Back to Top Skip to main content Skip to sub-navigation

The NICoE: Ten years of Healing ‘The Invisible Wounds of War’

Image of man hooked up to machine and walking on treadmill The National Intrepid Center of Excellence at Walter Reed National Military Medical Center houses the Computer Assisted Rehabilitation Environment (CAREN), a magnetoencephalography (MEG) machine used to analyze and train patient movement for peak efficiency and optimal execution. (WRNMMC photo).

Recommended Content:

Traumatic Brain Injury | Posttraumatic Stress Disorder | Centers of Excellence

The National Intrepid Center of Excellence first opened its doors to patients in June 2010, and Military Health System officials celebrated the 10th anniversary of the center, dedicated to advancing the nation’s understanding of and healing the invisible wounds of war, during a ceremony June 25 at the facility.

The interdisciplinary model of care developed at the NICoE, a part of Walter Reed National Military Medical Center, brings together neurologists, psychologists, family care doctors, psychiatrists, nutritionists, neuropsychologists, therapists, specialists and other professionals under one roof. This team collaborates in the diagnosis, treatment and care of MHS beneficiaries affected by traumatic brain injury (TBI) or those who may exhibit symptoms of post-traumatic stress (PTS). Their efforts have proven effective and allowed more than 90 percent of patients treated at the NICoE to continue on active duty in the armed forces, according to NICoE officials.

Research, treatment modalities and services at the NICoE include neuroimaging, art therapy, music therapy, animal-assisted therapy, audiology and vestibular care, a brain fitness center, driving assessment and rehabilitation, family education, and other complementary and integrative medicine techniques such as biofeedback, acupuncture and yoga. This Center of Excellence also houses the Computer Assisted Rehabilitation Environment, a magnetoencephalography machine used to analyze and train patient movement for peak efficiency and optimal execution, and a 3T Magnetic Resonance Imaging scanner, which provides researchers access to cutting-edge image acquisition methods, such as multiband diffusion tensor imaging and echo planar imaging sequences.

Last year, more than 2,000 patients received care from NICoE providers in more than 34,000 clinical encounters in the four-week Intensive Outpatient Program, in TBI outpatient services, and in collaboration with inpatient teams from other WRNMMC directorates, figures from NICoE indicate.

Man painting a mask
The National Intrepid Center of Excellence at Walter Reed National Military Medical Center, which is celebrating its 10th anniversary this year, offers patients affected by traumatic brain injury and post-traumatic stress, driving assessment and rehabilitation, in addition to a number of other treatment modalities. (WRNMMC photo)

Navy Capt. (Dr.) Walter Greenhalgh, NICoE director, credited “the persistent, strong advocacy of leadership from WRNMMC, the National Capital Region Market, the Defense Health Agency and the Department of Defense” for NICoE’s ability to provide “safe, reliable and innovative” health care to the nation’s heroes and their families. He added that, WRNMMC’s leadership has “held a spotlight on NICoE while continuously pushing the NICoE team to strive to be the best that it can be, guiding NICoE to make the most of the amazing resources it’s been granted by the American people, while integrating TBI into the MHS’s Pathway of Care.”

“The WRNMMC leadership has held NICoE to the same high standards of safe, quality health care as they have with the rest of the hospital because the most deserving of patients and their families deserve nothing less,” Greenhalgh said. He added, how the standard of care has extended nationwide through the NICoE network of facilities and providers in the Intrepid Spirit Centers.

Dr. Thomas DeGraba, chief innovation officer and deputy director of NICoE, said what has remained unwavering since the center first opened its doors, is “the outstanding dedication and expertise of the NICoE staff to do what’s necessary at any cost to be able to help service members recover from the injuries they sustained in the protection of this country.”

DeGraba added that, NICoE helped break down the stigma of those treated for TBI and PTS. He explained how TBI and PTS were once thought to be untreatable, and troops were medically dischargedout of the service without a good strategy for recovery.

“This center, along with a number of colleagues through the MHS, have proven [TBI and PTS are treatable],” DeGraba said. “The brain does heal, and service members can come up with strategies to be able to deal with those stressors that have caused them challenges so they can get back to productive lives, as well as get back to the interpersonal relationships with their families and friends that many times are disrupted by TBI and psychological health issues,” he furthered.

Army Col. (Dr.) Andrew Barr, WRNMMC director, also saluted NICoE and its staff for its 10 years of serving the nation, its heroes and their families.

“These past few months and this global pandemic have shown us just how adaptable and resilient we can be in times of great uncertainty and change. NICoE has led the way at this time with innovative approaches to maintain our missions,” Barr said. He added that this is indicative of NICoE achieving countless examples of excellence during his decade-long history.

“The words ‘Center of Excellence’ are more than just buzz words,” Barr continued. “You are a center of excellence in the truest definition of the term. This is reflected in the patient care, research and education that happens here every day, and the tangible, positive improvements made in the lives of our patients and their families.”

“NICoE’s guiding principles of excellence, innovation, compassion, collaboration and honor are evident in all that you do, and your patient- and family-centered holistic approach to TBI research and care, serve as a model throughout the MHS and for many other health organizations across the globe,” Barr concluded.

In an interview published in the February 2015 National Geographic focused on “Healing Our Soldiers, Unlocking the Secrets of Traumatic Brain Injury,” Army Staff Sgt. Perry Hopman discussed how NICoE’s arty therapy program helped him.

Hopman, who served as a flight medic in Iraq, said about the art therapy, “I think this is what started me kind of opening up and talking about stuff and actually trying to get better.”

You also may be interested in...

Military researchers gain new insights into brain injuries

Article
3/16/2021
Military personnel sitting at a table collecting data

Blast injury research helps to fill knowledge gaps about brain injury.

Recommended Content:

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

Army Announces FDA Clearance of Field Deployable TBI Blood Test

Article
3/12/2021
Military personnel standing in the snow preparing to fire a missile

The US Army announced Food & Drug Administration clearance of a field-deployable traumatic brain injury blood test.

Recommended Content:

Traumatic Brain Injury | Brain Injury Awareness Month | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | TBI Information | Brain Injury Awareness Toolkit | Health Innovation Month

HEADS: Protect Your Strongest Weapon

Publication
3/11/2021

This flyer promotes awareness of the key symptoms of concussion/mild TBI.

Recommended Content:

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

Distinguishing between TBIs, psychological conditions key to treatment

Article
3/10/2021
Military personnel holding a gun

Expert says long-lasting symptoms may be a sign of another issue.

Recommended Content:

Traumatic Brain Injury Center of Excellence | A Head for the Future | Traumatic Brain Injury | Brain Injury Awareness Month | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | TBI and Total Force Fitness

New NICoE director sets an ambitious agenda for the future

Article
3/8/2021
Military personnel wearing face mask while talking to each other

The accomplished new leader of the NICoE and Intrepid Spirit Center network has plans for increased services and a higher profile for the unique care center.

Recommended Content:

Traumatic Brain Injury | Brain Injury Awareness Month | TBI Education and Training Events | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Centers of Excellence

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.

Recommended Content:

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

Strategies for hearing loss prevention help service members stay ready

Article
3/3/2021
An infographic with the words "World Hearing Day" at the top, images of people using their hears to listen, and "educate, protect, monitor" at the bottom

The Defense Health Agency is one of many healthcare entities celebrating World Hearing Day on March 3.

Recommended Content:

Hearing Center of Excellence | Hearing and Balance Injuries | Centers of Excellence | Vision and Hearing Loss Prevention

Updated tools and training improve TBI and concussion recovery

Article
3/3/2021
A group of military personnel wearing face mask working on laptop computers

Up-to-date clinical tools help diagnose and manage TBI on and off the battlefield.

Recommended Content:

Traumatic Brain Injury | Traumatic Brain Injury Center of Excellence | TBICoE Podcasts | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Brain Injury Awareness Month | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit

NICoE Brain Injury Awareness/March 2021Events

Publication
3/2/2021

The National Intrepid Center of Excellence (NICoE) is hosting a number of virtual events throughout March 2021 in observance of Brain Injury Awareness Month.

Recommended Content:

Traumatic Brain Injury | Brain Injury Awareness Month | TBI Education and Training Events

March is Brain Injury Awareness Month; TBICoE’s mission lasts all year

Article
3/2/2021
Military health personnel performing a balance test on a patient

Staying a-head of TBI

Recommended Content:

Traumatic Brain Injury Center of Excellence | Brain Injury Awareness Toolkit | A Head for the Future | Brain Injury Awareness Toolkit | Traumatic Brain Injury | Brain Injury Awareness Month | Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Centers of Excellence

Progressive Return to Activity After Concussion Video

Video
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.

Recommended Content:

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

Brain Injury Awareness Month "Be TBI Ready" Infographic

Infographic
2/24/2021
March is Brain Injury Awareness Month. Be TBI Ready. A traumatic brain injury—or TBI—is a blow or jolt to the head that disrupts the normal function of the brain. The severity of the TBI is determined at the time of the injury and may be classified as: mild, moderate, severe, or penetrating.

During Brain Injury Awareness Month, TBICoE and the MHS will promote the theme “Be TBI Ready” — recognizing that health care providers and others in the military community need to be aware of the latest educational trainings, research, fact sheets, and other available resources to prevent, diagnose, and treat TBI.

Recommended Content:

Brain Injury Awareness Month | Traumatic Brain Injury | Traumatic Brain Injury Center of Excellence | TBI Educators | Brain Injury Awareness Toolkit

Returning to Duty After Concussion

Infographic
2/24/2021
What's the best way to recover from a concussion? Returning to duty too soon after a concussion can lead to prolonged symptoms, decreased readiness, poor marksmanship, accidents and falls, and increased risk of more concussions. Progressively increasing activity in a step-wise manner can help you resolve your symptoms and return to duty safely. Ask your primary health care provider about TBICoE's Progressive Return to Activity to help you return to duty as quickly and safely as possible. Visit health.mil/TBICoE.

This TBICoE infographic gives an overview of the risks of returning to duty too soon after a concussion and explains how a progressive increase in activity can help get you back to duty safely. Returning to duty too soon after concussion can lead to prolonged symptoms, poor marksmanship, decreased readiness, accidents and falls, and increased risk of more concussions.

Recommended Content:

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

Progressive Return to Activity Following Acute Concussion/Mild TBI

Publication
2/23/2021

The 2021 Progressive Return to Activity (PRA) Following Acute Concussion/Mild Traumatic Brain Injury Clinical Recommendation is an evidence-based return to activity protocol for primary care managers and concussion/traumatic brain injury (TBI) clinic providers. The PRA is a six-step approach that begins after the provider performs the Military Acute Concussion Evaluation 2 (MACE 2) and diagnoses the patient with a concussion/TBI. The PRA stages start with relative rest and allow service members to gradually increase activities until they receive clearance for return to full duty or activity. In each stage, it offers general and military specific activities and options to help providers manage their patients’ primary symptom clusters. The PRA also offers recommendations on specialty referrals and handouts are available for providers to give patients and leadership.

Recommended Content:

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

Progressive Return to Activity Following Acute Concussion/Mild TBI Provider Training

Publication
2/23/2021

The TBICoE revised the Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury Clinical Recommendation (PRA) and this updated provider training slide deck. The trainings objectives will help providers to identify the key changes to the updated 2021 PRA; explain the rationale for using a PRA protocol for service members post-concussion; understand the criteria for progression following a concussion or mild traumatic brain injury; identify appropriate activities at each stage of progression; understand how to apply primary care management strategies and specialty referral considerations to treat concussed service members who are not progressing as expected; utilize the Tri-Service Workflow mild TBI Alternate Input Method Form to document the PRA in the Armed Forces Health Longitudinal Application.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Provider Education | Provider Resources | TBI Educators | Traumatic Brain Injury | TBI Education and Training Events
<< < 1 2 3 4 5  ... > >> 
Showing results 61 - 75 Page 5 of 17

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.