USTA Military Outreach

• Active duty vs veterans
• Know your service branches
• Registration form ~does it apply to military population?
• Patients  (medical clearances, legal clearances)
• Work with hospital or facility staff. Find a contact!  
• What problems is the individual having?
• What are their rehab or individual goals? Make sure they coincide with your program goals.
• You are a part of the rehabilitation team!
• Not everyone is injured in combat (OEF/OIF). Know the difference between ill, injured and wounded.
• Connect with staff in facility (military vs clinician)

Traumatic brain injury (TBI) is being named the "signature injury" for the current war in Iraq & Afghanistan

• TBI occurs when a person’s brain is physically injured, usually by a sudden force i.e. concussive blast or explosion.
• It can also be caused by falls, motor vehicle accidents, assaults, or any sudden blow to the head.
• The injury is unique to the individual much like one’s own signature.
• Invisibly wounded

TBI Stats

• Based on existing data, veterans’ advocates believe that between 10 and 20% of Iraq veterans, or 150,000 and 300,000 people, have some level of TBI. Among wounded troops, the rate of TBI rises to 33%.
• More than 11,800 troops have been seriously injured in an IED attack, and many thousands more have been near enough to suffer a concussion.
• As of October 31st, 2006, only 1,652 soldiers and marines who served in Iraq and Afghanistan have been officially diagnosed with a Traumatic Brain Injury.
• About 7 percent reported both a probable brain injury and current PTSD or major depression.

Mild TBI ~ Present functionally

• Fatigue  (cognitive and physical)
• Headaches (can be triggered by activity, altitude, etc.)
• Visual disturbances
• Short term memory loss
• Poor attention and concentration
• Sleep disturbances
• Dizziness/loss of balance
• Irritability-emotional disturbances
• Feelings of depression
• Sensitivity to light and sounds
• Getting lost or confused
• Slowness in thinking
• Diminished judgment

Moderate TBI~

Severe TBI Deficits

• Physical paralysis/spasticity, chronic pain, control of bowel and bladder
• Cognitive difficulties with attention, concentration, distractibility, memory, speed of processing, confusion, perseveration, impulsiveness
• Speech and Language not understanding the spoken word (receptive aphasia), difficulty speaking and being understood (expressive aphasia), slurred speech, speaking very fast or very slow, problems reading, problems writing

TBI & Sports Activity

• Fatigue—chronic pain, sleep disturbances, and depression. Appropriately timed activities can help tremendously (e.g., certain times of the day, carefully timed bursts of aerobic activity). This applies to cognition as well
• Slowed thinking—Takes longer to process the information. Make sure to have a clear and concise breakdown of tasks.  Don’t overwhelm participant
• Memory and initiation—Have a properly structured workout and use repetitions and review.
• Medications—Ask the participants
• Emotional Behaviors—Impulsivity, poor judgment, indecision, and irritability are all examples. Simply focus on the task or try redirecting the negative behavior.

• Learn new recreation, sports or fitness activities
• Relearn/reconnect previous activities
• Provide participant with new community resources (DSUSA, CAF, Paralympics, local municipalities)
• Increase endurance and overall fitness
• Enhance quality of life though participation n activity
• Introduce participant to adaptive equipment if applicable
• Work collaboratively with rehab staff on patients goals (balance, vestibular, etc.)
• Make activities challenging but safe

Click here for a continuation of this study on Understanding and Working wtih Participants with PTSD/Combat Stress.