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Randomized Controlled Trial
. 2022 Nov-Dec;37(6):390-395.
doi: 10.1097/HTR.0000000000000800. Epub 2022 Jul 20.

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

Jan E Kennedy  1 , Douglas B Cooper, Glenn Curtiss, Janel L Shelton, Amy O Bowles, David F Tate, Blessen C Eapen, Rodney D Vanderploeg
Affiliations
Randomized Controlled Trial

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

Jan E Kennedy et al. J Head Trauma Rehabil. 2022 Nov-Dec.

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Cooper DB, Bowles AO, Kennedy JE, et al. Cognitive rehabilitation for military service members with mild traumatic brain injury: a randomized clinical trial. J Head Trauma Rehabil. 2017;32(3):E1–E15. doi:10.1097/HTR.0000000000000254
    1. Derogatis LR. Symptom Checklist-90-R: Administration, Scoring & Procedure Manual for the Revised Version of the SCL-90. National Computer Systems; 1994.
    1. Kolitz BP, Vanderploeg RD, Curtiss G. Development of the Key Behaviors Change Inventory: a traumatic brain injury behavioral outcome assessment instrument. Arch Phys Med Rehabil. 2003;84(2):277–284. doi:10.1053/apmr.2003.50100
    1. Cicerone KD, Kalmar K. Persistent postconcussion syndrome: the structure of subjective complaints after mild traumatic brain injury. J Head Trauma Rehabil. 1995;10(3):1–17. doi:10.1097/00001199-199510030-00002
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