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Military Health System

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* Neuroendocrine Dysfunction Following Concussion/Mild TBI Provider Fact Sheet


Find and download this new provider tool here!

Neuroendocrine Dysfunction Screening Following Concussion/Mild TBI

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

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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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 Center of Excellence

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 Center of Excellence

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 Center of Excellence

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 Center of Excellence

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 Center of Excellence

Help With Ongoing Symptoms Following Concussion/Mild TBI Fact Sheet

Fact Sheet
4/28/2021

Although the majority of service members recover from concussion with little to no intervention, some experience symptoms beyond the first three months after their initial injury. This fact sheet addresses why symptoms continue to persist in some patients and how they can cope or seek additional help.

Recommended Content:

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

MACE 2 Provider Training Refresher

Publication
4/5/2021

This version of the MACE 2 Provider Training is a shortened refresher of the full-length training slides.

Recommended Content:

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

Vision Problems After Concussion Fact Sheet

Fact Sheet
3/30/2021

This TBICoE fact sheet helps patients diagnosed with a concussion/mild TBI understand vision problems and provides insight into treatment options.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Patient and Family Resources | TBI Provider Resources | Centers of Excellence | Traumatic Brain Injury Center of Excellence | | Vision and Hearing Loss Prevention

TBI Hot Topics Bulletin March 2021

Publication
3/24/2021

Are you a busy health care provider? Not enough time to keep up with the latest TBI research trends and news? Stay informed with the TBI Hot Topics Bulletin. TBICoE tracks the latest TBI scientific studies, advances, and discoveries most relevant to health care providers. This issue covers the fourth quarter of calendar year 2020.

Recommended Content:

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

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 Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence

TBICoE 2020 Publications

Publication
2/25/2021

Master list of 2020 TBICoE Research Publications.

Recommended Content:

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

Returning to Duty After Concussion

Infographic
2/24/2021
Returning to Duty After Concussion

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

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 | TBI Provider Resources | TBI Educators | Education & Training Events

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 Center of Excellence | Brain Injury Awareness | Brain Injury Awareness | Total Force Fitness

2020 DOD Worldwide Numbers for TBI

Publication
1/28/2021

TBICoE is the Defense Department's office of responsibility for tracking traumatic brain injury data in the U.S. military. Here you'll find data on the number of active-duty service members—anywhere U.S. forces are located—with a first-time TBI diagnosis in calendar year 2020. The data is also broken down by each branch of the armed services.

Recommended Content:

Traumatic Brain Injury Center of Excellence | Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Patient and Family Resources
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Last Updated: September 15, 2022
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