Short- and Long-Term Effectiveness of a Subject's Specific Novel Brain and Vestibular Rehabilitation Treatment Modality in Combat Veterans Suffering from PTSD

Abstract

Introduction: Treatment for post-traumatic stress disorder (PTSD) in combat veterans that have a long-term positive clinical effect has the potential to modify the treatment of PTSD. This outcome may result in changed and saved lives of our service personnel and their families. In a previous before-after-intervention study, we demonstrated high statistical and substantively significant short-term changes in the Clinician Administered DSM-IV PTSD Scale (CAPS) scores after a 2-week trial of a subject's particular novel brain and vestibular rehabilitation (VR) program. The long-term maintenance of PTSD severity reduction was the subject of this study.

Material and methods: We studied the short- and long-term effectiveness of a subject's particular novel brain and VR treatment of PTSD in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. We analyzed the difference in the CAPS scores pre- and post-treatment (1 week and 3 months) using our subjects as their matched controls.

Results: The generalized least squares (GLS) technique demonstrated that with our 26 subjects in the 3 timed groups the R (2) within groups was 0.000, R (2) between groups was 0.000, and overall the R (2) was 0.000. The GLS regression was strongly statistically significant z = 21.29, p < 0.001, 95% CI [58.7, 70.63]. The linear predictive margins over time demonstrated strong statistical and substantive significance of decreasing PTSD severity scores for all timed CAPS tests.

Discussion: Our investigation has the promise of the development of superior outcomes of treatments in this area that will benefit a global society. The length of the treatment intervention involved (2 weeks) is less that other currently available treatments and has profound implications for cost, duration of disability, and outcomes in the treatment of PTSD in combat veterans.

Keywords: DSM-IV CAPS; PTSD; brain rehabilitation; off vertical axis rotation; vestibular rehabilitation.

Figure 1

Estimated effect size for one-way ANOVA.

Figure 2

Figure 2 CAPS severity scores for each of the paired observations and the regression line fitting the values.

Figure 3

Number of subjects for each of the categories of the CAPS DSM IV scores for each of the three testing sessions.

Figure 4

Caps DSM IV Severity Scores Over Time.

Figure 5

(A) CAPS DSM-IV component-plus-residual plot and residuals vs. fitted and (B) Residual vs. predicted plots.

Figure 6

Adjusted partial residual plot.