The Portable Warrior Test of Tactical Agility: A Novel Functional Assessment That Discriminates Service Members Diagnosed With Concussion From Controls

• Published in: Military medicine Vol. 188; no. 3-4; pp. e703 - e710
• Main Authors: Cecchini, Amy Seal, Prim, Julianna, Zhang, Wanqing, Harrison, Courtney H, McCulloch, Karen L
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 20.03.2023
• Subjects: Brain Concussion - complications; Brain Concussion - diagnosis; Forecasting; Humans; Military Personnel; Physical Examination; Task Performance and Analysis
• ISSN: 0026-4075; 1930-613X
• DOI: 10.1093/milmed/usab346

ABSTRACT Introduction Return-to-duty (RTD) readiness assessment for service members (SM) following concussion requires complex clinical considerations. The Portable Warrior Test of Tactical Agility (POWAR-TOTAL) is a functional assessment which improves on previous laboratory-based RTD assessments. Methods Sixty-four SM diagnosed with concussion and 60 healthy control (HC) SM participated in this study. Group differences were analyzed to validate the POWAR-TOTAL. The High-level Mobility Assessment Test (HiMAT) was used to examine concurrent construct validity. An exploratory logistic regression analysis examined predictive validity. Results The groups were demographically well-matched except for educational level. POWAR-TOTAL measures were statistically significantly different between the groups with moderate to large effect sizes. Concussed participants were less likely to be able to complete all trials of the POWAR-TOTAL. Motor scores correlated highly with HiMAT scores. POWAR-TOTAL motor task performance and membership in the control group was significantly associated with self-reported physical readiness to deploy. Conclusion The POWAR-TOTAL is a clinically feasible, military relevant assessment that is sensitive to differences between concussed and HC SM. This analysis supports the discriminant and construct validity of the POWAR-TOTAL, and may be useful for medical providers evaluating RTD readiness for SM who have sustained a concussion.