Filed under: Rehabilitation
Between 2000 and 2015, more than 339,000 service members sustained a traumatic brain injury (TBI) in the Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) conflicts. The first step to care is being able to recognize symptoms, especially for less obvious TBIs. While service members are at greater risk than their civilian counterparts, TBI is not just a military injury. Over 2.2 million American civilians are treated each year for TBI. Leading causes include falls and automobile accidents. In theater, blasts account for most TBIs. Each injury is unique, and each person’s road to recovery is different.
TBI involves alteration of brain function caused by an external physical force. A penetrating TBI is usually obvious, such as a bullet or stab wound to the head. Closed injuries sometimes aren’t so apparent: These include blast injuries, falls, vehicle crashes, and head-to-head collisions (such as on an athletic field).
Severity depends on the amount of brain tissue injured and ranges from mild to severe. Impairment can be physical, cognitive, sensory, and/or emotional.
About 82% of TBIs sustained in OIF/OEF conflicts were labeled mild (mTBI, also referred to as concussion). The most common symptom is headache. Other symptoms include dizziness, sleep disturbances, fatigue, attention and memory problems, irritability, and changes in vision, balance, and mood. However, symptoms can be subtle, and patients often don’t seek medical help for weeks or months after the injury occurred.
Most mTBI patients recover fully. The Defense and Veterans Brain Injury Center (DVBIC) “Blast Injuries” web page offers good advice for recovering from blast-induced mTBI.
Recovery from moderate-to-severe TBI usually requires treatment at a rehabilitation hospital. The goals are to improve function and promote independence and re-integration into the community. Progress can be slow, but change and improvement can continue for years.
Health.mil offers resources for both patients and clinicians. DVBIC’s A Head for the Future website provides educational materials to encourage prevention and promote recognition and treatment of TBI in the military.
Getting fit and staying healthy can be especially challenging for service members with chronic illnesses, injuries, or disabilities. The good news is that recreation therapy can make the process less painful. Recreation therapists can help motivate and design activities that are enjoyable while they improve both physical and mental function and fitness. Therapeutic recreation also can help make subsequent life more enjoyable.
The American Therapeutic Recreation Association (ATRA) suggests that those who are more active lead more satisfying, happier, and healthier lives. The U.S. Department of Veterans Affairs (VA) and DoD recommend injured veterans get involved in adaptive sport programs and/or recreation therapy as part of their rehabilitation. Most rehabilitation hospitals have a recreation therapist on staff who can help develop individualized programs. There are also local and national programs such as the VA Adaptive Sports Program, Paralympics, and the Military Adaptive Sports Program.
Pain can take a toll on you physically and emotionally, but there are some steps you can take to cope with it. First, know if your pain is “acute” or “chronic.” Acute pain is temporary, often stemming from injuries that will heal completely. Chronic pain is ongoing, lasting for more than 3 months. It’s hard to know what to do about chronic pain. And it’s a big problem: At least 25% of people in the U.S. suffer from it.
If you have pain, it’s important to see a medical provider to rule out something life-threatening. However, most injuries heal physically as much as possible after 3–6 months, so residual pain has more to do with complex mind-body processes than a clear-cut physical problem. Learn more about a 5-step structured approach you can use to tackle chronic pain from the video below developed by the DoD/VA Joint Pain Education Project and the Defense and Veterans Center for Integrative Pain Management.
Recovery Care Coordinators (RCC) help wounded, ill, and injured service members, their caregivers, and their families navigate the recovery, rehabilitation, and reintegration process. They help ensure a smooth transition from a recovery and rehabilitation setting back into the civilian community or, in some instances, back to military duty. An RCC is the first point of contact within each of the military services’ wounded warrior programs. RCCs are located at military treatment facilities and installations throughout the country and overseas. Referral to RCCs can come from the service member, a caregiver, a family member, medical personnel, or a wounded warrior program. For more information on the referral process (and for contact numbers), read this factsheet.
How do RCCs help support service members, their caregivers, and their families during what is often a difficult and stressful period in their lives? The RCC develops a comprehensive recovery plan (CRP) with the service member, caregivers, family members, and the recovery team to identify goals and resources needed to achieve those goals, such as assistive technology, education, employment, or housing.
The DoD Office of Warrior Care Policy is responsible for oversight, policy of the Recovery Coordination Program, and standardized training for all RCCs, but each military service branch implements its own Recovery Coordination Program in accordance with DoD policy. The terminology may differ with service (for example, advocate, care coalition, recovery care), but the mission and the standards are the same. Check out the following links for service-specific information:
Spring is just around the corner, so it’s time to start thinking about sports and outdoor recreation. In keeping with the Mission ReDefined campaign (a joint effort of the U.S. Department of Veterans Affairs and the U.S. Paralympics), VA encourages eligible veterans (those injured within the last six years) to apply for the 2015 National Veterans Summer Sports Clinic.
The purpose of the Clinic program is “early intervention for Veterans battling back from injury, not only strengthening their bodies but improving overall well-being and self-worth.”
Spend a week in San Diego learning about adaptive sport and recreational activities such as sailing, surfing, track and field events, kayaking, and cycling (hand and tandem). This is a national event open to Veterans from all across the country with combat injuries ranging from TBI and polytrauma to spinal cord injuries and loss of limbs.
The clinic will be held in San Diego, CA, from Sept 13–18. 2015. The deadline to sign up is May 1, 2015; visit the Registration tab at the Clinic link above for details and forms.
Antigravity treadmills are becoming increasingly popular in injury prevention and rehabilitation settings. These special treadmills reduce the stress placed on the lower body during rehabilitative exercises, like running and walking, while still conditioning muscles. However, there are still questions as to whether the scientific evidence supports their considerable cost. For more about the use, evidence, and cost of these devices, read HPRC’s “Effectiveness of Antigravity Treadmills for Injury Rehabilitation.”
Not only is exercise good for the body, it’s good for the mind. The expert consensus from the International Society of Sport Psychology is that exercise can increase your sense of well-being and help reduce anxiety, tension, and depression.
For veterans coping with depression, PTSD, or other mental-health issues, sports and exercise may be a great way to relieve stress. Scientists have shown the positive benefits of physical activity on symptoms of depression in veterans. What’s more, Veterans’ Administration studies have found that physical activity—especially vigorous activity—can decrease the risk of PTSD among Warfighters. The opposite is also true: Veterans who do not engage in physical activity are more likely to experience PTSD. Several organizations specialize in physical activity and exercise for warriors and their families, but you can always try a yoga class, a family bike ride, or other fitness opportunities in your community.
Getting motivated to exercise and stay active can be especially difficult for those suffering from PTSD and depression. Here are some tips to help you get up and get out the door.
- Make a date with yourself. Put it on your calendar or set a daily alarm—whatever you need to do to remind yourself that you’ve set aside some time for you to exercise. And don’t stand yourself up!
- Set a SMART goal and write it down. Post it on your bathroom mirror, your fridge, your car dashboard—wherever you’ll see it daily to remind yourself of what you want to accomplish.
- Recruit friends or family members to help. Telling people what your goals are is a great way to stay accountable. An exercise partner is especially helpful when you need that extra nudge to get off the couch and start moving.
- Keep a journal. Record your exercise activities and how you felt afterwards. While you may not feel better after every workout, you probably will most of the time. Being able to go back and read/remember how good exercise made you feel may motivate you for the next workout.
Are you or is a service member you know going through rehab for an injury? Well it should be a comfort to know that there are people out there working hard to make sure you/they receive the best and most advanced forms of therapy and technology during rehab. The Center for Rehabilitation Sciences Research (CRSR) is headquartered at the Uniformed Services University, in Bethesda, MD, and their goals are to find solutions for improving rehabilitative care for injured service members and promote successful return to duty and reintegration. Most of their research is focused in the areas of orthopedic trauma, limb loss, and neurological complications, but they’re not working alone. Their expert team of researchers is partnered with other military medical facilities across the country, and they are committed to educating and training future healthcare providers within the military healthcare system. Visit the CRSR website to learn more about their current research, publications, and events.
Attention, all disabled service members and veterans! Staying active helps with recovery by rebuilding strength and endurance—and in so many other ways, as well. A positive mindset and a supportive community are as important as fitness, and getting involved sports such as snowboarding, cycling, wheelchair basketball, and others can build both physical fitness and mental resilience. Consider checking out the Warfighter Sports Program developed by Disabled Sports USA. It offers more than 30 winter and summer adaptive sports in more than 150 events nationwide. Instruction, equipment, and transportation are provided to Warfighters and their guests. Become a part of the team and find the events happening in your area today!