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How TBI affects couples' relationships

A traumatic brain injury not only changes your loved one, it also changes your relationship as a couple.

When your partner suffers a traumatic brain injury (TBI), changes to your relationship are likely. Both of you can experience a range of emotions as you adapt to new expectations in your relationship, but you can weather the changes. TBIs can occur without warning, and the path to recovery isn’t always clear, which can add strain to your romantic relationship. Read more...

Musical healing for TBI and PTSD

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Music therapy has gained acceptance as an evidence-based treatment for TBI and PTSD. Learn more and watch a video of music therapy in action.

Music therapy is an evidence-based therapeutic application for the treatment of brain and psychological injuries such as traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). TBI and PTSD can be life-changing events that cause physical, cognitive, sensory, and/or emotional impairments. However, a trained music therapist can use music to activate injured areas of the brain involved in the control of movement, cognition, speech and emotions.

Substantial scientific evidence supports how and why music therapy works, but it also can be understood intuitively. Music evokes emotions and influences mood, whether happy or sad, relaxed or pumped. Music also inspires movement: Think how a good beat can induce foot tapping or dancing.

Injured nerve pathways actually can be stimulated by music. Music also can be used to stimulate speech and facilitate cognitive function. In those with PTSD, music can arouse memories that need to be accessed and processed during the healing process. Music can help to promote movement affected by TBI. Watch this video from the National Endowment for the Arts (NEA) and DoD to see music (and other arts) therapy helping injured service members.

Music therapy is part of the rehabilitation process at places such as NICOE, Walter Reed National Military Medical Center, and VA centers around the U.S. The VA also sponsors the National Veterans Creative Arts Festival, where veterans showcase their work. This TBICreative Forces fact sheet describes the NEA Military Healing Arts Network and lists several creative arts therapy locations.

How you can help prevent TBI

Learn how to prevent traumatic brain injury (TBI) by implementing safety precautions.

Traumatic Brain Injury (TBI) is a condition that can result from experiencing a blow or a jolt to the head, but education and proper safety precautions can prevent many of these injuries. TBI can range from mild concussion to a more serious and debilitating condition. Every year, thousands of Warfighters and veterans are diagnosed with TBI. You might expect that TBI happens mostly during deployments because of combat exposure, but almost 80% of TBIs occur in non-deployed settings, where most could be prevented.

Here are 3 tips that can help prevent TBI:

  • Put on a helmet. Whether you’re headed outside on your motorcycle, taking a springtime bicycle ride with your children, or looking to climb your next big rock, make sure everyone straps on a helmet. The helmet should be a well-maintained, approved safety device suitable for the activity and should fit properly. Helmet fact sheets are available on the Centers for Disease Control and Prevention (CDC) website.
  • Drive safely. Motor vehicle and motorcycle collisions account for most Warfighter TBIs. Always wear a seatbelt, and secure children in appropriate safety or booster seats. Don’t drive when you’re under the influence of drugs, alcohol, medication, or lack of sleep. Talk with your teens (and anyone else who will listen) about the dangers of distracted driving.
  • Prevent falls. Examine your environment at home and work, and identify possible safety risks that could contribute to falls and injuries. Clutter, wet or slippery surfaces, and the absence of safety features such as handrails along stairs can increase your chances of injury.

Education and an ounce of prevention are valuable to prevent injuries and TBI. To learn more about preventing, recognizing, and treating TBI, visit “A Head for the Future,” a Defense and Veterans Brain Injury Center Initiative, or HPRC’s TBI resource section.

Are girls at higher risk of concussion?

March is Brain Injury Awareness Month, and this year’s theme is “Think Ahead.” If you have a daughter, learn how to reduce her risk of concussion.

Girls might be at greater risk of concussion—also known as mild traumatic brain injury (mTBI)—than boys, so it’s important to recognize their symptoms and seek medical help. Female high school and college athletes report more concussion symptoms than their male counterparts. In addition, their reported symptoms are more severe and last longer than what boys experience.

In sports, a concussion can happen from hitting another player, ball, or surface with your head. It causes a disturbance in brain functioning and can lead to a number of symptoms, including headache, nausea, vomiting, dizziness, fatigue, and sensitivity to light or noise. In addition, you might feel foggy, have difficulty concentrating or remembering things, or feel confused about recent events. You also might feel irritable, sad, or nervous. While concussions can happen in any sport, they’re most likely to occur in football, soccer, rugby, basketball, and hockey.

It’s not clear why girls experience more concussions than boys. Girls are more likely to report symptoms, whereas boys tend to keep their concerns to themselves. So it might be the case that boys and girls are concussed at the same rates, but girls report their injuries more often. Hormone levels and blood flow differences in the sexes also might contribute to the rates of concussion among girls. For girls who have entered puberty, hormonal changes experienced along with their menstrual cycles might impact the severity of concussion symptoms. It takes longer for a girl to be symptom free after her concussion, and that might be due in part to where she is in her menstrual cycle.

If you have a daughter, take steps to prevent her from experiencing a concussion. If she is diagnosed with an mTBI, she’ll need “brain rest” to recover. She also should limit reading, homework, and screen time. And consult with her doctor to make sure that concussion symptoms resolve and she’s medically cleared before she returns to play her sport.

Supplements for concussions?

Don’t fall for dietary supplement products claiming to help with concussions.

Two-a-day practices have started for teens in fall sports. One big issue is concussion education: learning the signs of a concussion and then what to do if you actually have one—or if someone you know does. Several dietary supplement manufacturers have promoted products to help with recovery from concussions and traumatic brain injuries (TBIs), but there isn’t enough scientific evidence to support these claims. If you suffer from a concussion or TBI, make sure you follow your doctor’s orders for recovery. And if you have children involved in sports, watch them for possible signs.

FDA warns consumers to avoid using products that claim to prevent or treat a concussion or TBI. For more information, read FDA’s Consumer Update on dietary supplements and concussions.

 

Recognizing mild TBI

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Traumatic brain injury (TBI) is common among returning service members, but it’s also common among civilians. Learn to recognize symptoms.

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.

Brain injury and memory problems

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Many service members have been affected by traumatic brain injuries. Some have memory problems too. Learn more.

Since 2000, around 350,000 service members have been affected by traumatic brain injuries. TBI often impacts memory, especially short-term memory. Think of long-term memory and short-term memory as “holding bins” for information. Your long-term memory can hold information from several days to decades, while your short-term memory retains information for just a few seconds. And short-term memory is closely associated with working memory (your ability to manipulate information in your head) and sustained attention (your ability to maintain focus).

When memory problems strike, short-term memory, working memory, and sustained attention tend to suffer before long-term memory does. Regardless of cause, memory of a remote event stands out more than newer events because your mind has “rehearsed” the older event repeatedly, essentially embedding it in your brain through repetition. By comparison, your mind hasn’t yet “learned” the newer event. For example, you might recall every detail of combat stories but have difficulty remembering what you ate for lunch. In this case, brain connections that rehearsed the combat story have become solidified, while connections responsible for learning this new information haven’t formed yet.

Depending on the location and nature of the injury, your brain might work differently than it did in the past. This could happen because brain cells that used to “communicate” with each other easily are now being rerouted.

Short-term memory, working memory, and sustained attention also can be affected by other factors such as stress, distraction, poor sleep, depression, anxiety, and/or body toxins. The cause isn’t always obvious. Your doctor can help sort it out, answer questions about your condition, treatment, and prognosis, and refer you to a neuropsychologist for further evaluation. In the meantime, you might find HPRC’s TBI resources useful too.

Protective eyewear could prevent injuries

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Blast shockwaves can seriously damage eyes, but immediate treatment could aid healing. Learn more about protecting your eyesight.

Many service members exposed to bomb blasts in the field walk away unscathed—or so it would seem. However, there could be some damage they’re not “seeing.”

High-pressure shockwaves from explosive blasts can cause serious eye trauma. In fact, up to 10% of all blast survivors experience significant eye injuries from projectiles thrown into their eyes, eye perforations caused by the high-pressure blast waves, or effects on the eyes associated with traumatic brain injury (TBI). If you were exposed to a blast while in the field but weren’t otherwise injured, don’t wait to set up an appointment with your eye doctor. Prompt medical attention could prevent permanent injury.

 

Most eye injuries are preventable if you wear protective eyewear on-duty and off-duty. There are many options to choose from the Department of Defense’s (DoD) approved Authorized Protective Eyewear List (APEL). Your vision is extremely important! For more information on protecting your eyesight, visit the Vision Center of Excellence

Safe return to duty after a head injury

Filed under: Concussion, Injuries, TBI
Mild traumatic brain injuries (concussions) are very common in the military. Learn how you and your doctor can get you safely back to duty.

Returning to duty after a mild traumatic brain injury (mTBI; also referred to as acute concussion) requires a special recovery process. Until now, procedures used by military healthcare professionals were largely based on sports-related mTBI practices, which are not always appropriate for returning Warfighters to military activities and demands. Medical and military experts worked together to develop new recommendations for returning service members to military activity after mild traumatic brain injury. The six-step process includes progressing from rest through light to moderate activity and exercise and eventually to unrestricted activity. Patients cannot progress until they are symptom free at any given stage in the process. Almost 84% of military brain injuries in 2014 were from mTBI/concussions. Some of the most common causes of concussions occur in non-deployed setting. While not all mTBI/concussions are preventable, there are things that you can do to reduce your risk in your day-to-day life:

  • Always wear a seat belt when driving or riding in a vehicle.
  • Wear a helmet when suitable (for example, on a bicycle or motorcycle).
  • Create safe living spaces to reduce falls. Remove or secure potentially hazardous items from floors and overhead.
  • Be aware of your surroundings. Try these Mind Tactics Performance Strategies to improve your ability to control your attention.

Help for Warfighters at NICoE

Filed under: PTSD, TBI, Therapy
The National Intrepid Center of Excellence provides healing for Warfighters with TBI, and PTSD or other psychological problems because of combat.

Walk into the new facility of the National Intrepid Center of Excellence (NICoE) on the campus of Naval Support Activity Bethesda, and one of the first things you will see is a sign commemorating the center’s origins, including the fact that the $65 million facility itself was donated by the Intrepid Fallen Heroes Fund. NICoE is committed to the interdisciplinary diagnosis, treatment, and long-term healing of Warfighters, and educational support for their families, from all branches of service.

Unlike many military environments, the facility is curved, spacious, quiet, and pleasant. Some notable features are the high ceilings, artwork, and state-of-the-art treatment rooms.

Patients at NICoE typically are active-duty service members with mild traumatic brain injuries (mTBI) combined with other psychological health conditions such as post-traumatic stress (PTS), anxiety, and depression. Most have already begun treatment elsewhere, often with many medications. The tranquil environment of NICoE instantly helps put them at ease and often leads to more effective treatment with fewer medications.

Recognizing that traditional therapies can’t heal all wounds, NICoE has rooms dedicated to art therapy, virtual reality, and meditation. Beautiful masks line the entrance to the art therapy room, providing a small glimpse into Warfighters’ individual and unique roads to recovery. The virtual reality room allows Warfighters to face traumatic scenarios at a pace that makes sense, an incredibly lifelike setting full of sound, movement, scents, and images. The spirituality room lets in natural light to a space with a beautiful wood floor surrounded by natural plants and a speaker system that plays sounds of nature.

An interdisciplinary approach, combining traditional and integrative medicine, contributes to NICoE’s 99% satisfaction rate, with more than 600 patients from all different services having completed their four-week program. There is no one-size-fits-all approach to healing, and the interdisciplinary makeup of the clinical team enables patients to pursue various treatment options. Providers can collaborate regularly and have cutting edge equipment at their disposal.

Patients usually bring a non-medical attendant, often a spouse or parent. Children also are welcome at NICoE. A private family room with frosted glass includes a children’s play area, and a playground is located behind the facility.

NICoE also focuses on research to help ensure long-term treatment success. There has been discussion of opening their doors to a wider range of Warfighter patients (treating more conditions) and opening more NICoE satellite centers. Referred to as Intrepid Spirits, such centers are open already at Fort Belvoir and Camp Lejeune. The Intrepid Spirit at Fort Campbell will open this summer, and ground was broken recently for one at Fort Bragg. Other bases that may receive an Intrepid Spirit include Forts Hood, Bliss, and Carson, along with Joint Base Lewis-McCord and Camp Pendleton.

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