Mathilde Rioux, Penelope M A Brasher, Gabriel McKeown, Keith Owen Yeates, Ana-Maria Vranceanu, Deborah L Snell, Molly Cairncross, William J Panenka, Grant L Iverson, Chantel T Debert, Mark T Bayley, Cindy Hunt, Matthew J Burke, Noah D Silverberg
{"title":"Graded exposure therapy for adults with persistent symptoms after mTBI: A historical comparison study.","authors":"Mathilde Rioux, Penelope M A Brasher, Gabriel McKeown, Keith Owen Yeates, Ana-Maria Vranceanu, Deborah L Snell, Molly Cairncross, William J Panenka, Grant L Iverson, Chantel T Debert, Mark T Bayley, Cindy Hunt, Matthew J Burke, Noah D Silverberg","doi":"10.1080/09602011.2024.2403647","DOIUrl":null,"url":null,"abstract":"<p><p>Fear avoidance behaviour is associated with slow recovery from mild traumatic brain injury (mTBI). This study is a preliminary evaluation of graded exposure therapy (GET), which directly targets fear avoidance behaviour, for reducing post-concussion symptoms (PCS) and disability following mTBI. In a historical comparison design, we compared two groups from independent randomized trials. The GET + UC group (N = 34) received GET (delivered over 16 videoconference sessions) in addition to usual care (UC). The historical comparison group (N = 71) received UC only. PCS severity (Rivermead Post Concussion Symptoms Questionnaire; RPQ) and disability (World Health Organization Disability Assessment Schedule; WHODAS 2.0 12-item) were measured at clinic intake (M = 2.7, SD = 1.1 months after injury) and again at M = 4.9 (SD = 1.1) months after injury. Between-group differences were estimated using linear mixed effects regression, with a sensitivity analysis controlling for injury-to-assessment intervals. The estimated average change on the RPQ was -14.3 in the GET + UC group and -5.3 in the UC group. The estimated average change on the WHODAS was -5.3 in the GET + UC group and -3.2 in the UC group. Between-group differences post-treatment were -5.3 on the RPQ and -1.5 on the WHODAS. Treatment effects were larger in sensitivity analyses. Findings suggest that a randomized controlled trial is warranted.</p>","PeriodicalId":54729,"journal":{"name":"Neuropsychological Rehabilitation","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuropsychological Rehabilitation","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/09602011.2024.2403647","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Fear avoidance behaviour is associated with slow recovery from mild traumatic brain injury (mTBI). This study is a preliminary evaluation of graded exposure therapy (GET), which directly targets fear avoidance behaviour, for reducing post-concussion symptoms (PCS) and disability following mTBI. In a historical comparison design, we compared two groups from independent randomized trials. The GET + UC group (N = 34) received GET (delivered over 16 videoconference sessions) in addition to usual care (UC). The historical comparison group (N = 71) received UC only. PCS severity (Rivermead Post Concussion Symptoms Questionnaire; RPQ) and disability (World Health Organization Disability Assessment Schedule; WHODAS 2.0 12-item) were measured at clinic intake (M = 2.7, SD = 1.1 months after injury) and again at M = 4.9 (SD = 1.1) months after injury. Between-group differences were estimated using linear mixed effects regression, with a sensitivity analysis controlling for injury-to-assessment intervals. The estimated average change on the RPQ was -14.3 in the GET + UC group and -5.3 in the UC group. The estimated average change on the WHODAS was -5.3 in the GET + UC group and -3.2 in the UC group. Between-group differences post-treatment were -5.3 on the RPQ and -1.5 on the WHODAS. Treatment effects were larger in sensitivity analyses. Findings suggest that a randomized controlled trial is warranted.
期刊介绍:
Neuropsychological Rehabilitation publishes human experimental and clinical research related to rehabilitation, recovery of function, and brain plasticity. The journal is aimed at clinicians who wish to inform their practice in the light of the latest scientific research; at researchers in neurorehabilitation; and finally at researchers in cognitive neuroscience and related fields interested in the mechanisms of recovery and rehabilitation. Papers on neuropsychological assessment will be considered, and special topic reviews (2500-5000 words) addressing specific key questions in rehabilitation, recovery and brain plasticity will also be welcomed. The latter will enter a fast-track refereeing process.