following Mild to Severe Traumatic Brain Injury Requiring Inpatient Rehabilitation: A NIDILRR and VA TBI Model Systems Collaborative Project.","authors":"Aaron M Martin, Jessica M Ketchum, Stephanie Agtarap, Flora M Hammond, Mitch Sevigny, Mackenzie Peckham, Kristen Dams-O'Connor, John D Corrigan, William C Walker, Jeanne M Hoffman","doi":"10.1097/HTR.0000000000001036","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001036","url":null,"abstract":"<p><strong>Objective: </strong>Define and characterize extreme phenotypes of pain catastrophizing for persons with chronic pain following mild to severe traumatic brain injury (TBI) requiring inpatient rehabilitation.</p><p><strong>Setting: </strong>18 TBI Model System (TBIMS) centers.</p><p><strong>Participants: </strong>1762 TBIMS participants 1 to 30 years post-injury reporting chronic pain.</p><p><strong>Design: </strong>Cross-sectional, secondary analyses.</p><p><strong>Primary measures: </strong>Catastrophizing, sociodemographic, injury, functional outcome, pain, and treatment characteristics.</p><p><strong>Results: </strong>Participants were male predominantly (73%), White (76%), middle-aged (mean 46.5 years), injured in motor vehicle accidents (53%) or falls (20%). Extreme phenotypes were identified based on upper and lower 25th percentiles to create low catastrophizing (N = 434) and high catastrophizing (N = 458) groups. Bivariate comparisons found significant differences (P < .001) on all measures of concurrent function and pain interference with those in the low catastrophizing phenotype experiencing better function and lower pain interference than those in the high catastrophizing phenotype. Combination Lasso and logistic regression identified multivariable predictors of phenotypes. Increased odds of high versus low catastrophizing extreme phenotypes were associated being younger (odds ratio [OR] = 1.24 for a 10-unit decrease), less than a college level of education (OR = 1.70-2.53), no military history (OR = 3.25), lower FIM motor (OR = 1.20 for a 5-unit decrease) and cognitive (OR = 1.53 for a 5-unit decrease) scores, increased pain intensity (OR = 1.22 for a 1 unit increase) and pain interference (OR = 1.93 for a 1-unit increase), neuropathic type pain (OR = 1.82-1.86), and migraine type pain versus no head pain (OR = 1.65).</p><p><strong>Conclusion: </strong>High pain catastrophizing phenotypes were associated with a greater degree of pain and functional disability and higher likelihood of neuropathic pain and migraine headache. Given pain catastrophizing's contribution to pain-related disability and treatment outcomes, additional research is necessary to investigate its role in adjustment to chronic pain among individuals with TBI. Adapting evidence-based interventions for this population that specifically targets pain catastrophizing is warranted.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Clinical TBI Severity and Military Factors With Veteran TBI Service-Connected Disability Ratings and Total Compensation: A Long-Term Impact of Military Brain Injury Consortium (LIMBIC) Study.","authors":"Clara E Dismuke-Greer, Aryan Esmaeili, Mary Jo Pugh, Terri K Pogoda, Megan Amuan, David X Cifu","doi":"10.1097/HTR.0000000000001052","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001052","url":null,"abstract":"<p><strong>Objective: </strong>To understand how traumatic brain injury (TBI) clinical severity and military factors were associated with the likelihood of receiving a TBI service-connected disability (SCD) determination and monthly total SCD compensation among Veterans.</p><p><strong>Setting: </strong>Veterans Health Administration (VHA) and Veterans Benefits Administration (VBA).</p><p><strong>Participants: </strong>1 319 590 veterans with a VBA SCD rating who entered the VHA between October 1, 2000, and September 24, 2019.</p><p><strong>Design: </strong>This retrospective study analyzed the association of TBI severity and military factors with a TBI SCD determination, TBI SCD rating percentage, and monthly total SCD compensation. Administrative VHA and VBA records were utilized.</p><p><strong>Main measures: </strong>Any TBI SCD determination, TBI SCD rating percentage, and monthly SCD compensation.</p><p><strong>Results: </strong>93 911 (7.1%) Veterans had an SCD rating for TBI. TBI SCD increased monthly total compensation by $362 (95% CI 353, 370) in bivariate and $45 (95% CI 38, 52) in adjusted models. Females had lower TBI SCD percentage (-3.03; 95% CI -3.92, -2.14) but higher monthly compensation ($37; 95% CI 33, 42). TBI severity was associated with increasing TBI SCD percentage and monthly SCD compensation. In adjusted models, deployment (-2.36; 95% CI -3.02, -1.69) was associated with lower TBI SCD percentage but not monthly compensation, while combat exposure was not associated with TBI SCD percentage but was associated with higher compensation ($46; 95% CI 40, 53).</p><p><strong>Conclusion: </strong>TBI severity was significantly associated with TBI SCD determination and TBI SCD rating percentage, in addition to overall SCD compensation. Although deployment was significantly associated with TBI SCD determination, non-deployment was associated with higher TBI SCD percent ratings. These results may be explained by TBI occurring in non-deployment military settings, such as training. This highlights the need to study risk for TBI in the general military environment to ensure that all military-related TBI exposures are recognized and that any related disability is appropriately compensated.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collegiate Participation in Repetitive Head Impact Sports Does Not Adversely Affect Gait Dual Task Cost.","authors":"Thomas A Buckley, Kristen Williams, Jessie R Oldham, Katherine J Hunzinger, Caitlin Gallo, Scott W Passalugo, Barry Bodt, Melissa N Anderson, Kelsey Bryk, Barry A Munkasy","doi":"10.1097/HTR.0000000000001051","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001051","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to assess gait related dual task cost (DTC) changes over the course of a collegiate athletic career in both repetitive head impact (RHI) exposed and non-RHI exposed athletes.</p><p><strong>Setting: </strong>University Research Laboratory.</p><p><strong>Participants: </strong>We recruited 47 NCAA intercollegiate athletes and grouped by RHI exposed (N = 27) and non-RHI (N = 20) sports.</p><p><strong>Design: </strong>Participants completed 5 trials of single task (ST) and 5 trials of dual task (DT) gait with a working memory cognitive challenge both prior to their collegiate athletic careers (pre) and then again after they completed their collegiate athletic careers (post) (mean 1173 ± 341 days between tests) in this prospective longitudinal design. To assess for changes over the course of a career, separate 2 (group: RHI, non-RHI) × 2 (time: pre, post) mixed design ANOVA were performed for each dependent variable of interest (DTC gait velocity and DTC step length) and the model was adjusted for concussion history at the time of test and sex.</p><p><strong>Main measures: </strong>Gait velocity and step length DTC.</p><p><strong>Results: </strong>There were no significant group by time interactions for DTC gait velocity (F = 0.517, P = .476, η2 = 0.012) or DTC step length ((F = 0.206, P = .652, η2 = 0.005).</p><p><strong>Conclusions: </strong>The primary finding of this study indicated no difference between RHI exposed and non-RHI exposed athletes gait DTC performance between the beginning and conclusion of their collegiate athletic careers. While the long-term effects of RHI remain to be fully determined, these results suggest that RHI may not adversely affect ST or DT gait performance when the individual is young.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}