The Sensor Technology and Rehabilitative Timing (START) Protocol: A Randomized Controlled Trial for the Rehabilitation of Mild Traumatic Brain Injury
| Autor: | Mahmoud El-Gohary, Jess VanDerwalker, Jennifer Wilhelm, Charles Murchison, Timothy E. Hullar, Laurie A. King, Deborah A Jehu, Fay B. Horak, Robert J. Peterka, Sean Pearson, Samuel Stuart, Lucy Parrington, Natalie Pettigrew, James C. Chesnutt, Peter C. Fino |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors medicine.medical_treatment Poison control Physical Therapy Sports Therapy and Rehabilitation B300 B700 law.invention Wearable Electronic Devices 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Intervention (counseling) Outcome Assessment Health Care Health care Injury prevention Ambulatory Care medicine Humans Veterans Affairs Brain Concussion Randomized Controlled Trials as Topic Rehabilitation business.industry Posturography 030229 sport sciences Middle Aged Home Care Services C600 Exercise Therapy B900 Treatment Outcome Sample Size Physical therapy business Protocols 030217 neurology & neurosurgery |
| Zdroj: | Phys Ther |
| ISSN: | 0031-9023 |
| Popis: | Background Clinical practice for rehabilitation after mild traumatic brain injury (mTBI) is variable, and guidance on when to initiate physical therapy is lacking. Wearable sensor technology may aid clinical assessment, performance monitoring, and exercise adherence, potentially improving rehabilitation outcomes during unsupervised home exercise programs. Objective The objectives of this study were to: (1) determine whether initiating rehabilitation earlier than typical will improve outcomes after mTBI, and (2) examine whether using wearable sensors during a home-exercise program will improve outcomes in participants with mTBI. Design This was a randomized controlled trial. Setting This study will take place within an academic hospital setting at Oregon Health & Science University and Veterans Affairs Portland Health Care System, and in the home environment. Participants This study will include 160 individuals with mTBI. Intervention The early intervention group (n = 80) will receive one-on-one physical therapy 8 times over 6 weeks and complete daily home exercises. The standard care group (n = 80) will complete the same intervention after a 6- to 8-week wait period. One-half of each group will receive wearable sensors for therapist monitoring of patient adherence and quality of movements during their home exercise program. Measurements The primary outcome measure will be the Dizziness Handicap Inventory score. Secondary outcome measures will include symptomatology, static and dynamic postural control, central sensorimotor integration posturography, and vestibular-ocular-motor function. Limitations Potential limitations include variable onset of care, a wide range of ages, possible low adherence and/or withdrawal from the study in the standard of care group, and low Dizziness Handicap Inventory scores effecting ceiling for change after rehabilitation. Conclusions If initiating rehabilitation earlier improves primary and secondary outcomes post-mTBI, this could help shape current clinical care guidelines for rehabilitation. Additionally, using wearable sensors to monitor performance and adherence may improve home exercise outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|