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TBI 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

ICD-10 Coding Guidance for TBI

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* Neuroimaging Following Concussion/Mild TBI: Guidance for the Primary Care Manager Clinical Recommendation

Find and download the new clinical recommendation here!

Neuroimaging Following Concussion/Mild TBI

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

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.

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Interview with the SEAC: TBI from a Joint Perspective

Video
7/18/2022
Interview with the SEAC: TBI from a Joint Perspective

In this episode of Picking Your Brain, Traumatic Brain Injury Center of Excellence Branch Chief Capt. Scott Cota and clinical moderator Amanda Gano interview the Senior Enlisted Advisor to the Chairman of the Joint Chiefs of Staff (SEAC), Ramón Colón-López. The discussion covers the health impacts of TBI and blast-related concussion stemming from the demands of combat and training. The SEAC also addresses the importance of maintaining medical readiness through education and military leadership. Listen to more Picking Your Brain episodes at www.health.mil/TBIPodcasts, on DVIDS, or wherever you listen to podcasts.

Recommended Content:

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

PRA Training Video 6: The Return to Duty Screening

Video
7/22/2021
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 | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 8: Clinical Case Scenario

Video
7/22/2021
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 | TBI Provider Resources | Provider Education | Traumatic Brain Injury

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

Video
7/22/2021
PRA Training Video 7: 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 | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 3: Understanding Relative Rest

Video
7/22/2021
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 | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 2: Six Major Changes

Video
7/22/2021
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 | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 1: PRA Overview

Video
7/22/2021
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 | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 5: The Six Stages of the PRA

Video
7/22/2021
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 | TBI Provider Resources | Provider Education | Traumatic Brain Injury

PRA Training Video 4: PRA Progression Criteria

Video
7/22/2021
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 | TBI Provider Resources | Provider Education | Traumatic Brain Injury

Progressive Return to Activity After Concussion Video

Video
2/25/2021
Progressive Return to Activity After Concussion Video

The PRA is an evidence-based, easy-to-use approach to help providers return service members with mild TBIs back to duty safely. TBICoE researchers have found that, if medical providers completed a two-hour, in-person training on the use of the PRA, their patients saw an overall reduction in symptoms after one week, one month, and three months, when compared to patients treated by providers who had not received the training.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | TBI Educators | Traumatic Brain Injury | TBI Resources | TBI Screening

Sleep and TBI

Video
2/8/2021
Sleep and TBI

Sleep disturbances are common for service members and veterans following a mild TBI, also known as concussion.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | Patient and Family Resources | TBI Provider Resources | Traumatic Brain Injury | Brain Injury Awareness To Improve Readiness | Brain Injury Awareness To Improve Readiness | Total Force Fitness

MACE 2 Provider Training Video

Video
9/29/2020
MACE 2 Provider Training Video

This video illustrates how to conduct a Military Acute Concussion Evaluation 2 (MACE 2) training event. This video supports the MACE 2 and its training materials created by the Traumatic Brain Injury Center of Excellence (TBICoE).

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury | TBI Provider Resources | TBI Educators | Provider Education
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Last Updated: June 27, 2022

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