Evaluation of the Effectiveness of a Novel Brain and Vestibular Rehabilitation Treatment Modality in PTSD Patients Who have Suffered Combat-Related Traumatic Brain Injuries

Abstract

Introduction: Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a “signature injury.” Vestibular complaints are the most frequent sequelae of mTBI, and vestibular rehabilitation (VR) has been established as the most important treatment modality for this group of patients.Materials and Methods: We studied the effectiveness of a novel brain and VR treatment post-traumatic stress disorder (PTSD) in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as Identifier: NCT02003352. (). We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS) scores pre- and post-treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of <0.05 and power of 80%.Results: Prior to treatment, 75 subjects representing 76.53 % of the sample were classified in the 2 most severe categories of PTSD. Forty-one subjects, representing 41.80 % of the total sample, were classified in the extreme category of PTSD and 34 subjects, representing 34.70 % of the total sample, were classified in the severe category of PTSD. After treatment, we observed a large reduction in CAPS severity scores with both statistical and substantive significance.Discussion: Treatment of PTSD as a physical injury rather than a psychiatric disorder is associated with strong statistical and substantive significant outcomes associated with a decrease of PTSD classification. The stigma associated with neuropsychiatric disorders may be lessened when PTSD is treated with brain and VR with a potential decrease in suffering of patients, family, and society.

Neuropsychiatric Outcomes in UK Military Veterans With Mild Traumatic Brain Injury and Vestibular Dysfunction

“…Carric et al 42 showed a reduction in PTSD, as measured by the CAPS, after 2 weeks of 397 vestibular-ocular co-ordination involving gaze stabilisation, visual pursuit and saccadic 398 eye movement. Carric et al 42 also noted that treating PTSD as a physical injury rather than 399 as a psychiatric disorder helped lessen the stigma that veterans often feel towards help-Page 17…”

Unravelling Functional Neurology: an overview of all published documents by FR Carrick, including a critical review of research articles on its effect or benefit

“…Thus, fourteen articles appeared to have studied the effect/benefit of treatment/intervention. However, six [22][23][24][25][26][27] of these were removed, because there were no control groups and could therefore only report on 'outcome', which may or may not have been caused by the treatment/intervention. Another article [28] was later removed, because, on further scrutiny, it was found not to be appropriate for this review.…”

Neuropsychiatric Outcomes in UK Military Veterans With Mild Traumatic Brain Injury and Vestibular Dysfunction.

“…In preliminary support of this idea, Kleffelgaard et al 41 showed in a case series of 3 civilians with mTBI and dizziness/imbalance that a programme of vestibular rehabilitation was associated with reduced psychological distress and improved health-related quality of life. In veterans, Carric et al 42 showed a reduction in PTSD, as measured by the CAPS, after 2 weeks of vestibular-ocular co-ordination involving gaze stabilisation, visual pursuit and saccadic eye movement. Carric et al 42 also noted that treating PTSD as a physical injury rather than as a psychiatric disorder helped lessen the stigma that veterans often feel towards helpseeking which in turn could encourage treatment uptake.…”

“…In veterans, Carric et al 42 showed a reduction in PTSD, as measured by the CAPS, after 2 weeks of vestibular-ocular co-ordination involving gaze stabilisation, visual pursuit and saccadic eye movement. Carric et al 42 also noted that treating PTSD as a physical injury rather than as a psychiatric disorder helped lessen the stigma that veterans often feel towards helpseeking which in turn could encourage treatment uptake.…”