Measuring Soldier Performance During the Patrol-Exertion Multitask: Preliminary Validation of a Post-Concussive Functional Return to Duty Metric

Publication date: Available online 10 May 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Matthew Scherer, Margaret M. Weightman, Mary Vining Radomski, Laurel Smith, Marsha Finkelstein, Amy Cecchini, Kristin Jensen Heaton, Karen McCulloch
ObjectiveTo assess the discriminant validity of the Patrol-Exertion Multitask (PEMT), a novel, multi-domain, functional return-to-duty clinical assessment for Active Duty military personnel.DesignMeasurement development studySettingNon-clinical indoor testing facility, Fort Bragg NCParticipants51 healthy control (HC) Service Members and 33 military personnel with persistent post-concussive symptoms receiving rehabilitation (mTBI)InterventionNot applicableMain Outcome MeasuresKnown-groups discriminant validity was evaluated by comparing performance on the PEMT in two groups of Active Duty SM, HC and personnel with mTBI residual symptoms. Participant PEMT performance was based on responses in four sub-tasks during a 12 minute patrolling scenario: a) accuracy in identifying virtual improvised explosive device markers and responses to scenario-derived questions from a computer simulated foot patrol; b) auditory reaction time responses; c) rating of perceived exertion during stepping; and d) self-reported visual clarity (i.e., gaze stability) during vertical head-in-space translation while stepping.ResultsSignificant between group differences for the PEMT were observed in two of four performance domains. Post-patrol IED identification task/ question responses (p=0.179) and Rating of Perceived Exertion (p=0.133) did not discriminate between groups. Participant self-report of visual clarity during stepping revealed significant (p<0.001) between group differences. SM reaction time responses to scenario-based auditory cues were significantly delayed in the mTBI group in both early (p=0.013) and late (p=0.002) stages of the PEMT.ConclusionsFindings from this study support the use of a naturalistic, multi-domain, complex clinical assessment to discriminate between healthy SM and personnel with mTBI residual symptoms. Based on this preliminary study, additional research to further refine the PEMT and extend its application to return-to-work outcomes in military and civilian environments is warranted



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