mTBI clinic opens new facility, enhances active duty transition

By Ms. Ashley E Braun (IMCOM)February 26, 2010

mTBI
Civilian aide to the Secretary of the Army for Connecticut Gil Sanborn listens to Lt. Col. Larry R. Patterson, commander of the Bamberg Health Clinic, explain some of the dynamic assessment and progression programs used at Bamberg's mild Traumatic Br... (Photo Credit: U.S. Army) VIEW ORIGINAL

BAMBERG, Germany - Warner BarracksAca,!a,,c mild Traumatic Brain Injury clinic here is moving forward with a dynamic assessment and progression program to assist Soldiers who have sustained an mTBI and want to return to active duty service.

After observing the Warrior Resiliency Program at Fort Campbell, Ky., BambergAca,!a,,cs mTBI began working to develop a similar program entitled Return to Duty, which will ensure a SoldierAca,!a,,cs preparedness to return to active duty after graduation from the clinicAca,!a,,cs rehabilitation program.

The clinic plans to incorporate pre-deployment training exercises and create mTBI patient teams who will work to complete training missions with the assistance of BambergAca,!a,,cs Training Support Center.

Though the mTBI program has existed at Warner Barracks for more than a year, the recent move to a new facility at Preston Hall has allowed the staff to move forward with some program goals. New treatment and assessment equipment, as well as increased staff, are paving the way for the incorporation of the Return to Duty program.

Civilian aide to the Secretary of the Army for Connecticut Gil Sanborn visited the clinic Feb. 5. Sanborn hopes to raise awareness about mTBI and treatment facilities like the one at Warner Barracks.

Aca,!A"ItAca,!a,,cs so important to have that multidiscipline approach because the issues are complex,Aca,!A? Sanborn said. Aca,!A"ItAca,!a,,cs such a dominant part of the casualties from the conflict. ItAca,!a,,cs so critical in terms of civilian support.Aca,!A?

Sindy McCord, occupational therapist at the clinic, is facilitating the start up of the program.

Aca,!A"The bigger goal for the Army, our Army goal, is for Soldiers to return to duty,Aca,!A? McCord said. Aca,!A"Currently a Soldier comes in and each discipline sees them for the amount of time that they feel is necessary.Aca,!A?

Then the physician decides if the Soldier will go on to medical board or back to active duty.

Aca,!A"It really depends on the Soldier too and what they want to do. Part of our program is to support them through whatever they decide,Aca,!A? she said.

In January, McCord went to Fort Campbell to observe the mTBI clinic and Warrior Resiliency Program there.

Aca,!A"They have one of the top programs,Aca,!A? she said. Aca,!A"The thing that theyAca,!a,,cve been able to accomplish is to integrate the Warrior Resiliency Program with the active duty piece in the community. TheyAca,!a,,cve been able to work with the Training Support Center and the units.Aca,!A?

McCord was able to meet with the programAca,!a,,cs occupational therapist, gather information from the entire team and observe their progress. While there, she also witnessed an engagement skills exercise involving program participants and staff.

They created a scenario to make the Soldiers feel as though they were downrange, simulating special effects such as smoke, gunfire and dummy bodies, she said. The therapist and the TSC participants then observed the group, to assess functionality of the Soldiers involved.

Though Return to Duty is still in the initial stages of development at Warner Barracks, the mTBI clinic has partnered with the local TSC to ensure all the equipment required for deployment readiness is available for Soldiers who complete mTBI rehab and want to remain active duty. The support center is equipped with an Engagement Skills Trainer 2000, Humvee Egress Assistance Trainer, Military Operations in Urban Terrain Site, firing range and all the related facilities and land area for pre-deployment training.

Daniel Cintron, Bamberg TSC chief, discussed the possibility of the support centerAca,!a,,cs involvement in the program with McCord prior to her Fort Campbell TDY.

Aca,!A"She told me we were the test pilot for Bavaria,Aca,!A? Cintron said. Aca,!A"She had some ideas for the program here in Bamberg.Aca,!A?

A disabled veteran himself, Citron was eager to learn how TSC could support the clinic.

Aca,!A"IAca,!a,,cm just excited that I can help in this program,Aca,!A? Cintron said. Aca,!A"I just want to help these men and women over here in the Army. I think the program is outstanding; I wish I had a program like it before I retired.Aca,!A?

Cintron suggested McCord attend the program management review of all regional training support centers, which took place at Warner Barracks on Jan. 19. She briefed attendees on the program and received widespread support.

Aca,!A"YouAca,!a,,cve got to get a military person involved from your side,Aca,!A? Cintron said. Aca,!A"We just provide the training enablers for the units. I told her you need a green-suiter here to run some of the tasks, like land navigation.Aca,!A?

McCord is still working on actively involving unit representatives.

Just as a unit would send out teams to complete training, a team of Soldiers will undergo training once theyAca,!a,,cve graduated from the mTBI program.

Aca,!A"The occupational therapist and the physical therapist engage with the Training Support Center to actually pull them together like a unit,Aca,!A? McCord said. Aca,!A"Say there are five guys in our program, those five guys become a unit and we take them through [the training].Aca,!A?

The clinic maintains equipment, such as balance assessment and virtual reality simulators, to which combat scenarios can be implemented to see a patientAca,!a,,cs progress and ability to adapt cognitively.

Soldiers who want to change their MOS though, or have physical or cognitive limitations which are mild, would be supported with that transition, McCord said. The mTBI clinic staff wants to help that person discover the direction he or she should take.

Though the development and implementation of Return to Duty is a goal for the clinic, the program continues to focus on its main purpose: Rehabilitating Soldiers who have suffered an mTBI.

Aca,!A"This program is about rehabilitation toward functional independence no matter where that is, Army or civilian or change of MOS,Aca,!A? McCord said. Aca,!A"ItAca,!a,,cs about the service members and their Families.Aca,!A?

The staff coordinates treatment through regular meetings and discussions of patient care.

Aca,!A"We meet every week and we also keep in close connection and communication with Behavioral Health Services and with the health clinic,Aca,!A? McCord said. Aca,!A"We want this to be a team effort so thereAca,!a,,cs communication between all the members [of the staff].Aca,!A?

After a person has been referred to the clinic, staff members assess the brevity of his or her situation through initial screenings.

Aca,!A"The first thing I look for is a report of any event that raises the suspicion the Soldier had a mild traumatic brain injury,Aca,!A? said Dr. Juan Hill, neuropsychologist. Aca,!A"We look for any loss of consciousness. We try to get any kind of corroborating information from the commander or anyone else who was there at the scene. The Soldier may not recall what happened; we try to put together a picture through history gathering.Aca,!A?

Hill said one of the major concerns is that the varying mechanisms of war can disorient or daze a person, but if they do not lose consciousness, Soldiers sometimes dismiss these occurrences without seeking treatment.

Aca,!A"Things that are indicative of a mild Traumatic Brain Injury are memory loss of an event, headaches, dizziness,Aca,!A? he said.

Aca,!A"We really encourage the spouse to be involved from the beginning,Aca,!A? McCord said. Aca,!A"The patient is at the center of the treatment.Aca,!A?

The clinic is currently working on developing a video connection for web-based conferences or consultations between staff members here and at other locations. It is also working on acquiring a driving simulator.

Behavioral Health Services, Social Work Services and the Bamberg Health Clinic continue to support the mTBI program and assist team members there through treatment, consultations and referrals. Now that the TSC is also on board, the program has really gained the support of the community and will continue to progress and explore new facets of treatment.

Sanborn hopes to convey the success and progress of the clinic to civilian medical contacts in the United States.

Aca,!A"This is a great facility,Aca,!A? Sanborn said.