Format

Send to

Choose Destination
J Head Trauma Rehabil. 2013 Jul-Aug;28(4):313-22. doi: 10.1097/HTR.0b013e3182915cb5.

Cognitive-behavioral prevention of postconcussion syndrome in at-risk patients: a pilot randomized controlled trial.

Author information

1
GF Strong Rehab Centre, Vancouver, University of British Columbia, Vancouver, Canada. noah.silverberg@vch.ca

Abstract

OBJECTIVE:

To examine the tolerability and estimate the treatment effect of cognitive-behavioral therapy (CBT) delivered soon after mild traumatic brain injury to patients at risk for chronic postconcussion syndrome (PCS).

SETTING:

Tertiary rehabilitation center.

PARTICIPANTS:

Twenty-eight patients with uncomplicated mild traumatic brain injury, determined to be at risk for chronic PCS based on a published algorithm that incorporates subacute postconcussion symptoms and maladaptive illness beliefs (recovery expectations and perceived consequences). They were enrolled within 6 weeks postinjury.

DESIGN:

Open-label, parallel-group, randomized controlled trial, with masked outcome assessment 3 months after enrolment. Interventions were (1) treatment as usual (education, reassurance, and symptom management strategies) from an occupational therapist, or (2) treatment as usual plus CBT delivered by a psychologist.

MAIN MEASURES:

Rivermead Postconcussion Symptoms Questionnaire.

RESULTS:

Four participants (2:2) withdrew. Treatment credibility and satisfaction ratings were high in the CBT group. Treatment effect sizes were moderate for postconcussion symptoms (Cohen d = 0.74) and moderate-large for most secondary outcome measures (Cohen d = 0.62-1.61). Fewer participants receiving CBT had a diagnosis of PCS at follow-up (54% vs 91%, P < .05).

CONCLUSION:

Our preliminary data suggest that CBT delivered soon after mild traumatic brain injury is well tolerated and may facilitate recovery in patients who are at risk for chronic PCS. A definitive clinical trial is warranted.

PMID:
23640544
DOI:
10.1097/HTR.0b013e3182915cb5
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center