{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:45:23Z","timestamp":1792165523885,"version":"4.4.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"5-6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,18]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>There are established protocols for staged return to physical activity in sport and military settings following concussion. Currently, there is no evidence-based staged return to shooting protocol in use by the U.S. military despite the unique challenges and stresses shooting places on the vestibular\u2013ocular and cognitive systems often disrupted by a concussion. The primary purpose of this scoping review was to summarize available evidence and current practices on return to shooting post-concussion, with the goal of optimizing an evidence-based return to shooting protocol for military service members. Our secondary aim was to identify individuals who may benefit from a return to shooting progression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>A comprehensive search of PubMed, SPORTDiscus, and Google Scholar was performed from the earliest dates to April 2023. A gray literature (Google) search was also performed. Articles were included if they studied a population with concussion, addressed return to shooting, and were written in English. Articles were excluded if they discussed health conditions other than concussion, focused on non-shooting interventions, did not use human subjects, or were written in a language other than English.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our search strategy yielded 134 articles: 1 article met our inclusion and exclusion criteria, whereas the other 133 articles were rejected. The gray literature search yielded one item.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Based on our results, there is insufficient evidence to inform current practices on return to shooting post-concussion. In the absence of a published return to shooting protocol, we offer recommendations for identifying individuals who may benefit from a return to shooting progression and a revised version of a U.S. Army Special Operations Command Return to Range Progression. This protocol follows a conceptual framework for progression for variables such as environment, weapon type\/caliber, and shooter position\/movement. Further research is needed on identifying individuals who may benefit from a return to shooting protocol and safely and effectively progressing these individuals through a return to shooting protocol post-concussion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad399","type":"journal-article","created":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T05:37:30Z","timestamp":1697261850000},"page":"e1336-e1342","source":"Crossref","is-referenced-by-count":3,"title":["Post-concussion Return to Shooting Progression for\u00a0Military Service Members: A Scoping Review and\u00a0Conceptual Framework"],"prefix":"10.1093","volume":"189","author":[{"given":"Erin","family":"Smith","sequence":"first","affiliation":[{"name":"Army-Baylor University Doctoral Program in Physical Therapy , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Houtchens","sequence":"additional","affiliation":[{"name":"Army-Baylor University Doctoral Program in Physical Therapy , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pearson","sequence":"additional","affiliation":[{"name":"Army-Baylor University Doctoral Program in Physical Therapy , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery A","family":"Dolbeer","sequence":"additional","affiliation":[{"name":"U.S. Army Special Operations Command , Fort Liberty, NC 28310,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Kneller","sequence":"additional","affiliation":[{"name":"Houston Rockets , Houston, TX 77002,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott M","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center , Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen H","family":"Lambert","sequence":"additional","affiliation":[{"name":"Hearing Center of Excellence , Lackland Air Force Base, TX 78236,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5104-7448","authenticated-orcid":false,"given":"Carrie W","family":"Hoppes","sequence":"additional","affiliation":[{"name":"Army-Baylor University Doctoral Program in Physical Therapy , Joint Base San Antonio\u2014Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"2025012315134758600_R1","article-title":"DOD TBI worldwide numbers","author":"Agency MHSaDH","year":"2023"},{"key":"2025012315134758600_R2","volume-title":"Estimating the Cost of Injuries among U.S. Army Soldiers. 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