Cognitive and vocational rehabilitation after mild-to-moderate traumatic brain injury: A randomised controlled trial.

Autor: Fure SCR; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway. Electronic address: siljfu@ous-hf.no., Howe EI; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway., Andelic N; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway., Brunborg C; Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway., Sveen U; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway., Røe C; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway., Rike PO; Department of Research, Sunnaas Rehabilitation Hospital Trust, Nesoddtangen, Norway., Olsen A; Department of Psychology, Norwegian University of Technology and Science, Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Spjelkavik Ø; Work Research Institute, Oslo Metropolitan University, Oslo, Norway., Ugelstad H; Department of Vocational Rehabilitation, Norwegian Labor and Welfare Administration, Oslo, Norway., Lu J; Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway; Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA., Ponsford J; Monash Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia., Twamley EW; Center of Excellence for Stress and Mental Health, Veterans Affairs (VA) San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA., Hellstrøm T; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway., Løvstad M; Department of Research, Sunnaas Rehabilitation Hospital Trust, Nesoddtangen, Norway; Department of Psychology, University of Oslo, Oslo, Norway.
Jazyk: angličtina
Zdroj: Annals of physical and rehabilitation medicine [Ann Phys Rehabil Med] 2021 Sep; Vol. 64 (5), pp. 101538. Date of Electronic Publication: 2021 Jul 22.
DOI: 10.1016/j.rehab.2021.101538
Abstrakt: Background: Returning to work is often a primary rehabilitation goal after traumatic brain injury (TBI). However, the evidence base for treatment options regarding return to work (RTW) and stable work maintenance remains scarce.
Objective: This study aimed to examine the effect of a combined cognitive and vocational intervention on work-related outcomes after mild-to-moderate TBI.
Methods: In this study, we compared 6 months of a combined compensatory cognitive training and supported employment (CCT-SE) intervention with 6 months of treatment as usual (TAU) in a randomised controlled trial to examine the effect on time to RTW, work percentage, hours worked per week and work stability. Eligible patients were those with mild-to-moderate TBI who were employed ≥50% at the time of injury, 18 to 60 years old and sick-listed ≥50% at 8 to 12 weeks after injury due to post-concussion symptoms, assessed by the Rivermead Post Concussion Symptoms Questionnaire. Both treatments were provided at the outpatient TBI department at Oslo University Hospital, and follow-ups were conducted at 3, 6 and 12 months after inclusion.
Results: We included 116 individuals, 60 randomised to CCT-SE and 56 to TAU. The groups did not differ in characteristics at the 12-month follow-up. Overall, a high proportion had returned to work at 12 months (CCT-SE, 90%; TAU, 84%, P=0.40), and all except 3 were stably employed after the RTW. However, a significantly higher proportion of participants in the CCT-SE than TAU group had returned to stable employment at 3 months (81% vs. 60%, P=0.02).
Conclusion: These results suggest that the CCT-SE intervention might help patients with mild-to-moderate TBI who are still sick-listed 8 to 12 weeks after injury in an earlier return to stable employment. However, the results should be replicated and a cost-benefit analysis performed before concluding.
(Copyright © 2021 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)
Databáze: MEDLINE
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