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Provider Resources

TBICoE develops practical, easy-to-use clinical tools to support military and civilian health care providers in assessing and treating service members and veterans who have sustained a TBI. Providers can access clinically-relevant information and resources that address common symptoms associated with mild TBI, such as headache, sleep disturbances and vision problems. We also offer Provider Education materials for our clinical recommendations and tools.

Most clinical recommendations have related patient resources to help providers educate their patients through recovery. Check out the Patient and Family Resources section to locate fact sheets, family and caregiver support tools.

TBI educators, known as regional education coordinators, may also be available in your location to provide training on our clinical tools. Email TBICoE's dissemination branch to be connected with an REC nearest you.

Supporting TBI Resources for DoDI 6490.11 and DHA-PI 6490.04

The DoDI 6490.11, DOD Policy Guidance for Management of Mild Traumatic Brain Injury/Concussion in the Deployed Setting establishes policy, assigns responsibilities, and provides procedures on the management of mild traumatic brain injury (mTBI), also known as concussion, in the deployed setting. The DHA-PI 6490.04 Required Clinical Tools and Procedures for Assessment and Clinical Management of Mild Brain Injury (mTBI)/Concussion in Non-Deployed Setting establishes the Defense Health Agency's required clinical tools and procedures for management of mTBI/concussion, specifically, the use of the Military Acute Concussion Evaluation, Version 2 (MACE 2) and a progressive return to activity (PRA) framework for the assessment, management, and rehabilitation of all patients with mTBI/concussion.

The following resources specifically support these policies.

Military Acute Concussion Evaluation 2 (MACE 2)

Progressive Return to Activity Following Acute Concussion/Mild TBI

Recurrent Concussion Evaluation Card

Clinical Recommendations for Mild TBI

TBICoE optimizes clinical care by combining evidence from medical literature, health care research and expert opinion to develop and provide clinical suites to help providers deliver evidence-based treatment and address the challenges associated with mild TBI.

Learn more about clinical recommendations and supporting resources.

*NEW* Dizziness and Visual Disturbances Following Mild TBI Clinical Suite

Find and download the new clinical recommendation and supporting resources here!

Dizziness and Visual Disturbances Following Concussion/Mild Traumatic Brain Injury

Sleep Disturbances Following Concussion/Mild TBI

Headache Following Concussion/Mild TBI

Cognitive Rehabilitation Following Mild to Moderate TBI

Neuroimaging Following Concussion/Mild TBI

Neuroendocrine Dysfunction Screening Following Concussion/Mild TBI

Neurocognitive Assessment Tool (NCAT) Testing Following Concussion/Mild TBI

Additional Clinical Support Tools

TBICoE also offers the following tools to assist in the identification, treatment and management of patients with mild TBI in deployed and non-deployed settings.

Find and download the additional tools here.

You also may be interested in...

Acute Concussion Pathway of Care: MACE 2 and PRA Training

Publication
10/26/2021

The Traumatic Brain Injury Center of Excellence is hosting a combined Military Acute Concussion Evaluation (MACE 2) and Progressive Return to Activity (PRA) clinical recommendation virtual training.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | TBI Education and Training Events | TBI Educators | Centers of Excellence

Assessment and Management of Dizziness and Visual Disturbances Following Concussion/Mild Traumatic Brain Injury

Publication
10/22/2021

This clinical recommendation provides medical staff with a single, comprehensive reference for the assessment and management of dizziness and visual disturbances following mild TBI/concussion. Dizziness and visual disturbances often present with overlapping symptoms and should prompt a provider to perform a visual and dizziness—or vestibular—assessment.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | TBI Resources | Centers of Excellence

Improving Relationships after TBI

Publication
10/21/2021

Flier for the Interactive Relationship Building Workshop for Active-Duty Military and Veteran TBI Caregivers and Families: This flier provides information on TBICoE's educational session for caregivers of active-duty service members and veterans who have sustained a TBI. In addition to sharing caregiver resources and current research initiatives, webinar topics will also include relationship building strategies, improving communication and addressing intimacy after TBI.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Patient and Family Resources | Provider Resources | Centers of Excellence | TBI Resources

TBI Hot Topics Bulletin, September 2021 Edition

Publication
10/19/2021

The TBI Hot Topics Bulletin is a product of the TBICoE research branch and provides a quarterly summary of TBI research relevant to health care providers. This issue covers research published April to June 2021.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBICoE Research | Provider Resources

PRA Case Study Workbook

Publication
7/23/2021

This workbook, paired with corresponding PRA Training Video 8, is an interactive clinical case scenario to test your understanding in applying the Progressive Return to Activity. We hope this will help medical providers become more familiar with the PRA process when treating service members with concussion.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 1: PRA Overview

Video
7/22/2021
Thumbnail image of PRA training video 1, PRA overview.

In the first of TBICoE's Progressive Return to Activity (PRA) video training series, you will learn about the reasons for using a progressive return to activity process and receive an overview of the 2021 PRA algorithm and its associated tools. By the end of lesson one, providers will better understand the PRA process, and explain that process to service members diagnosed with concussion. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 2: Six Major Changes

Video
7/22/2021
Thumbnail image of PRA Training Video 2, Six Major Changes

In this lesson we review the six major changes in the TBICoE's revised 2021 Progressive Return to Activity (PRA) Clinical Recommendation that differ from the original recommendation. The changes reflect the latest TBI research, and will make it easier for providers to manage the recovery process and return service members with concussion to full duty as quickly and safely as possible. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 3: Understanding Relative Rest

Video
7/22/2021
Thumbnail image for PRA Training video 3, understanding relative rest

In this lesson we explain the differences between complete rest and relative rest in a staged concussion recovery process, and provide examples of activities that promote relative rest. The revised Progressive Return to Activity (PRA) Clinical Recommendation uses the term 'relative rest' to emphasize the importance of early introduction of physical and cognitive activities that do not provoke symptoms following TBI. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 4: PRA Progression Criteria

Video
7/22/2021
Thumbnail image for PRA Training video 4, PRA progression criteria

In this lesson, we review the criteria for advancing through the stages of the Progressive Return to Activity (PRA) Clinical Recommendation. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 5: The Six Stages of the PRA

Video
7/22/2021
Thumbnail image for PRA training video 5, the six stages of the PRA

In this lesson, we cover the key activity objectives for each of the six stages of the Progressive Return to Activity (PRA) Clinical Recommendation and provide activity examples for each stage. Each stage is designed to gradually increase the intensity and duration of a service member's physical and cognitive activity as they advance in the PRA process. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 6: The Return to Duty Screening

Video
7/22/2021
Thumbnail image of PRA training video 6, the return to duty screening

In this lesson, we cover how to perform the Return to Duty, or RTD screening, which now includes both vestibular/physical and neurocognitive examinations. The purpose of the RTD screening is to objectively measure whether a service member is ready for return to full duty. Each video in the Progressive Return to Activity training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 7: Symptom-Guided Management and Specialty Referral Guidance Tables

Video
7/22/2021
Thumbnail image of PRA training video 7, the symptom-guided management and specialty referral guidance tables.

This lesson covers how to use the Progressive Return to Activity, or PRA's Symptom-Guided Management and Specialty Referral Guidance tables. This lesson also details primary care management strategies for service members who are not progressing as expected in the PRA. Each video in the Progressive Return to Activity training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 8: Clinical Case Scenario

Video
7/22/2021
Thumbnail image of PRA training video 8, clinical case scenario.

This is an interactive clinical case scenario to test your understanding in applying the Progressive Return to Activity (PRA). We hope this will help medical providers become more familiar with the PRA process when treating service members with concussion. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Provider Education | Traumatic Brain Injury

TBI Hot Topics Bulletin May 2021

Publication
7/8/2021

The TBI Hot Topics Bulletin is a product of the TBICoE research branch and provides a quarterly summary of TBI research relevant to health care providers. This issue covers research published January to March 2021.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBICoE Research | Provider Resources | Traumatic Brain Injury

Progressive Return to Activity Following Concussion/mTBI Patient and Leadership Guide

Publication
6/22/2021

The Progressive Return to Activity Following Concussion/mTBI Patient and Leadership Guide alerts command and line leaders about the PRA process and provides service members with appropriate activities for each stage of their recovery.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Resources | Traumatic Brain Injury
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