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Introducing heart rate variability technology into the UK defence mild traumatic brain injury service
  1. Andrew David Houston1,
  2. H Brunger2,
  3. T White2,
  4. H Ellis2,
  5. S Dharm-Datta2,
  6. K Brockman2 and
  7. P Ladlow1
  1. 1 Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
  2. 2 Neurorehabilitation Unit, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
  1. Correspondence to Dr P Ladlow, Academic Department of Military Rehabilitation (ADMR), Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK; peter.ladlow100{at}mod.gov.uk

https://doi.org/10.1136/bmjmilitary-2022-002113

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    Symptoms following mild traumatic brain injury (mTBI) can include headaches, dizziness, nausea, balance difficulties, cognitive impairments, emotional disturbance, memory impairment, sleep disruption and fatigue.1 While these symptoms typically resolve within a few weeks or months, long-term sequelae are not uncommon. Recovery following mTBI is frequently determined by resolution of symptoms. However, symptoms are poor, non-specific indicators of underlying cognitive and physiological disturbances, and evidence suggests that recovery extends beyond symptom resolution.2

    Autonomic nervous system dysfunction is postulated as one factor producing clinical symptoms during recovery following mTBI.1 Heart rate variability (HRV) (see Figure 1) is reportedly reduced following TBI.3 A reduction in HRV following mTBI may have implications for changes in cardiac demand while performing physically arduous tasks, accelerating fatigue and worsening recovery status, in addition to reducing cerebrovascular perfusion.4 HRV has shown promise as an objective non-invasive, clinically useful tool to monitor mTBI recovery, thereby helping to facilitate clinical decision making.

    Figure 1

    Patient injury history and heart rate variability protocol.

    Any technology that can be used to better inform current and future rehabilitation practice in patients …

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    Footnotes

    • Twitter @andrewhouston95

    • Contributors ADH and PL conceived the study idea; ADH and PL collected the data; ADH analysed the data; ADH, HB and PL interpreted the findings; HB, TW, HE, SD-D and KB were responsible for delivering rehabilitation care; all authors read and confirmed the final manuscript submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.