Improving Psychological and Vestibular Health Using a Novel Intervention: The Making Informed Decisions in Gaze and Postural Stability (MINDGAPS) System
Abstract
Objectives and Rationale: The overall goal of this research is to assess and refine a novel intervention system for vestibular rehabilitation: the Making INformed Decisions in Gaze And Postural Stability (MINDGAPS) system, to prepare for a future large-scale clinical trial and promote translation into practice. The objectives of this proposal are three-fold: (1) examine the ability of MINDGAPS-informed rehabilitation to improve psychological health and vestibular disturbance in a cohort of Service Members (SMs) with mild traumatic brain injury (mTBI), (2) develop military-specific vestibular normative data to inform care decisions, and (3) refine the MINDGAPS system in collaboration with a community advisory board (CAB). The CAB will consist of military SMs with mTBI (and caregivers), as well as clinicians. We will use community-based participatory research to refine MINDGAPS and ensure it is well-suited to SMs, family members, and clinicians. Vestibular disturbance (i.e., inner ear dysfunction) is one of the most common and debilitating sequelae of mTBI and includes symptoms such as dizziness, poor balance, blurred vision, vertigo, motion sensitivity, and brain fog. These symptoms are present in up to 80% of SMs who have sustained mTBI and are also strongly linked to poor psychological health. Unfortunately, the effectiveness of vestibular rehabilitation in practice is limited by lack of access to vestibular assessment and lack of personalization of care. In particular, military settings (i.e., Military Treatment Facilities or downrange settings) have limited access to vestibular testing equipment due to high cost, the time-consuming nature of the testing, and the need for specialized training to use the equipment. In the case of mTBI occurring in a far-forward, austere environment, the Warfighter is left without access to critical vestibular assessment and rehabilitation tools. Applicability of the Research: This project aligns directly with the Fiscal Year 2021 Traumatic Brain Injury and Psychological Health Research Program Translational Research Award. Specifically, the proposed each of the three Focus Areas: Understand – Understanding of…factors contributing to an individual’s response, recovery, and long-term outcomes following mTBI. This project is designed to advance the understanding of an established link between vestibular disturbance and poor psychological health in SM with mTBI. Prevent –Development of clinical decision-making frameworks or tools that incorporate objective assessments. The MINDGAPS system uses wearable sensors to precisely measure objective and extensively validated surrogates of vestibular health. Treat – Research will address immediate and long-term treatments and improvements in systems of care, including access to and delivery of healthcare services. Vestibular assessment is key to effective care, as it allows for personalization of a treatment program and monitoring of progress over time. MINDGAPS is inexpensive and efficient (performed in <10 minutes), thereby enabling its integration in a variety of care settings (e.g., clinic, home, far-forward military settings). Patient Population: Patients in this study will include active-duty and Veteran SMs with sub-acute and chronic mTBI. Completion of this study will have an immediate impact on our understanding of the relationship between vestibular dysfunction and psychological health in SMs with mTBI and will position the work to move forward to a large clinical trial. Clinical Application, Benefits and Risks: The MINDGAPS system is intended to be user-friendly for care providers with minimal additional training, thereby expanding accessibility to vestibular assessment and rehabilitation. However, implementation into clinical care may face unexpected challenges. Therefore, a CAB will be consulted throughout our investigation. Via this work, we hope to troubleshoot implementation challenges. This will also allow for a r
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2220061
Entities
People
- Brian J Loyd
Organizations
- United States Army
- University of Montana