Examining the Relationship Between Conventional Outcomes and Immersive Balance Task Performance in Service Members...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Human Performance

Background:

• Mild traumatic brain injury (mTBI) significantly impacts active duty service members (SMs), causing financial burdens, reduced readiness, and quality of life issues.
• Vestibular impairments, such as chronic dizziness and postural instability, are common post-mTBI symptoms, often exacerbated by psychological comorbidities like PTSD.
• Comprehensive vestibular evaluations are crucial for assessing mTBI-related symptoms and guiding treatment decisions.

Purpose of the Study:

• To investigate the relationship between conventional vestibular assessment outcomes and performance in virtual environments (VEs) using the Computer-Assisted Rehabilitation Environment (CAREN).
• To determine if VE performance can predict conventional clinical outcomes in SMs with mTBI.
• To explore the influence of Post-Traumatic Stress Disorder (PTSD) on these assessments.

Main Methods:

• A retrospective analysis of 112 SMs with mTBI history who underwent vestibular evaluations and completed CAREN immersive balance tasks.
• Conventional outcomes included Sensory Organization Test (SOT), Functional Gait Assessment (FGA), Activities Balance Confidence (ABC) Scale, and Dizziness Handicap Inventory (DHI). PTSD Checklist-Military Version was also administered.
• CAREN outcomes involved time to complete Balance Cubes (BC-Static, BC-PM) and Shark Hunt (SH-Standard, SH-Recall) VEs. Statistical analyses included t-tests, Pearson's correlations, and logistic regressions.

Main Results:

• Faster completion of BC-Static correlated with better overall balance (higher ABC, SOT, FGA scores).
• Objective balance and gait measures (SOT, FGA) showed strong correlations with VE performance (BC-PM, SH-Standard).
• VE performance (BC-Static, BC-PM, SH-Standard) significantly predicted SOT scores. Comorbid mTBI and PTSD were associated with increased disability and diminished VE performance.

Conclusions:

• Objective balance and gait assessments (SOT, FGA) demonstrate strong correlations with immersive VE performance in the CAREN.
• Immersive balance tasks within VEs show potential as adjunctive assessments for evaluating balance in SMs.
• Future research aims to develop portable VE systems for broader clinical accessibility.