Mild Traumatic Brain Injury is a serious issue affecting many Soldiers today. The physical stresses and dangers of repeat deployments have increased the probability that a Soldier will be affected by mTBI, and due to its complexity, treatment is often delayed.

Bamberg is one of the first posts in Bavaria to bolster its health care commitment to its Soldiers and community by opening a facility to specifically diagnose and treat mTBI.

Set to become a fully functioning facility in December, part of Preston Hall will be transformed into Warner Barracks' own mTBI clinic. The program for treating these injuries has been in place for some time, at the Behavioral Health Services building, but will now have a separate location and increased staff.

Although Soldiers are often involved in training exercises and highenergy activities outside of deployment rotations, mTBI is a heightened occurrence during deployments.

"There is a qualitative difference between non-deployed and deployed injuries because during deployment the stress is so much higher," mTBI psychologist Dr. Alan Scheuermann said. "Your brain is so much more keyed up due to the stress chemicals in the body that are required of someone in the combat zone."

Scheuermann gave an example of a person sustaining a sportsrelated injury. If a football player is injured during a game, there is a backup person on the bench to replace the injured teammate, he
said. A Soldier does not have the luxury, or does not want to "step out of the game" downrange.

Much of the literature on mTBI suggests it often goes untreated, or treatment is delayed.

"I think a lot of people don't recognize the immediate symptoms of a concussion," Scheuermann said. "So it might go left untreated initially, and if the stress is so high, they may not notice the impact of a concussion until much later, because they're focused on so many other extremely important things."

Not having time to rest or recuperate when a battle scenario occurs, Soldiers often don't have their injuries assessed until much later, he said.

Although it is difficult to adjust to the ever-changing circumstances of war, Scheuermann feels an establishment like the mTBI clinic is an adaptive step.

"The Army has been making huge amounts of change to deal with this sooner and closer to the point of injury," he said.

Scheuermann expressed the goal of mTBI providers at Warner Barracks.

"Given the research at this point in time, we're assuming that [most] people who have had concussions...will be able to return to their previous level of function, but not all," he said. "Some may not be able to, but we still have every intent and expectation they can return to a greater level of function."

Program professionals agree the new facility will benefit Bamberg community members suffering from mTBI.

"The mTBI clinic is actually a primary care driven and integrated program because it has physical and mental health components to it," Scheuermann said.

"Having a separate building allows all of the providers to work together as a team...so we can quickly assess and treat these folks more efficiently, and get them back to full capability."

Sindy McCord is an occupational therapist in the mTBI program. She discussed her role on the team.

"The occupational therapist is just as much a part of the screening process before diagnosis," she said. "Each discipline has a different perspective to bring to the table on determining the Service Member diagnosis. Even though we are not able to diagnose we certainly assist in identifying the service member's areas of deficits, and in turn, assist the doctor in making the determination."

Occupational therapists work in a variety of settings and with all ages and populations, McCord said.

She said the more holistic approach of the practice enables the therapist to treat the entire person, not just the injury. Stress management, job skills and general life training allow for a smoother reintegration into Army or civilian society.

"The role of occupational therapy practitioners is to help military personnel maintain their highest level of performance for daily life skills as well as support for their dependents," she said.

Currently under renovation, the front half of Preston Hall, will serve as the mTBI clinic on Warner Barracks. The auditorium will remain.

Unit physician's assistants and primary care doctors can give referrals for the mTBI clinic, but Soldiers will also be welcome to seek treatment at the clinic on their own, Scheuermann said.

The process would begin with a case manager who would direct appointments to a variety of professionals. Aside from administration, the staff includes physical and occupational therapists, a neuropsychologist, psychologist, psychiatrist and audiologist.

The neurologist in Vilseck is relied upon, Scheuermann said, so that a drive to Landstuhl is not a regular necessity for patients.

The team also uses the services of an optometrist when needed.

"A multi-disciplinary team is essential in the successful assessment and treatment of the service member," McCord said. "Communication is the key to quality care and especially inviting service members and their families to be part of the development of their personal plan of care."

McCord said the new site will be a big change for the team, who previously worked side by side with behavioral health professionals.

"There is certainly a plus side to having our new site in relation to having more space for the team as well as activity space for the service member," she said. "I will miss being in such close proximity of our amazing behavioral health professionals, however, I am confident we will continue to maintain close communication by attending meetings, and staffing between all health care facilities."

For more information on the Warner Barracks mTBI program, call 469-7984.

Page last updated Wed October 21st, 2009 at 08:01