Vestibular Balance Deficits Following Head Injury: Recommendations Concerning Evaluation and Rehabilitation in the Military Setting

Vestibular Balance Deficits Following Head Injury: Recommendations Concerning Evaluation and Rehabilitation in the Military Setting
http://www.dtic.mil/dtic/tr/fulltext/u2/a557843.pdf

ARMY AEROMEDICAL RESEARCH LAB FORT RUCKER AL
Lawson, Ben D ; Rupert, Angus H ; Legan, Shauna M
27 Feb 2012




Vestibular pathology has been documented following barotrauma and/or head acceleration associated with exposure to explosions. The usual symptoms include dizziness and headache, with dizziness and associated imbalance contributing disproportionately to disability. Several agencies have noted the need for better vestibular evaluation and rehabilitation following exposure to improvised explosive devices (IEDs). The authors asked subject matter experts to assist in formulating recommendations for initial assessment and rehabilitation of balance problems following IED exposure, focusing on strategies that are either available or in development. This report summarizes feedback obtained from approximately 50 vestibular researchers, scientific advisors, clinicians, and biomedical engineers working for government agencies, universities, clinics/hospitals, and businesses. Tests appropriate for early (post-injury) functional assessment in the military setting are considered, along with the optimal application of novel tactile balance feedback technologies being developed to augment vestibular rehabilitation.


Descriptors : *EXPOSURE(GENERAL), *HEAD(ANATOMY), *IMPROVISED EXPLOSIVE DEVICES, *REHABILITATION, *WOUNDS AND INJURIES, CLINICAL MEDICINE, CONCUSSION, EQUILIBRIUM(GENERAL), EXPLOSIONS, HEADACHES, INCAPACITATION, SIGNS AND SYMPTOMS, TRAUMATIC BRAIN INJURIES, VERTIGO, VESTIBULAR APPARATUS

United States Air Force School of Aerospace Medicine Laser Injury Guidebook

United States Air Force School of Aerospace Medicine Laser Injury Guidebook
http://www.dtic.mil/dtic/tr/fulltext/u2/a559312.pdf

Special rept. Nov 2011-Apr 2012
AFRL-SA-WP-SR 2012-0005

SCHOOL OF AEROSPACE MEDICINE WRIGHT PATTERSON AFB OH AEROSPACE MEDICINE DEPT
 Gooch, John M ; Harvey, Richard R ; Parham-Bruce, Wanda ; Rogers, Bret Z ; McLin, Jr, Leon N

The primary purpose of the laser injury guidebook is to provide guidelines and instructions for flight surgeons' interaction with potential laser beam exposures in aircrew and ground personnel. The intent is to provide an evaluation and initial management process to assess and respond to laser beam exposures of ocular and adnexal injury. Subjects covered in detail include the laser beam exposure threat in the HR aviation environment and the role of the flight surgeon in the management of laser beam exposures. Specifically, history, external examination, near visual acuity testing, far visual acuity testing, Amsler grid testing, pupils evaluation, stereopsis evaluation, color vision, slit lamp, dilation fundoscopy, and vitreoretinal hemorrhage are covered in detail. A point of contact list is provided as well as a suggested list of supplies and equipment. A laser beam incident questionnaire is included.


Descriptors : *FLIGHT CREWS, *FLIGHT SURGEONS, *LASER BEAMS, *WOUNDS AND INJURIES, COLOR VISION, EXPOSURE(PHYSIOLOGY), GROUND CREWS, HISTORY, INSTRUCTIONS, INTERACTIONS, LASER HAZARDS, MEDICINE, QUESTIONNAIRES, RETINA, STEREOSCOPES, STUDENTS, TEST AND EVALUATION, THREATS, VISUAL ACUITY

Comparison of Motionlogger Watch and Actiwatch Actigraphs to Polysomnography for Sleep/Wake Estimation in Healthy Young Adults

Comparison of Motionlogger Watch and Actiwatch Actigraphs to Polysomnography for Sleep/Wake Estimation in Healthy Young Adults


WALTER REED ARMY INST OF RESEARCH WASHINGTON DC DEPT OF BEHAVIORAL BIOLOGY
Rupp, Tracy L. ; Balkin, Thomas J.


Sleep/wake identification and sleep parameter estimates from Motionlogger Watch and Actiwatch-64 actigraphs were compared to polysomnography (PSG). Following one night of baseline sleep, 29 volunteers remained awake for 36 h, followed by 11 h of recovery sleep in the laboratory. Two sets of analyses were performed: (1) epoch-by-epoch agreement and discriminability index (d') calculations, and (2) sleep parameter concordance with repeated measures ANOVAs. Sensitivity (sleep identification), specificity (wake detection), and overall agreement with PSG, as well as d' were higher for the Motionlogger than for Actiwatch. Relative to PSG, the Actiwatch-estimated total sleep time and sleep efficiency were underestimated and the number of awakenings was overestimated for baseline and recovery;sleep latency was underestimated on the baseline night. On the other hand, the Motionlogger-estimated total sleep time and sleep efficiency estimates were underestimated, and the sleep latency was overestimated on recovery, versus PSG. Despite these misestimations, it was concluded that the Motionlogger provided nominally better agreement with PSG, and that actigraphy generally constitutes a reasonably reliable tool for producing objective measurements of sleep/wake, but that users should remain mindful of its limitations.



*SLEEP DEPRIVATION, ANALYSIS OF VARIANCE, ESTIMATES, TIME, INSOMNIA, ADULTS, ELECTROENCEPHALOGRAPHY, SLEEP, HUMANS

Longitudinal Study of Sleep Patterns of United States Military Academy Cadets

http://www.dtic.mil/dtic/tr/fulltext/u2/a535854.pdf

Longitudinal Study of Sleep Patterns of United States Military Academy Cadets

NAVAL POSTGRADUATE SCHOOL MONTEREY CA DEPT OF OPERATIONS RESEARCH


 Miller, Nita L. ; Shattuck, Lawrence G. ; Matsangas, Panagiotis

2010

The study provided an opportunity to observe sleep patterns in a college-age population attending the United States Military Academy. This 4-year longitudinal study investigated sleep patterns of cadets. A stratified sample of 80 cadets had sleep patterns monitored using actigraphy for 8 months: one month in both fall and spring academic semesters over a 4-year period. Data were collected at the United States Military Academy, West Point, NY. Participants were members of the class of 2007 (n~1300) ranging in age from 17 to 22 when entering USMA. A sample of the class (n = 80) wore wrist activity monitors and completed activity logs for one month in fall and spring academic semesters for the 4-year period. On average over the 4 years, cadets slept < 5.5 h on school nights. Cadets napped extensively, perhaps in an attempt to compensate for chronic sleep debt. Cadets slept more during fall than spring semesters. Male and female cadet sleep patterns varied dramatically, with males consistently receiving less sleep than females (~21 m for nighttime sleep and ~23 m for daily sleep). Cadet sleep at USMA is related to academic year, semester, season, sex, school day or weekend, and day of the week. These students suffer from chronic sleep debt. Restrictions imposed by the military academy limit the generalizability of the findings to other college age populations.


Descriptors : *SLEEP, *CADETS, PATTERNS, SLEEP DEPRIVATION,  SEASONAL VARIATIONS,

Sleep and Fatigue Issues in Continuous Operations: A Survey of U.S. Army Officers

Sleep and Fatigue Issues in Continuous Operations: A Survey of U.S. Army Officers

http://www.dtic.mil/dtic/tr/fulltext/u2/a534777.pdf

NAVAL POSTGRADUATE SCHOOL MONTEREY CA DEPT OF OPERATIONS RESEARCH


2009




 A group of 49 US Army Officers recently returned from combat and attending the Infantry Officers Advanced Course at FT Benning, GA were surveyed to assess the sleep hygiene of their units and to determine the tactics, techniques, and procedures (TTPs) they used to reduce the effects of sleep deprivation in their units. Results indicate that despite Army policy, nearly 80% of the study participants had not received a sleep management plan during their most recent deployment. Over half (55%) of respondents reported that fatigue was a problem in their unit. The majority of respondents who received a sleep plan briefing indicated that their unit had done a good job of managing sleep routines (66% with vs. 25% without sleep plan briefing). Attention to the importance of sleep and fatigue management, manifested by sleep plan briefings, seems to be an important means by which units can mitigate fatigue in continuous combat operations. Respondents reported that during their most recent combat deployment, they spent nearly half (46.7%) of their time at high operational tempo (OPTEMPO). This factor becomes especially important when considering that survey respondents report receiving only four hours of sleep per day during periods when their units are at high OPTEMPO, just over half the amount the report when at low OPTEMPO (4.0 vs. 7.8 hours). The vast majority of respondents (82.6%) report feeling sleep-deprived occasionally, sometimes or all the time while they are at high OPTEMPO

*FATIGUE, *OFFICER PERSONNEL, *SLEEP DEPRIVATION, *PERFORMANCE(HUMAN), *ARMY PERSONNEL, SURVEYS, ARMY OPERATIONS, HYGIENE, MANAGEMENT PLANNING AND CONTROL