Research Letter: Long-Term Outcomes Following Cognitive Rehabilitation for Mild Traumatic Brain Injury: A 5-Year Follow-Up of a Cohort From the SCORE Randomized Clinical Trial. Issue 6 (20th November 2022)

• Record Type: Journal Article
• Authors: Kennedy, Jan E.; Cooper, Douglas B.; Curtiss, Glenn; Shelton, Janel L.; Bowles, Amy O.; Tate, David F.; Eapen, Blessen C.; Vanderploeg, Rodney D.
• Is Part Of: Journal of head trauma rehabilitation. Volume 37:Issue 6(2022)
• Page Start: 390
• Page End: 395
• Publication Date: 2022-11-20
• Subjects: cognitive therapy -- military personnel -- postconcussion syndrome -- randomized controlled trial -- rehabilitation outcome -- traumatic brain injuries; Brain damage -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Periodicals; 617.4810443
• DOI: 10.1097/HTR.0000000000000800
• Languages: English
• ISSNs: 0885-9701

Abstract

Abstract : Objective: To examine the functioning of military service members 5 years after completing a randomized controlled trial (RCT) of cognitive rehabilitation for mild traumatic brain injury (mTBI). Setting: Home-based telephonic interview and internet-based self-ratings. Participants: Sixty-nine of the 126 (55%) active-duty service members who were enrolled in a 4-arm RCT of cognitive rehabilitation 3 to 24 months after mTBI and were successfully contacted by phone 5 years later. Original and 5-year follow-up participants in each of 4 RCT treatment arms included: psychoeducation ( n = 32 original, n = 17 follow-up), computer ( n = 30 original, n = 11 follow-up), therapist-directed ( n = 30 original, n = 23 follow-up), integrated ( n = 34 original, n = 18 follow-up). Design: Inception cohort evaluated 5 years after completion of an RCT of cognitive rehabilitation. Main Measures: Postconcussion symptoms (Neurobehavioral Symptom Inventory total score), psychological distress (Symptom Checklist-90-revised Global Severity Index score), and functional cognitive/behavioral symptoms (Key Behaviors Change Inventory total average score). Results: Participants' postconcussive symptoms and psychological distress improved at the 5-year follow-up. Functional cognitive/behavioral symptoms were not significantly improved, but therapeutic gains were maintained across time, to 5 years after completing the RCT. Conclusion: In this sample of military personnel, postconcussive symptoms and psychological distress significantly improved from posttreatment to 5 years after cognitive rehabilitation, regardless of treatment arm. Functional cognitive/behavioral symptoms significantly improved with treatment while treatment gains were maintained at the 5-year follow-up. Replication of these results with a larger sample and interim data between 18 weeks and 5 years post-treatment is needed.