Assessment of Military Multitasking Performance: Validation of a Dual-Task and Multitask Protocol.

摘要

The Assessment of Military Multitasking Performance (AMMP) is a battery of functional dual-tasks and multitasks based on military activities that target known sensorimotor, cognitive, and physical/exertional vulnerabilities after concussion/mild traumatic brain injury (mTBI). The AMMP was developed to help address known limitations in post concussive return to duty (RTD) assessment and decision making. Using an iterative process using data from both healthy controls (HC) and subjects with mTBI residual symptoms, task refinement has resulted in task metrics with overall excellent interrater reliability. Dual-task metrics in the AMMP battery were most sensitive to between group differences when cognitive loads were added to military relevant motor tasks including the loading of rounds into magazines, walking, or running an agility course. Multiask metrics were sensitive to performance differences in reaction time during a simulated combat patrol and organization and planning during a complex Charge of Quarters duty scenario. Inertial sensor measures of peak velocities during 180 degree turns in normal walking, and exploratory analyses using time series analysis methodologies is demonstrating the potential to correctly categorize healthy control and subjects with mTBI. Once validated, the AMMP, either as a battery or as individual tasks, is intended for use in combination with other metrics to inform duty-readiness decisions in Active Duty Service Members following concussion. There is likely an optimal balance of symptom report, impairment and AMMP functional metrics that can be modeled to optimally discriminate between ready and non-duty ready personnel.