Journal of Rehabilitation Research & Development (JRRD)

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Volume 52 Number 5, 2015
   Pages 591 — 604

Abstract — Characterizing effects of mild traumatic brain injury and posttraumatic stress disorder on balance impairments in blast-exposed servicemembers and Veterans using computerized posturography

Joanna R. Wares, PhD;1* Kathy W. Hoke, PhD;1 William Walker, MD;2–3 Laura Manning Franke, PhD;2–3 David X. Cifu, MD;2 William Carne, PhD;2 Cheryl Ford-Smith, PT, DPT, MS, NCS4

1Department of Mathematics and Computer Science, University of Richmond, Richmond, VA; 2Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA; 3Defense and Veterans Brain Injury Center, Department of Veterans Affairs, Richmond, VA; 4Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA

Abstract — The high rate of blast exposures experienced by U.S. servicemembers (SMs) during the recent conflicts in Iraq and Afghanistan has resulted in frequent combat-related mild traumatic brain injuries (mTBIs). Dizziness and postural instability can persist after mTBI as a component of postconcussion syndrome, but also occur among the somatic complaints of posttraumatic stress disorder (PTSD). The goals of this study were to examine the use of computerized posturography testing (CPT) to objectively characterize chronic balance deficits after mTBI and to explore the utility of CPT in distinguishing between combat and blast-exposed participants with and without mTBI and PTSD. Data were analyzed from a subject pool of 166 combat-exposed SMs and Veterans who had a blast experience within the past 2 yr while deployed. Using nonparametric tests and measures of impairment, we found that balance was deficient in participants diagnosed with mTBI with posttraumatic amnesia (PTA) or PTSD versus those with neither and that deficits were amplified for participants with both diagnoses. In addition, unique deficiencies were found using CPT for individuals having isolated mTBI with PTA and isolated PTSD. Computerized balance assessment offers an objective technique to examine the physiologic effects and provide differentiation between participants with combat-associated mTBI and PTSD.

Key words: balance, balance impairment, blast exposure, computerized posturography, impairment, mild traumatic brain injury, posttraumatic amnesia, posttraumatic stress disorder, servicemembers, Veterans.


View HTML ¦ View PDF ¦ Contents Vol. 52, No.5

This article and any supplementary material should be cited as follows:
Wares JR, Hoke KW, Walker W, Manning Franke L, Cifu DX, Carne W, Ford-Smith C. Characterizing effects of mild traumatic brain injury and posttraumatic stress disorder on balance impairments in blast-exposed servicemem
bers and Veterans using computerized posturography. J Rehabil Res Dev. 2015;52(5):591–604.
http://dx.doi.org/10.1682/JRRD.2014.08.0197
ResearcherID: Laura Manning Franke, PhD: F-2670-2012
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