The Academy was approached by the White House Office of the First Lady in coordination with Dr. (Mrs.) Biden to participate on their Joining Forces project as part of a strategy conference on providing support to U.S. veterans, military members, and their families suffering under the impact of PTSD/TBI. Representatives of Joining Forces asked each organization to consider how they and their membership can commit to addressing these issues.
The Academy has a history of working with the DOD and VA to develop solutions that would provide physical rehabilitation needed by military personnel returning with TBI, SCI and amputations and other severe disabilities. Many Academy resources presented to DOD and VA were reflective of the stated objectives of the White House roundtable discussions to generate a series of effective and near-term strategies to:
- Raise awareness of and screening for military mental health issues by civilian health care professionals;
- Promote development of and participation in professional educational opportunities regarding the care and referral of those with combat-related mental health conditions, such as PTSD and traumatic brain injury;
- Share existing referral resources and improve coordination of care between civilian, military, and Veteran health care systems.
The Academy has established this page of resources in an effort to further educate our membership on these important issues.
Advocacy
The Academy has a long history of involvement with rehabilitation services for active duty and veteran military personnel. This position was clearly articulated in the AAPM&R legislative position paper on Wounded Military Personnel (2007).
The Academy has arranged a February 2, 2012 meeting with Wounded Warrior representatives to meet with U.S. Senator James M. Inhofe who is also developing a Uniformed Services University of the Health Sciences (USUHS)/National Institutes of Health (NIH) collaborative on TBI).
AAPM&R and other TBI Stakeholders are co-signing a letter of support to reauthorize the Traumatic Brain Injury Act of 1996, as amended. As you are aware, the TBI Act authorizes programs housed in the Centers for Disease Control and Prevention (CDC) for TBI data, prevention, and education programs; and in the Health Resources and Services Administration (HRSA) which awards grants to States to expand services for individuals with TBI of all ages, and Protection and Advocacy services for the Traumatic Brain Injury (PATBI) program, which provides critical advocacy services to ensure that people with TBIs live full and independent lives free from abuse, neglect, and financial exploitation.
The Academy has approached the American Academy of Neurology (AAN) to volunteer participation and support to update consensus statements on TBI and Concussion.
AAPM&R participates in the TBI Resource Optimization Center (ROC), a private sector based organization addressing the service and evidence-based research gaps within brain injury rehabilitation, as an advisory member. One of this group's initiatives is the TBI–Evidence Based Practices Database. Three Academy volunteers serve on behalf of the Academy.
Educational Resources
The Academy has long used its Annual Assembly, including plenary sessions in 2008, 2010 and 2011 as a forum to highlight the importance to the health of the nation's active duty military personnel and veterans. The Academy will continue to offer this national platform.
AAPM&R has also developed PM&R Knowledge NOW is an evolving, dynamic online resource that highlights the breadth and depth of clinical topics in the specialty of PM&R. A list of already published NOW topics on TBI and Concussion includes:
The Academy has posted online Self-Assessment Examination for Practitioners (SAE-P) titled Concussion and Mild Traumatic Brain Injury: Current and Future Concepts, as well as a slide lecture on Objective Evaluation of Medications to Promote Recovery During Acute TBI Rehabilitation and case studies on Management of Agitation in a TBI Patient and Posttraumatic Stress Disorder as the Primary Cause of Disability in Chronic Pain Patients.
AAPM&R has published several CME activities in its PM&R Journal including:
- Rehabilitation Outcomes Following Anoxic Brain Injury: A Case-Controlled Comparison with Traumatic Brain Injury (12/09)
- Post-injury Personality and Outcome in Acquired Brain Injury: The Millon Behavioral Medicine Diagnostic (3/10)
- A Randomized Controlled Trial of Exercise to Improve Mood after Traumatic Brain Injury (10/10)
- Does Neurologic Examination During Inpatient Rehabilitation Help Predict Global Outcome after Non-Penetrating Traumatic Brain Injury? (1/11)
- Pervasive Cognitive Impairment in Acute Rehabilitation Inpatients "Without" Brain Injury (5/11)
The Academy has posted several newly developed educational tools related to concussion and TBI including a plenary session, slide lectures, videos and podcasts.
Marketing/Member News Publications
AAPM&R is publishing an article in The Physiatrist, the official membership publication of the Academy, in February with a follow-up in March.
AAPM&R offers an online peer forum for physicians called PhyzForum. One of the groups is devoted to concussion and TBI. We envision promotion of the Joining Forces activities in this forum specifically and others as appropriate.
PM&R Journal
The PM&R Journal published a special supplement titled Concussion and Mild Traumatic Brain Injury: Current and Future Concepts in its October 2011 issue. This issue included a report titled "Concussions and the Military: Issues Specific to Service Members." This particular issue was sent to all physiatrists in the United States. Additionally, a special mailing was also sent to Congressmen, legislators, agency staff and key stakeholder groups.
Several related articles and scientific posters have already been published including:
- Rehabilitation Needs of Combat-Injured Service Members Admitted to the VA Polytrauma Rehabilitation Centers: The Role of PM&R in the Care of Wounded Warriors (1/09)
- Physical Exercise and Cognitive Recovery in Acquired Brain Injury: A Review of the Literature (6/09)
- Poster 15: Outcome of an Interdisciplinary, Community-Based Rehabilitation Program for Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Personnel (9/09)
- Physiological and Psychological Fatigue in Extreme Conditions: The Military Example (5/10)
- Posttraumatic Stress Disorder Versus Traumatic Brain Injury (11/10)
- A New Functional Outcome Assessment Tool for Military Musculoskeletal Rehabilitation: A Pilot Validation Study (6/11)
- Poster 92 The Identification of Transient Altered Consciousness Induced by Military-related Blast Exposure and Its Relation to Post-concussion Syndrome (9/11)
- Certifying Fitness for Duty for High-Functioning Amputees: A Review (12/11)
The PM&R Journal is open to publication of any relevant articles contingent on their successfully completing a required peer-review process.
Similarly, the PM&R Journal is pleased to offer public-service type announcements and advertising on a space-available basis.