Abstract
Objective
To assess the discriminant validity of the Patrol-Exertion Multitask (PEMT), a novel,
multidomain, functional return-to-duty clinical assessment for active duty military
personnel.
Design
Measurement development study.
Setting
Nonclinical indoor testing facility.
Participants
Participants (N=84) were healthy control (HC) service members (SMs; n=51) and military
personnel (n=33) with persistent postconcussive symptoms receiving rehabilitation
(mild traumatic brain injury [mTBI]).
Interventions
Not applicable.
Main Outcome Measures
Known-groups discriminant validity was evaluated by comparing performance on the PEMT
in 2 groups of active duty SMs: HCs and personnel with mTBI residual symptoms. Participant
PEMT performance was based on responses in 4 subtasks during a 12-minute patrolling
scenario: (1) accuracy in identifying virtual improvised explosive device (IED) markers
and responses to scenario-derived questions from a computer-simulated foot patrol;
(2) auditory reaction time responses; (3) rating of perceived exertion during stepping;
and (4) self-reported visual clarity (ie, gaze stability) during vertical head-in-space
translation while stepping.
Results
Significant between-group differences for the PEMT were observed in 2 of 4 performance
domains. Postpatrol IED identification task/question responses (P=.179) and rating of perceived exertion (P=.133) did not discriminate between groups. Participant self-report of visual clarity
during stepping revealed significant (P<.001) between-group differences. SM reaction time responses to scenario-based auditory
cues were significantly delayed in the mTBI group in both the early (P=.013) and late (P=.002) stages of the PEMT.
Conclusions
Findings from this study support the use of a naturalistic, multidomain, complex clinical
assessment to discriminate between healthy SMs 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.
Keywords
List of abbreviations:
AMMP (Assessment of Military Multitasking Performance), HC (healthy control), IED (improvised explosive device), mTBI (mild traumatic brain injury), PEMT (Patrol-Exertion Multitask), RPE (rating of perceived exertion), RT (reaction time), RTD (return to duty), SM (service member), SRT (simple reaction time), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 09, 2017
Footnotes
Support for the Assessment of Military Multitasking Performance validation study was provided by the United States Army Medical Research Materiel Command (award no. W81XWH-12-2-0070). The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
