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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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Healthy Sleep Following Concussion/mTBI Fact Sheet

Fact Sheet
11/16/2022

Getting restful sleep is one of the most important things you can do for your health, and it often takes thoughtful preparation during the day. This fact sheet offers service members and veterans who experience sleep disturbances after a concussion with healthy sleep tips that can likely improve sleep.

Recommended Content:

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

2022 (Q2) DOD Worldwide Numbers for TBI

Report
11/9/2022

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 the calendar year 2022 through the second quarter. The data is also broken down by each branch of the armed services.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DOD TBI Worldwide Numbers | TBI Provider Resources | TBI Educators | TBICoE Research | Armed Forces Health Surveillance Division

2000-2022 Q2 DOD Worldwide Numbers for TBI

Report
11/9/2022

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 from calendar year 2000 through the second quarter of 2022. The data is also broken down by each branch of the armed services.

Recommended Content:

Traumatic Brain Injury Center of Excellence | DOD TBI Worldwide Numbers | TBI Provider Resources | TBI Educators | TBICoE Research | Armed Forces Health Surveillance Division

2021 DOD Worldwide Numbers for TBI

Report
11/9/2022

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 2021. The data is also broken down by each branch of the armed services.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Educators | TBI Provider Resources | DOD TBI Worldwide Numbers

Neuroendocrine Dysfunction Following Concussion/Mild TBI Provider Fact Sheet

Fact Sheet
9/14/2022

The Neuroendocrine Dysfunction Following Concussion/Mild TBI Provider Fact Sheet, developed by TBICoE, is a one page document that gives primary care managers (PCMs) an overview of neuroendocrine dysfunction (NED) that can occur after concussion, or mild TBI. It highlights conditions with overlapping symptoms, screening and treatment considerations, risk factors, and referral guidance for suspected NED.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources

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 Center of Excellence

Neuroimaging Following Mild TBI Clinical Recommendation

Publication
5/16/2022

This TBICoE clinical recommendation allows primary care managers to make an informed, evidenced-based decision regarding whether or not imaging is indicated following a concussion/mild TBI.

Recommended Content:

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

2021 Traumatic Brain Injury Center of Excellence Annual Report

Publication
4/26/2022

The 2021 Traumatic Brain Injury Center of Excellence (TBICoE) Annual Report provides a look at accomplishments and activities from calendar year 2021.

Recommended Content:

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

Acute Concussion Pathway of Care: MACE 2 and PRA Training

Publication
10/26/2021

The Traumatic Brain Injury Center of Excellence is hosting a combined Military Acute Concussion Evaluation (MACE 2) and Progressive Return to Activity (PRA) clinical recommendation virtual training.

Recommended Content:

Traumatic Brain Injury Center of Excellence | TBI Provider Resources | Education & Training Events | TBI Educators | Centers of Excellence

Assessment and Management of Dizziness and Visual Disturbances Following Concussion/Mild Traumatic Brain Injury

Publication
10/22/2021

This clinical recommendation provides medical staff with a single, comprehensive reference for the assessment and management of dizziness and visual disturbances following mild TBI/concussion. Dizziness and visual disturbances often present with overlapping symptoms and should prompt a provider to perform a visual and dizziness—or vestibular—assessment.

Recommended Content:

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

Improving Relationships after TBI

Publication
10/21/2021

Flier for the Interactive Relationship Building Workshop for Active-Duty Military and Veteran TBI Caregivers and Families: This flier provides information on TBICoE's educational session for caregivers of active-duty service members and veterans who have sustained a TBI. In addition to sharing caregiver resources and current research initiatives, webinar topics will also include relationship building strategies, improving communication and addressing intimacy after TBI.

Recommended Content:

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

PRA Case Study Workbook

Publication
7/23/2021

This workbook, paired with corresponding PRA Training Video 8, is an interactive clinical case scenario to test your understanding in applying the Progressive Return to Activity. We hope this will help medical providers become more familiar with the PRA process when treating service members with concussion.

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 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 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
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Last Updated: September 15, 2022
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