By Shannon Collins
/ Published November 30, 2017
A Defense Department study on the benefits of surfing for patients with post-traumatic stress. A clinical tracking tool used to manage patient care. An advanced electroencephalogram and eye tracker.
The traumatic brain injury clinic at Naval Medical Center San Diego and the Naval Health Research Center at Naval Base Point Loma in San Diego are developing and using cutting-edge research to better help service members, their family members and retirees.
At the research center, Kristen Walter is conducting DoD's first research study of its kind on the psychological and physical effects of a surf therapy program for patients with post-traumatic stress disorder and other issues. Almost 70 active duty and reserve component patients from all service branches, primarily the Marine Corps and the Navy, participated in the study.
“Initial results suggest that both PTSD and depression symptoms improve for those affected with the disorders,” Walter said. “We’ve also found our strongest effects are improvements in positive effect and decreases in negative effect. We assess individuals before and after each surf therapy session.”
After this first study, she added, she and her team will look into not only the effects not only of surfing therapy, but also of hiking and other recreational therapies that would be accessible for more patients. She said she has personally noticed the change in the patients.
Sense of Community
“There’s definitely a sense of community here in addition to the surf therapy," she added. “It improves mood, makes people feel better -- more connected to the environment and also to other people.”
Patients typically undergo standard psychotherapies for psychological disorders, but recreational outlets offer them an alternative, Walter said.
“Some people don’t benefit from our standard treatment," she explained. "Getting people actively engaged in their environment, doing things that matter to them -- that’s incredibly important for mental and physical health. It’s really important to study those effects.”
The team designed the algorithm for the clinical tracking tool with Navy Seal patients because of the Seals’ high operations tempo, said Dr. Lars Hungerford, senior clinical research director for the Defense and Veterans Brain Injury Center, which oversees the research at the TBI clinic.
“We created an algorithm and a tool so that we can screen them while they’re still overseas so we’ll know how many people we’ll need to see [and] get them set up so that when they hit the ground here, they’re all set up and running. We can just move on from there,” he said.
On the Same Page
While a patient is undergoing treatment at the hospital, Hungerford said, all of the different specialists who see the patient will put in their notes and appointments and see the patient’s goals so that everyone is on the same page.
“For example, when we first see a patient, we do an intake, meet as a team and come up with a treatment plan for what that person needs," he said. “They need occupational therapy, speech, neuropysch -- that gets put into the referral and gets kicked over to the individual providers, and then they write up their notes and we track all of their symptoms in the system.
“We see they have a headache goal,” he continued. “According to the tracking system, we’ve met, and we’re about halfway through the headache goal, but now they’re complaining more about memory problems, so things might shift as we go along. You can capture that quickly by looking at this system, and [all of the providers] can communicate and coordinate care.”
The eye tracker is used to measure saccade response, or reaction time and speed of response, Hungerford said. The new wireless EEG prototype is portable and doesn’t require liquid or gel.
“With the old EEGs, you had to put on a lot of gel, and patients left with a goopy head and had to go home and take a shower,” he said. “With this prototype, we can apply it within a few minutes and get a nice reading of the EEG waves. When the sensors touch skin, they don’t have to go through hair. They’re flat for comfort and don’t have prongs. It’s advanced technology.”
The new fusion study is using both the eye tracking and EEG at the same time. “That’s probably something that hasn’t been done,” Hungerford said. Looking at the different modalities that diagnose TBIs and comparing what the eyes are doing to what the brain is doing to what the MRI reveals combine to achieve a better understanding of what is going on with the patients, he added.