Effectiveness of Combining Compensatory Cognitive Training and Vocational Intervention vs. Treatment as Usual on Return to Work Following Mild-to-Moderate Traumatic Brain Injury: Interim Analysis at 3 and 6 Month Follow-Up

Howe, Emilie Isager; Fure, Silje C. R.; Løvstad, Marianne; Enehaug, Heidi; Sagstad, Kjersti; Hellstrøm, Torgeir; Brunborg, Cathrine; Røe, Cecilie; Nordenmark, Tonje Haug; Søberg, Helene Lundgaard; Twamley, Elizabeth W.; Lü, Juan; Anđelić, Nada

doi:10.3389/fneur.2020.561400

Cited by 13 publications

(13 citation statements)

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“…The aim of the rehabilitation was to assist the patients’ return to daily life activities and work by providing information, support and recommendations. The outpatient clinic treatment is described in more detail in a study by Howe et al 28 In the control group, the family members were invited to attend a 2.5-hour psychoeducational group session conducted by an occupational therapist and a psychologist from the multidisciplinary team. The group session focused on brain anatomy, traumatic brain injury and post-injury challenges in functioning and in resuming daily life activities and work, but not specifically on family functioning.…”

Section: Methodsmentioning

confidence: 99%

The effectiveness of a family-centred intervention after traumatic brain injury: A pragmatic randomised controlled trial

et al. 2021

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Objectives: To determine the effectiveness of a family-centred intervention for patients with traumatic brain injury and family members. Design: Open-labelled, two-armed randomised controlled trial. Settings: Outpatient clinic and family residences. Participants: Sixty-one patients (33 women) with traumatic brain injury, with mean (SD) age 43.8 (12.2), and 63 family members (33 women), with mean (SD) age 42.6 (11.3), were assign to intervention ( n = 30 families) and control group ( n = 31 families). Intervention: An eight-session single-family intervention to improve individual and family functioning. Outcome measures: Self-reported questionnaires at start-of-treatment, median (IQR) 11.4 (8.4, 15.9) months post-injury, and at two follow-ups, 2.7 (2.3, 3.8) and 9.2 (8.2, 9.9) months after start-of-treatment. Primary outcome measures were the SF-36 Mental Component Summary (MCS) and Caregiver Burden Scale (CGB). Secondary outcome measures were the Family Adaptability and Cohesion Evaluation Scale (FACES) and Quality of Life after Brain Injury Questionnaire (QOLIBRI). Group differences were analysed with linear mixed-model analysis for repeated measurements. Results: No significant between-group differences were found. The intervention group significantly improved on the MCS, the CGB and FACES in the treatment period, whereas the controls did not. The mean (SD) MCS change in the treatment period was 2.4 (1.1) points P = 0.028 in the intervention group. Mean (SE) MCS scores were 47.9 (1.26) and 47.3 (1.27) in the intervention and control group at last follow-up. Conclusions: Receiving an eight-session family intervention, in addition to specialised rehabilitation for the patients, was not superior to rehabilitation at a specialised traumatic brain injury outpatient clinic.

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Section: Methodsmentioning

confidence: 99%

The effectiveness of a family-centred intervention after traumatic brain injury: A pragmatic randomised controlled trial

et al. 2021

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“…Few RCTs have tested interventions on HRQL in patients with TBI ( 30 ). In the current study, all participants received the routine outpatient rehabilitation offered at the specialized rehabilitation clinic to patients with a protracted course of recovery after mild to moderate TBI ( 19 ). As this programme comprises individual assessments and addresses activity pacing, self-efficacy, and a timely return to work, it may well capture and reduce the emotional distress and post-concussion symptoms associated with HRQL reported in non-randomized studies.…”

Section: Discussionmentioning

confidence: 99%

“…Another limitation is the skewness in the total number of therapy sessions. The control group received TAU, which was delivered by a multidisciplinary team ( 19 ), whereas the intervention group received TAU and VR intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Briefly, all patients were assessed prior to allocation, and then were randomly assigned to the intervention group or the control group. Both groups received the usual multidisciplinary outpatient rehabilitation (TAU) delivered at our hospital ( 19 ). The focus of the outpatient rehabilitation was to strengthen the patients’ self-efficacy and facilitate their return to activities of daily living and work.…”

Section: Methodsmentioning

confidence: 99%

“…The guidance emphasized self-efficacy and a salutogenic perspective. After the 8-week intervention period, all patients could participate in the outpatient rehabilitation programme at the hospital with 4 weekly psychoeducational group sessions that addressed strategies to reduce post-concussion symptoms and facilitate return to work ( 19 ).…”

Section: Methodsmentioning

confidence: 99%

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What are the effects of different modes of exercise training for intermittent claudication? - A Cochrane Review summary with commentary

Søberg

Anđelić²,

Langhammer³

et al. 2021

J Rehabil Med

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Objective Secondary analysis, testing the effect on change in health-related quality of life of group-based vestibular rehabilitation in patients with mild-moderate traumatic brain injury, dizziness and balance problems. Design A single-blind randomized controlled trial. Subjects A total of 65 patients aged 16–60 years with a Rivermead Post-concussion Symptoms Questionnaire dizziness score ≥2, and DizzinessHandicap Inventory score >15 points. Data collection was performed at baseline 3.5 (standard deviation (SD) 2.1) months post-injury, end of intervention, and 4.4 (SD 1.0) months after baseline. Methods Quality of Life after Brain Injury was the main outcome. Independent variables were demographic and injury variables, Hospital Anxiety and Depression Scale, changes on the Rivermead Post-concussion Symptoms Questionnaire (RPQ3 physical and RPQ13 psychological/cognitive), and Vertigo Symptom Scale-Short Form. Results Mean age of participants was 39.4 years (SD 13.0); 70.3% women. Predictors of change inthe Quality of Life after Brain Injury were receiving the vestibular rehabilitation ( p =0.049), baseline psychological distress ( p =0.020), and changein RPQ3 physical ( p =0.047) and RPQ13 psychological/cognitive ( p =0.047). Adjusted R2 was 0.399,F=6.13, p < 0.001. Conclusion There was an effect in favour of the intervention group in improvement in health-related quality of life. Changes on the Rivermead Post-concussion Symptoms Questionnaire were also associated with change on the Quality of Life after Brain Injury. LAY ABSTRACT This paper is the first to present results of a vestibular rehabilitation intervention study on changes in health-related quality of life in patients with dizziness and balance problems after mild-to-moderate traumatic brain injury. The intervention group received exercises and guidance aimed at self-efficacy and how to cope with their dizziness and balance problems. In addition, both the intervention and control groups received treatment as usual, comprising multidisciplinary rehabilitation at a university hospital. The main result was measured as change on the Quality of Life after Brain Injury questionnaire. Post-concussion symptoms, vertigo and psychological distress were also measured. The study showed that the group receiving the vestibular rehabilitation intervention underwent more improvement in health-related quality of life than the group receiving usual treatment alone. Other factors that influenced the improvement in quality of life were psychological distress at the start of the study and fewer post-concussion symptoms.

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Predictors of return to work after moderate-to-severe traumatic brain injury: a systematic review of current literature and recommendations for future research

Deynse

Kazadi

Kimpe

et al. 2021

Disability and Rehabilitation

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Effectiveness of Combining Compensatory Cognitive Training and Vocational Intervention vs. Treatment as Usual on Return to Work Following Mild-to-Moderate Traumatic Brain Injury: Interim Analysis at 3 and 6 Month Follow-Up

Cited by 13 publications

References 50 publications

The effectiveness of a family-centred intervention after traumatic brain injury: A pragmatic randomised controlled trial

The effectiveness of a family-centred intervention after traumatic brain injury: A pragmatic randomised controlled trial

What are the effects of different modes of exercise training for intermittent claudication? - A Cochrane Review summary with commentary

Predictors of return to work after moderate-to-severe traumatic brain injury: a systematic review of current literature and recommendations for future research

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