Efficacy of Psychoeducation and Cognitive Rehabilitation After Mild Traumatic Brain Injury for Preventing Post-concussional Syndrome in Individuals With High Risk of Poor Prognosis: A Randomized Clinical Trial

Caplain, Sophie; Chenuc, G.; Blancho, Sophie; Marque, Sébastien; Aghakhani, Nozar

doi:10.3389/fneur.2019.00929

Cited by 28 publications

(23 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patient education on the presence of these symptoms, given as instructions at discharge from the ED, can also facilitate better outcome. A recent study on unfavorable outcomes in patients with mild TBI showed that early multidimensional management involving psychoeducation and cognitive rehabilitation considerably improves the outcome of these patients [ 37 ]. Future research could further explore the patterns of cognitive, somatic and emotional symptoms to provide specific interventions to reduce post-concussion symptoms and therewith optimize recovery of injury.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Post-Concussion-Like Symptoms in the General Injury Population and the Association with Health-Related Quality of Life, Health Care Use, and Return to Work

Vlegel

Polinder

Toet

et al. 2021

JCM

View full text Add to dashboard Cite

Little is known about post-concussion-like symptoms in the general injury population and the association of these symptoms with outcome after injury. This study aimed to assess the prevalence of post-concussion-like symptoms in a general injury population and describe the association between post-concussion syndrome (PCS) and health-related quality of life (HRQL), health care use, and return to work. In this longitudinal study of a cohort of injury patients, data were collected 6 and 12 months after their Emergency Department visit. Questionnaires included socio-demographics, health care utilization, return to work and the five-level version of the EuroQol five-dimensional descriptive system (EQ-5D-5L) to measure HRQL. The 12-month questionnaire included the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). In total, 282 (22.0%) of the 1282 patients met the criteria for PCS. Apart from the high prevalence of PCS in patients with head injuries (29.4%), a considerable proportion of non-head injury patients also had PCS (20.6%) a year after injury. Patients with PCS had lower HRQL, lower return to work rates, and higher health care utilization, compared to patients without PCS. This underlines the importance of developing strategies to prevent post-concussion-like symptoms among injury patients, raising awareness among patients and physicians on the occurrence of PCS, early detection of PCS in the general injury population, and development of strategies to optimize recovery in this group of injury patients, ultimately leading to lower the individual and economic burden of injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of Post-Concussion-Like Symptoms in the General Injury Population and the Association with Health-Related Quality of Life, Health Care Use, and Return to Work

Vlegel

Polinder

Toet

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“… 42 , 43 Furthermore, 1 relevant RCT 44 was identified in a systematic review for manual treatment of neck and back. A total of 19 individual RCTs 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 comprising 2007 participants (1064 women [53.0%]; 943 men [47.0%]) were identified for 6 of the clinical questions. Nine 43 , 45 , 46 , 47 , 49 , 52 , 53 , 55 , 60 of these included a minority of adolescents in the sample.…”

Section: Resultsmentioning

confidence: 99%

“…Caplain et al, 54 Elgmark-Andersson et a,l 55 Kjeldgaard et a,l 56 Potter et al, 57 Rytter et al, 42 Silverberg et al, 58 Thastum et al, 43 Tiersky et al, 59 and Vikane et al 60 …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Nonpharmacological Treatment of Persistent Postconcussion Symptoms in Adults

Rytter

Graff²,

Henriksen³

et al. 2021

JAMA Netw Open

View full text Add to dashboard Cite

IMPORTANCE Persistent (>4 weeks) postconcussion symptoms (PPCS) are challenging for both patients and clinicians. There is uncertainty about the effect of commonly applied nonpharmacological treatments for the management of PPCS. OBJECTIVE To systematically assess and summarize evidence for outcomes related to 7 nonpharmacological interventions for PPCS in adults (aged >18 years) and provide recommendations for clinical practice. DATA SOURCES Systematic literature searches were performed via Embase, MEDLINE, PsycINFO, CINAHL, PEDro, OTseeker, and Cochrane Reviews (via MEDLINE and Embase) from earliest possible publication year to March 3, 2020. The literature was searched for prior systematic reviews and primary studies. To be included, studies had to be intervention studies with a control group and focus on PPCS. STUDY SELECTION A multidisciplinary guideline panel selected interventions based on frequency of use and need for decision support among clinicians, including early information and advice, graded physical exercise, vestibular rehabilitation, manual treatment of neck and back, oculomotor vision treatment, psychological treatment, and interdisciplinary coordinated rehabilitative treatment. To be included, studies had to be intervention studies within the areas of the predefined clinical questions, include a control group, and focus on symptoms after concussion or mild traumatic brain injury. DATA EXTRACTION AND SYNTHESIS Extraction was performed independently by multiple observers. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for data abstraction and data quality assessment. Included studies were assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool and the Cochrane Risk of Bias (randomized clinical trials) tool. Meta-analysis was performed for all interventions where possible. Random-effects models were used to calculate pooled estimates of effects. The level and certainty of evidence was rated and recommendations formulated according to the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. MAIN OUTCOMES AND MEASURESAll outcomes were planned before data collection began according to a specified protocol. The primary outcomes were the collective burden of PPCS and another outcome reflecting the focus of a particular intervention (eg, physical functioning after graded exercise intervention). RESULTSEleven systematic reviews were identified but did not contribute any primary studies; 19 randomized clinical trials comprising 2007 participants (1064 women [53.0%]) were separately (continued)

show abstract

“…Evidence of objective gains in cognition has been lacking since these publications. Caplain et al (2019) investigated the use of a "multidimensional management" approach, which used psychoeducation plus cognitive rehabilitation for participants at high risk of developing pPCS following mTBI. Results showed that 94% of treated participants did not have pPCS 6 months after injury, whereas 52% of the control patients had pPCS.…”

Section: Current Treatmentsmentioning

confidence: 99%

EMDR Treatment for Persistent Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Case Study

Moore¹

2021

J EMDR Prac Res

View full text Add to dashboard Cite

The majority of people who experience mild Traumatic Brain Injury (mTBI) have a healthy recovery, where initial somatic, cognitive, psychological, and behavioral mTBI-related symptoms resolve naturally within hours or days. Unfortunately, a significant minority of people unfortunately develop persistent symptoms referred to as persistent Post Concussion Syndrome (pPCS), often causing severe long-term reduction in wellbeing and daily function. Psychological and neuropsychological treatments are typically limited to antidepressants, psycho-education on mTBI and pPCS, basic neuro-rehabilitative cognitive compensatory strategies, traditional Cognitive Behavioral Therapy, or no treatment at all. This paper discusses a single case study which demonstrates how Eye Movement Desensitization Reprocessing (EMDR) therapy might provide psychological improvement in clients who sustain mTBI who develop pPCS. The case example describes a 57-year-old man who sustained a mTBI from a serious road traffic collision as a pedestrian, and who developed pPCS. Treatment included nine, 1.5-hour EMDR sessions across a 5-month period (1st being an assessment). Measures of psychological symptom change and client feedback were taken at pretreatment, midtreatment, posttreatment, and aftertreatment had ceased to gauge long-term status. Measures were taken at 18-month follow-up and 4-year review (which followed litigation settlement). The novel viability for the application of EMDR for this client group is discussed.

show abstract

Efficacy of Psychoeducation and Cognitive Rehabilitation After Mild Traumatic Brain Injury for Preventing Post-concussional Syndrome in Individuals With High Risk of Poor Prognosis: A Randomized Clinical Trial

Cited by 28 publications

References 45 publications

Prevalence of Post-Concussion-Like Symptoms in the General Injury Population and the Association with Health-Related Quality of Life, Health Care Use, and Return to Work

Prevalence of Post-Concussion-Like Symptoms in the General Injury Population and the Association with Health-Related Quality of Life, Health Care Use, and Return to Work

Nonpharmacological Treatment of Persistent Postconcussion Symptoms in Adults

EMDR Treatment for Persistent Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Case Study

Contact Info

Product

Resources

About