At a new clinic for troops, doctors tackle a complex interplay between head injuries and posttraumatic stress

...The first stop for patients is a room with a large sectional couch. Here, patients tell their story to a team of specialists who will follow them throughout their stay, including a neurologist, psychiatrist, internist, physical therapist, and a spiritual adviser of their choosing. This arrangement eliminates the need for patients to relive their trauma each time they tell another doctor their story. Family members also attend this introductory session, and patients leave with a set of goals and a rehab plan for their stay of typically 2 to 3 weeks. “High-touch” features at NICoE include a large room for art therapy.

The “high-tech” component includes several virtual-reality environments, including a CAREN system, one of only seven in North America. A 180-degree video screen wraps around a 3-meter circular platform with a treadmill, and 12 infrared cameras monitor a patient’s movement as the platform rotates and tilts (patients wear a harness). Therapists use the system to assess patients’ balance and coordination in situations that mimic real life, such as walking down a city street. Many patients can walk a straight line down the hall in a doctor’s office. But reality is more complicated, and a patient’s balance problems can be compounded by attention deficits (a symptom of TBI) or hypervigilance (a symptom of PTSD)...

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