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Traumatic Brain Injury

According to the Centers for Disease and Prevention (CDC), 1.7 million people are diagnosed with a brain injury each year.

What is Traumatic Brain Injury—or TBI?

TBI occurs as the result from a blow or jolt to the head that disrupts the normal function of the brain. Categories for TBI are:

  • Mild
  • Moderate
  • Severe
  • Penetrating

The most common form of TBI in the military is mild, and is also known as a concussion.

According to the Defense Health Agency Traumatic Brain Injury Center of Excellence (TBICoE), 444,328 service members have been diagnosed with a first-time TBI since 2000. The most common form of TBI in the military is mild, and is also known as a concussion. To learn more about TBI numbers, visit the DOD TBI Worldwide Numbers page.

Traumatic Brain Injury Awareness

TBI Topic Page Review Form

The Traumatic Brain Injury Center of Excellence (TBICoE) manages the content on the Health.mil Traumatic Brain Injury Topic Page for the Defense Health Agency (DHA). To submit content for review and approval to this page, Military Health System agencies and other government partners can download and email this form, along with attached content in a Word document, to the TBICoE website manager at dha.TBICoEinfo@mail.mil.

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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 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 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 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).

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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).

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

MHS Minute March 2021

Video
4/1/2021
Image of MHS Minute Carousel

March marked Brain Injury Awareness month in the military. We're spotlighting efforts across the MHS to combat Traumatic Brain Injury (TBI), and better understand how TBI impacts our Service members. For more information about the National Intrepid Center of Excellence (NICoE), go to walterreed.tricare.mil/NICoE For more info on the Traumatic Brain Injury Center of Excellence (TBICoE), go to Health.mil/TBICoE

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Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Traumatic Brain Injury

Traumatic Brain Injury Awareness

Video
3/8/2021
DHA Seal

A TBI is a blow or jolt to the brain that can be life-altering if the symptoms are not recognized. If you or a loved one experience the symptoms mentioned in this video, speak to a health care professional for more information.

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Traumatic Brain Injury | Brain Injury Awareness Month | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit

Progressive Return to Activity After Concussion Video

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2/25/2021
DHA Seal

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.

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

Sleep and TBI

Video
2/8/2021
DHA Seal

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

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

TBI Champions Roxana Delgado & Victor Medina

Video
11/17/2020
TBI Champions Roxana Delgado & Victor Medina

While he was deployed, retired Army Sgt. 1st Class Victor Medina was in a vehicle that was hit by an explosive device. He sustained a traumatic brain injury (TBI) that severely impaired some of his physical functions and ability to speak. Medina’s wife, Roxana Delgado, continued her pursuit of a Ph.D. in health sciences and became his caregiver. As they adjusted to a life neither one of them had imagined, their marriage became a new kind of partnership.

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Traumatic Brain Injury Center of Excellence | Patient and Family Resources | A Head for the Future | Traumatic Brain Injury

TBI Champion Gary Moran

Video
11/17/2020
TBI Champion Gary Moran

SGM Gary D. Moran shares his TBI recovery story, and tips for talking to kids about TBI.

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Traumatic Brain Injury Center of Excellence | A Head for the Future | Patient and Family Resources | Traumatic Brain Injury

TBI Champion Micah Norgard

Video
11/16/2020
TBI Champion Micah Norgard

After 12 years as an infantryman, Norgard's biggest battle was recognizing the cumulative effects of multiple TBIs.

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Traumatic Brain Injury | Traumatic Brain Injury Center of Excellence | A Head for the Future
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