Terri K Pogoda1,2, Charles E Levy3,4,5, Katherine Helmick6, Mary Jo Pugh7,8. 1. a Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System , Boston , MA , USA. 2. b Department of Health Law, Policy & Management , Boston University School of Public Health , Boston , MA , USA. 3. c Physical Medicine and Rehabilitation Service, Center of Innovation on Disability and Rehabilitation Research, North Florida/South Georgia Veterans Health System , Gainesville , Florida , USA. 4. d Department of Occupational Therapy, College of Public Health and Health Professions , University of Florida , Gainesville , Florida , USA. 5. e Center for Arts in Medicine, College of the Arts, University of Florida , Gainesville , Florida , USA. 6. f Defense and Veterans Brain Injury Center , Silver Spring , Maryland , USA. 7. g South Texas Veterans Healthcare System , San Antonio , Texas , USA. 8. h Department of Epidemiology and Biostatistics , University of Texas Health Science Center San Antonio , San Antonio , Texas , USA.
Abstract
OBJECTIVE: We review health services and reintegration practices that contribute to the rehabilitation of US active duty service members (ADSMs) and Veterans who experienced traumatic brain injury (TBI), especially mild TBI (mTBI), as discussed at the 2015 Department of Veterans Affairs (VA) TBI State-of-the-Art (SOTA) Conference. METHODOLOGY: We reviewed the state-of-the-art at the time of the previous 2008 TBI SOTA Conference, advances in the field since then, and future directions to address gaps in knowledge. MAIN RESULTS: We reviewed: (1) mTBI and its comorbid conditions documented in ADSMs and Veterans, and recognized the need for additional healthcare utilization, health cost and quality of care studies; (2) VA vocational rehabilitation programmes and the effectiveness of supported employment for helping those with workplace difficulties; (3) the application of technology to assist in TBI rehabilitation, including mobile device applications for self-management, videoconferencing with providers, and virtual reality to help with behavioural and cognitive challenges, and (4) Department of Defense (DoD)-VA partnerships on identification, evaluation and dissemination of TBI best practices. CONCLUSIONS: There have been significant advances in TBI rehabilitation, but multiple areas across the DoD and VA care continuum need further exploration and development to meet the needs of ADSMs and Veterans.
OBJECTIVE: We review health services and reintegration practices that contribute to the rehabilitation of US active duty service members (ADSMs) and Veterans who experienced traumatic brain injury (TBI), especially mild TBI (mTBI), as discussed at the 2015 Department of Veterans Affairs (VA) TBI State-of-the-Art (SOTA) Conference. METHODOLOGY: We reviewed the state-of-the-art at the time of the previous 2008 TBI SOTA Conference, advances in the field since then, and future directions to address gaps in knowledge. MAIN RESULTS: We reviewed: (1) mTBI and its comorbid conditions documented in ADSMs and Veterans, and recognized the need for additional healthcare utilization, health cost and quality of care studies; (2) VA vocational rehabilitation programmes and the effectiveness of supported employment for helping those with workplace difficulties; (3) the application of technology to assist in TBI rehabilitation, including mobile device applications for self-management, videoconferencing with providers, and virtual reality to help with behavioural and cognitive challenges, and (4) Department of Defense (DoD)-VA partnerships on identification, evaluation and dissemination of TBI best practices. CONCLUSIONS: There have been significant advances in TBI rehabilitation, but multiple areas across the DoD and VA care continuum need further exploration and development to meet the needs of ADSMs and Veterans.
Entities:
Keywords:
Assistive technology; cognition; rehabilitation; supported employment; system of care; traumatic brain injury
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