EARLY TEAM BASED NEURO-REHABILITATION AFTER MILD TRAUMATIC BRAIN INJURY: A PILOT STUDY

TL;DR

A pilot study tested early team-based rehabilitation for mild traumatic brain injury patients, finding some improvements but also challenges in mental health outcomes.

Contribution

This pilot study evaluates the feasibility of a future full-scale trial on early neuro-rehabilitation for mild traumatic brain injury.

Findings

Both groups showed improvement in symptoms, activity levels, and sleep.

General fatigue and overall health worsened in both groups.

No improvement in anxiety or depression was observed.

Abstract

Evaluate study design, procedure, and measurements for future study of early
rehabilitation after mild traumatic brain injury.

A randomized controlled study was conducted.

Patients from a county hospital emergency department, diagnosed with mild Traumatic
Brain Injury were contacted 2 weeks post-trauma.

Patients who met the inclusion criteria were randomized into 2 groups
(n=28). The intervention group received early rehabilitation from a
team consisting of physio- and occupational therapists. The control group received usual
care. Patient-reported outcomes for measures were fatigue, anxiety and depression,
health-related quality of life, physical and activity levels, and sleep after trauma.
Data were collected 3 and 16 weeks after trauma.

Patient-reported outcomes measures showed improvement in both groups for symptoms,
physical and activity levels, sleep quality and quantity. Also, improvement in the
sub-scales of fatigue and health- related quality of life but worsening for general
fatigue and general health at post-test in both groups. Neither group showed improvement
for anxiety or depression: the intervention group rated depression higher, and the
control group rated anxiety higher, post-test.

Design, procedures, measurements and interventions were feasible but need refinement
for a full-scale study.

This pilot study explored whether the design and methods for a future full scale
randomized controlled trial on early rehabilitation after mild traumatic brain injury
would be feasible. Patients diagnosed with mild traumatic brain injury at a county
hospital were contacted 2 weeks post injury. Twenty-eight participants were randomly
assigned to either early rehabilitation with physiotherapists and occupational therapists
or to treatment as usual. They completed questionnaires on fatigue, anxiety and
depression, health-related quality of life, physical and activity levels, and sleep habits
at 3- and 16 weeks post injury. Both groups showed improvement in symptoms, activity
levels, and sleep. However, general fatigue and overall health worsened, and there was no
improvement in symptoms of anxiety or depression. Depression increased in the early
rehabilitation group, while anxiety increased in the control group. The study methods were
feasible but require some adjustments before a full-scale trial.

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