Objective Dual-task Turning Measures for Return-to-duty Assessments

NCT ID: NCT03892291

Last Updated: 2025-06-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

185 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-09-01

Study Completion Date

2024-09-01

Brief Summary

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The overall objective is to evaluate objective dual-task turning measures for use as rehabilitative outcomes and as tools for return-to-duty assessments in individuals with mild traumatic brain injury (mTBI).This project consists of three goals examining the I) Diagnostic Accuracy, II) Predictive Capacity, and III) Responsiveness to Intervention of dual task turning measures in individuals with mTBI.

The investigators hypothesize that objective measures of dual-task turning will have high diagnostic accuracy, predictive capacity, and responsiveness to intervention in people with mTBI.

Detailed Description

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The purpose of this project is to expand the investigators' prior preliminary work on wearable sensors to evaluate objective dual-task turning measures for use as rehabilitative outcomes and as tools for objective return-to-duty assessments following mild traumatic brain injury (mTBI). The investigators will assess the diagnostic accuracy, predictive capacity, and responsiveness to intervention of measures obtained from clinically feasible, dual-task turning tasks in an effort to evaluate the utility of turning measures for clinical return-to-duty decisions.

This study is divided into two phases. For phase one, participants will be recruited from the general populations surrounding four sites (Oregon Health \& Science University, the University of Utah, Courage Kenny Research Center, and Fort Sam Houston), including active duty service members at Fort Sam Houston. For phase two, participants will be recruited from active duty service members referred to military medical treatment facilities (Warrior Recovery Center, Madigan Army Medical Center) for vestibular rehabilitation following mTBI.

Phase One: Fifty civilian individuals with mTBI, 50 healthy control individuals, and 40 healthy control active duty service members will be recruited for phase one. Participants will complete a battery of clinical, neuropsychological, and balance tests, including three clinically feasible turning tasks while wearing inertial sensors. The investigators will evaluate the capability of objective, dual-task turning measures to discriminate between healthy controls and people with chronic mTBI, determine clinically relevant measures of dual-task turning based on clinometric properties (e.g., minimum detectable change), and determine whether active-duty SMs perform dual-task turning tasks differently than civilians, assess the capacity of dual-task turning measures to predict performance in a civilian-relevant task, and assess the capacity of dual-task turning measures to predict performance in a military-relevant task.

Phase Two: Forty active-duty service members with mTBI referred to vestibular rehabilitation at the Warrior Recovery Center or Madigan Army Medical Center will be recruited for phase two. Participants will complete a selected turning task from phase one at the beginning and end of the treatment. The investigators will determine the clinically important difference of turning outcomes and compare the effect of rehabilitation to the minimum detectable change for each outcome.

Conditions

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Mild Traumatic Brain Injury Gait Balance Veterans Mobility

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Civilian mTBI

Civilians with persistent symptoms from mTBI

No interventions assigned to this group

Civilian Control

Civilian healthy controls

No interventions assigned to this group

Active Duty Control

Active duty service member healthy controls

No interventions assigned to this group

Active Duty mTBI

Active duty service members with persistent symptoms from mTBI who are referred for physical therapy due to their symptoms

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

Participants may be active duty (at FSH), Veterans or non-Veterans or a civilian and must:

1. have a diagnosis of mTBI based upon VA/DoD criteria
2. be between 18-50 years-old,
3. be outside of the acute stage (\> 3 weeks post-concussion) according to the VA/DoD clinical practice guidelines but within 3 years of their most recent mTBI and still reporting symptoms.

Exclusion Criteria

Participants must not:

1. have had or currently have any other injury, medical, or neurological illness that could potentially explain balance deficits (e.g., central or peripheral nervous system disease, stroke, greater than mild TBI, lower extremity amputation, recent lower extremity or spine orthopedic injury requiring a profile)
2. meet criteria for moderate to severe substance-use disorder within the past month, as defined by DSM-V,
3. display behavior that would significantly interfere with validity of data collection or safety during study,
4. be in significant pain during the evaluation (7/10 by patient subjective report),
5. be a pregnant female (balance considerations), or
6. unable to communicate in English.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Courage Kenny Research Center

UNKNOWN

Sponsor Role collaborator

University of Utah

OTHER

Sponsor Role collaborator

Fort Sam Houston

UNKNOWN

Sponsor Role collaborator

Warrior Recovery Center

UNKNOWN

Sponsor Role collaborator

Madigan Army Medical Center

FED

Sponsor Role collaborator

Oregon Health and Science University

OTHER

Sponsor Role lead

Responsible Party

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Laurie King

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Laurie King

Role: PRINCIPAL_INVESTIGATOR

Oregon Health and Science University

Locations

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Warrior Recovery Clinic

Fort Carson, Colorado, United States

Site Status

Courage Kenny Research Center

Minneapolis, Minnesota, United States

Site Status

Oregon Health & Science University

Portland, Oregon, United States

Site Status

Fort Sam Houston

San Antonio, Texas, United States

Site Status

University of Utah

Salt Lake City, Utah, United States

Site Status

Madigan Army Medical Center

Lakewood, Washington, United States

Site Status

Countries

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United States

References

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Fino PC, Parrington L, Walls M, Sippel E, Hullar TE, Chesnutt JC, King LA. Abnormal Turning and Its Association with Self-Reported Symptoms in Chronic Mild Traumatic Brain Injury. J Neurotrauma. 2018 May 15;35(10):1167-1177. doi: 10.1089/neu.2017.5231. Epub 2018 Mar 23.

Reference Type BACKGROUND
PMID: 29078732 (View on PubMed)

Scherer MR, Weightman MM, Radomski MV, Davidson LF, McCulloch KL. Returning service members to duty following mild traumatic brain injury: exploring the use of dual-task and multitask assessment methods. Phys Ther. 2013 Sep;93(9):1254-67. doi: 10.2522/ptj.20120143. Epub 2013 Jun 13.

Reference Type BACKGROUND
PMID: 23766395 (View on PubMed)

King LA, Mancini M, Fino PC, Chesnutt J, Swanson CW, Markwardt S, Chapman JC. Sensor-Based Balance Measures Outperform Modified Balance Error Scoring System in Identifying Acute Concussion. Ann Biomed Eng. 2017 Sep;45(9):2135-2145. doi: 10.1007/s10439-017-1856-y. Epub 2017 May 24.

Reference Type BACKGROUND
PMID: 28540448 (View on PubMed)

Fino PC, Michielutti PG, Pelo R, Parrington L, Dibble LE, Hoppes CW, Lester ME, Weightman MM, King LA. A Hybrid Assessment of Clinical Mobility Test Items for Evaluating Individuals With Mild Traumatic Brain Injury. J Neurol Phys Ther. 2023 Apr 1;47(2):84-90. doi: 10.1097/NPT.0000000000000427. Epub 2022 Dec 19.

Reference Type DERIVED
PMID: 36538333 (View on PubMed)

Parrington L, King LA, Hoppes CW, Klaiman MJ, Michielutti P, Fino PC, Dibble LE, Lester ME, Weightman MM. Exploring Vestibular Ocular Motor Screening in Adults With Persistent Complaints After Mild Traumatic Brain Injury. J Head Trauma Rehabil. 2022 Sep-Oct 01;37(5):E346-E354. doi: 10.1097/HTR.0000000000000762. Epub 2022 Jan 20.

Reference Type DERIVED
PMID: 35067602 (View on PubMed)

Fino PC, Weightman MM, Dibble LE, Lester ME, Hoppes CW, Parrington L, Arango J, Souvignier A, Roberts H, King LA. Objective Dual-Task Turning Measures for Return-to-Duty Assessment After Mild Traumatic Brain Injury: The ReTURN Study Protocol. Front Neurol. 2021 Jan 15;11:544812. doi: 10.3389/fneur.2020.544812. eCollection 2020.

Reference Type DERIVED
PMID: 33519659 (View on PubMed)

Other Identifiers

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W81XWH1820049

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

18749

Identifier Type: -

Identifier Source: org_study_id

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