Journal of Head Trauma Rehabilitation最新文献

{"title":"Developing Brain Injury Resource Facilitation for Acquired Brain Injury: Indications and Unmet Needs.","authors":"Bei Zhang, Tatyana Mollayeva, Srikant Devaraj, Cara Meixner, Judy Dettmer, John D Corrigan, Peggy Reisher, Flora M Hammond, Maria Pollifrone, Samantha Backhaus, Lance E Trexler","doi":"10.1097/HTR.0000000000001024","DOIUrl":"10.1097/HTR.0000000000001024","url":null,"abstract":"<p><p>Owing to major progress in the survivorship following acquired brain injury (ABI), there exists a pressing need for the development of systems of care and rehabilitation tailored to ABI. One of the supportive systems is brain injury resource facilitation (brain injury RF), which focuses on having therapeutic, social, and financial resources readily available and easily accessible for persons with ABI. Brain injury RF comprises identification of a person's strengths and challenges, goal setting, resource identification, coordination, access, utilization, monitoring, evaluation, and advocacy. Brain injury RF is critically important in bridging community services for persons with ABI and eliminating disjointed approaches of care that fail to address the full range of the individual's needs and long-term success. Over recent years, multiple stakeholders in the field of ABI have worked to develop and implement strategies for timely brain injury RF. This white paper aims to provide an overview of the current status of brain injury RF and an analysis on the challenges and opportunities in brain injury RF for ABI. Practical policy recommendations for its implementation are proposed to the potential funders of brain injury RF programs at the national, state, and community levels. We call for attention to this pressing need in society and advocate for a novel, pragmatic, and culturally informed approach in the development of brain injury RF in communities where people with ABI reside.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E272-E280"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Letter: Sexual Minority Disparities in Self-Reported Sport- or Recreation-Related Concussion Rates in a Nationally Representative US Sample.","authors":"Shawn R Eagle, Sophia Choukas-Bradley","doi":"10.1097/HTR.0000000000001002","DOIUrl":"10.1097/HTR.0000000000001002","url":null,"abstract":"","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E329-E333"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Traumatic Brain Injury and Hearing: Results From the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS).","authors":"Andrea L C Schneider, Vidyulata Kamath, Nicholas S Reed, Thomas Mosley, Rebecca F Gottesman, A Richey Sharrett, Frank R Lin, Jennifer A Deal","doi":"10.1097/HTR.0000000000001032","DOIUrl":"10.1097/HTR.0000000000001032","url":null,"abstract":"<p><strong>Objective: </strong>To examine associations of traumatic brain injury (TBI) with self-reported and clinical measures of hearing function.</p><p><strong>Setting: </strong>Four US communities.</p><p><strong>Participants: </strong>A total of 3176 Atherosclerosis Risk in Communities Study participants who attended the sixth study visit in 2016-2017, when hearing was assessed.</p><p><strong>Design: </strong>Prospective cohort study. TBI occurring prior to the hearing assessment was defined using self-reported questions and \"International Classification of Diseases-9th/10th Edition\" (ICD-9/10) codes.</p><p><strong>Main measures: </strong>Hearing function was assessed by self-reported questionnaires and clinically measured indices (audiometry [4-frequency pure tone average for each ear] and speech-in-noise testing). Linear, logistic, and multinomial logistic models adjusted for sociodemographics, vascular risk factors, and occupational noise exposure were used to examine associations.</p><p><strong>Results: </strong>Participants were a mean age of 79 years, 59% were female, 21% were of self-reported Black race, and 33% had a history of TBI (median time from first TBI to hearing assessment: 39 years (25th-75th percentile = 19-63 years). Compared to participants without TBI, participants with prior TBI had higher age-adjusted prevalence of self-reported hearing loss (42.3% vs 35.3%), tinnitus (28.0% vs 23.8%), hearing aid use (23.4% vs 17.8%), pure tone average > 40 dB (30.6% vs 24.8%), and presence in the lowest quartile of speech-in-noise performance (27.6% vs 22.8%). With further adjustment, and particularly with adjustment for occupational noise exposure, associations with hearing measures were largely no longer statistically significant. In secondary analyses of associations of TBI frequency and severity with hearing function, results were similar to our main analyses, without evidence of dose-dependent associations.</p><p><strong>Conclusions and relevance: </strong>In this community-based cohort, prior TBI was associated with impaired hearing on both self-reported and clinically measured assessments, but these associations were attenuated after adjustment for occupational noise exposure. These results underscore the importance of the consideration of loud noise exposures, which may confound associations of TBI with hearing, in future studies.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"287-295"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Family Needs After a Traumatic Brain Injury: A VA TBI Model Systems Study.","authors":"Jonathan Tsen, Jacob A Finn, Farina A Klocksieben, Therese M O'Neil-Pirozzi, Angelle M Sander, Stephanie D Agtarap, Laura E Dreer, Bridget A Cotner, Tiffanie A Vargas, Mia E Dini, Paul B Perrin, Risa Nakase-Richardson","doi":"10.1097/HTR.0000000000001015","DOIUrl":"10.1097/HTR.0000000000001015","url":null,"abstract":"<p><strong>Objective: </strong>To describe the self-reported needs of family caregivers of service members and veterans (SMVs) with traumatic brain injury (TBI) at 10 to 15 years post-injury and to identify unique predictors of unmet family needs.</p><p><strong>Setting: </strong>Five Department of Veterans Affairs Polytrauma Rehabilitation Centers.</p><p><strong>Participants: </strong>A total of 209 family caregivers of SMVs with TBI from the VA TBI Model Systems national database who completed a 10- or 15-year follow-up assessment.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Main outcome measure: </strong>Family Needs Questionnaire-Revised (FNQ-R).</p><p><strong>Results: </strong>Item-, domain-, and total score-level descriptive analyses of FNQ-R responses were conducted. On average, 56.3% of the FNQ-R family caregiver needs were reported as met. Health information and involvement in care needs were the most often met, and emotional support and instrumental support needs were the least often met. Adjusted multivariable regression models demonstrated that urban-dwelling SMVs (compared to suburban) and spouses/significant others (compared to parents) were associated with more unmet family needs. Distinct associations were identified between the 6 FNQ-R domains and SMV environmental factors (ie, urbanicity, rurality, and being active duty at follow-up), SMV comorbidities (ie, receiving mental health treatment in the year prior to the follow-up), and caregiver factors (ie, spouses/significant others).</p><p><strong>Conclusion: </strong>Family caregivers of SMVs with TBI reported multiple unmet needs at 10 to 15 years post-injury, emphasizing the importance of ongoing caregiver support after TBI. Policy and programming to support military caregivers should consider the current findings to direct resources to address the identified unmet needs.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"258-268"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Variation in Inpatient Rehabilitation Outcomes After Traumatic Brain Injury.","authors":"Nathan Darji, Bei Zhang, Richard Goldstein, Shirley L Shih, Mary Alexis Iaccarino, Jeffrey C Schneider, Ross Zafonte","doi":"10.1097/HTR.0000000000001033","DOIUrl":"10.1097/HTR.0000000000001033","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether regional variations exist in functional outcomes of patients with traumatic brain injury (TBI) admitted to inpatient rehabilitation facilities (IRFs) across the United States, while controlling for demographic and clinical variables.</p><p><strong>Setting: </strong>Inpatient rehabilitation facilities (IRFs) across 4 U.S. regions: West, Midwest, South, and East.</p><p><strong>Participants: </strong>Adult patients with open or closed TBI (Rehabilitation Impairment Codes 2.21 or 2.22) discharged from an IRF between 2016 and 2019.</p><p><strong>Design: </strong>This is a retrospective analysis de-identified data from the Uniform Data System for Medical Rehabilitation. The study compared total functional independence measure (FIM) scores and discharge dispositions across the 4 regions.</p><p><strong>Main measures: </strong>Primary outcomes were FIM scores at discharge, changes in FIM scores between admission and discharge, and community discharge rates, adjusted for demographic and clinical factors. Cohen's d effect sizes were calculated to assess the clinical significance of regional differences on FIM scores. Prevalence ratios were used for discharge disposition outcomes.</p><p><strong>Results: </strong>Regional differences were identified in functional outcomes for patients with TBI. The West had the highest community discharge rate (80.9%) compared to the East (70.5%). Discharge FIM scores were significantly lower in the Midwest and East compared to the South (-1.98 and - 2.31, respectively, P < .01), while the West showed no significant difference from the South (-0.78, P = .11). Effect sizes for FIM total scores were small across regions, with Cohen's d for West versus South at 0.017, Midwest versus South at 0.047, and East versus South at 0.047. Prevalence ratios for community discharge showed minor differences: West versus South at 1.010, Midwest versus South at 0.937, and East versus South at 0.918; all without statistical significance.</p><p><strong>Conclusions: </strong>Regional disparities in functional outcomes following inpatient rehabilitation for TBI were observed, particularly in community discharge rates and total FIM scores. However, based on the effect sizes and prevalence ratios, these differences may not be clinically meaningful and could not be fully explained by demographic and clinical factors. Further studies are needed to explore region-specific factors influencing rehabilitation efficacy to improve outcomes for patients with TBI nationwide.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E292-E299"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobehavioral Symptoms Partially Mediate the Effects of Depression and PTSD on Participation for Veterans With Mild Traumatic Brain Injury: A Cross-Sectional Study.","authors":"Jordan M Wyrwa, Lisa A Brenner, Xiang-Dong Yan, Alexandra L Schneider, Lindsay Burke, Samuel E King, Jeri E Forster, Adam R Kinney","doi":"10.1097/HTR.0000000000001012","DOIUrl":"10.1097/HTR.0000000000001012","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether neurobehavioral symptoms mediate the relationship between comorbid mental health conditions (major depressive disorder [MDD] and/or posttraumatic stress disorder [PTSD]) and participation restriction among Veterans with mild traumatic brain injury (mTBI).</p><p><strong>Setting: </strong>Veterans Health Administration (VHA).</p><p><strong>Participants: </strong>National sample of Veterans with mTBI who received VHA outpatient care between 2012 and 2020.</p><p><strong>Design: </strong>Secondary data analysis of VHA clinical data. We specified a latent variable path model to estimate relationships between: (1) comorbid mental health conditions and 3 latent indicators of neurobehavioral symptoms (vestibular-sensory; mood-behavioral; cognitive); (2) latent indicators of neurobehavioral symptoms and 2 latent indicators of participation restriction (social and community participation; productivity); and (3) comorbid mental health conditions and participation restriction.</p><p><strong>Main measures: </strong>International Classification of Diseases codes, Neurobehavioral Symptom Inventory, and Mayo-Portland Adaptability Inventory Participation Index to measure mental health conditions, neurobehavioral symptoms, and participation restrictions, respectively.</p><p><strong>Results: </strong>Indirect effect estimates indicated that comorbid MDD and/or PTSD was associated with greater social and community participation restrictions, as mediated by mood-behavioral ( β  = .22-.33; 99% CI 0.18-0.4; small to medium effect) and cognitive symptoms ( β  = .08-.13; 99% CI 0.05-0.18; small effect), and with greater productivity restrictions, as mediated by vestibular-sensory ( β  = .06-.11; 99% CI 0.04-0.15; small effect) and cognitive symptoms ( β  = .08-.13; 99% CI 0.05-0.18; small effect). Direct effect estimates indicated that comorbid MDD and/or PTSD was associated with greater challenges with both social and community participation ( β  = .19-.40; 99% CI 0.12-0.49; small to medium effect) and productivity ( β  = .08-.44; 99% CI -0.02 to 0.55; small to medium effect).</p><p><strong>Conclusion: </strong>Neurobehavioral symptoms partially mediated the impact of MDD and/or PTSD on participation restrictions among Veterans with mTBI. These findings advance the understanding of explanatory mechanisms underlying participation challenges among Veterans with comorbid mTBI and mental health challenges, thereby informing the development of tailored intervention strategies.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E281-E291"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Early/Unplanned Separation Among US Service Members With a History of Mild Traumatic Brain Injury.","authors":"Isabelle Wal, Peter Hoover, Rachel Sayko Adams, Jeri E Forster, Jesus J Caban, Mary B Engler","doi":"10.1097/HTR.0000000000001034","DOIUrl":"10.1097/HTR.0000000000001034","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence of early/unplanned (E/U) separations following mild traumatic brain injury (mTBI) and assess whether sex impacts the hazard of separation.</p><p><strong>Setting: </strong>Military Health System (MHS).</p><p><strong>Participants: </strong>Active duty service members (N = 75,730) with an initial mTBI diagnosis in military records between January 2011 and January 2018.</p><p><strong>Design: </strong>Retrospective cohort study of electronic health records in the MHS. Cause-specific Cox proportional hazards models were used with sex at birth as the primary predictor.</p><p><strong>Main measures: </strong>Early/unplanned (E/U) separation, defined as military separation attributed to disability, misconduct, poor performance, death, or other medical circumstances, within 2 years following the initial mTBI.</p><p><strong>Results: </strong>Incidence of E/U separation within 2 years following mTBI was 13.7% (11.0% in women and 14.2% in men). Disability and misconduct separations were most common. Female service members had lower adjusted hazards for any E/U separation (Hazard Ratio [HR] = 0.65; 95% Confidence Interval [CI]: 0.61,0.69), disability separation (HR = 0.71; 95% CI: 0.65, 0.78), misconduct separation (HR = 0.40; 95% CI: 0.36, 0.45), and poor performance separation (HR = 0.84; 95% CI: 0.72, 0.99), compared to males, but had higher adjusted hazards for separations due to other medical circumstances (HR = 1.24; 95% CI: 1.04, 1.48).</p><p><strong>Conclusion: </strong>Male and female service members had different hazards of E/U separation following mTBI. Separating early may increase the risk of adverse health and socioeconomic outcomes, so additional research is needed on why these separations occur and why they may be impacting men and women differently.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"296-306"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional Classification and Prediction of Outcome Following Traumatic Brain Injury.","authors":"Jennie L Ponsford, Gershon Spitz, Phillipa Pyman, Sarah Carrier, Amelia J Hicks, Jack V Nguyen, Angelle M Sander, Mark Sherer","doi":"10.1097/HTR.0000000000001018","DOIUrl":"10.1097/HTR.0000000000001018","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify outcome clusters among individuals with traumatic brain injury (TBI), 6 months to 10 years post-injury, in an Australian rehabilitation sample, and determine whether scores on 12 dimensions, combined with demographic and injury severity variables, could predict outcome cluster membership 1 to 3 years post-injury.</p><p><strong>Setting: </strong>Rehabilitation hospital.</p><p><strong>Participants: </strong>A total of 467 individuals with TBI, aged 17 to 87 ( M = 44.2 years), 70% male, with mean post-traumatic amnesia 24 days (range 0.5-455 days), were assessed a mean of 3.4 years post-injury (range 0.5-10 years). A subgroup of 138 participants was also evaluated as rehabilitation inpatients and followed up 1 year post-injury.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Main measures: </strong>TBI Quality of Life subscales (Upper Extremity, Pain Interference, Headache Pain, Anxiety, Resilience, Emotional and Behavioral Dyscontrol, General Cognitive Concerns, Independence, and Economic Quality of Life Scale), Neurobehavioral Symptom Inventory, Family Assessment Device General Functioning Scale, Wechsler Adult Intelligence Scale-IV Letter-Number-Sequencing and Coding, Rey Auditory Verbal Learning Test, Trail Making Test Part A, Verbal Fluency Test, Word Memory Test, Participation Assessment with Recombined Tools-Objective, and Glasgow Outcome Scale-Extended.</p><p><strong>Results: </strong>K-means cluster analysis revealed 5 clusters across 12 dimensions: Good Outcome, High Cognition, Poor Cognition, Poor Outcome, and Poor Adjustment, aligning with Sherer and colleagues' clusters. Inpatient assessments (n = 138) identified profiles predictive of outcome group membership. Participants with Good Outcomes exhibited lower anxiety and higher independence, self-esteem, and resilience, despite some cognitive deficits. High Cognition correlated with robust Economic and Family Support. Poor Cognition aligned with impaired cognitive function but positive psychosocial ratings suggest limited self-awareness. Poor Outcome featured low initial cognitive scores and poor psychosocial adjustment. Poor Adjustment participants, without inpatient cognitive impairments, reported persistent pain, physical symptoms, and emotional distress.</p><p><strong>Conclusions: </strong>Findings support the evaluation of cognitive and psychosocial factors during rehabilitation to predict outcomes with potential to inform rehabilitative interventions to optimize outcomes.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"221-232"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Letter: Assessing Traumatic Brain Injury in Refugees: Feasibility, Usability, and Prevalence Insights From a US-Based Clinical Sample.","authors":"Sofia Sherman Rosa, Rodrigo Nadal, Altaf Saadi","doi":"10.1097/HTR.0000000000001037","DOIUrl":"10.1097/HTR.0000000000001037","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed (1) the feasibility and usability of traumatic brain injury (TBI) assessment using the Ohio State University TBI Identification Method (OSU-TBI-ID) in a sample of English and Spanish-speaking refugees and asylum seekers (hereafter refugees), and (2) the prevalence and characteristics of TBI in this population.</p><p><strong>Setting and participants: </strong>Refugees seeking care from Massachusetts General Hospital (MGH) Asylum Clinic, the MGH Chelsea HealthCare Center, and other asylum programs in the Greater Boston Area.</p><p><strong>Design and main measures: </strong>Bilingual clinical research coordinators screened 158 English and Spanish-speaking refugees using the OSU-TBI-ID. A \"positive\" screen for TBI was made if a participant reported loss of consciousness (LOC) or being dazed or confused following a head injury, with determinations of mild, moderate, and severe TBI based on established metrics of TBI severity using duration of LOC. We conducted descriptive statistics of the sample demographics and screening outcomes, including group comparisons between those with and without TBI and associated demographic characteristics.</p><p><strong>Results: </strong>The mean age was 36.8 years (SD: 9.1), with participants predominantly from Latin America and the Caribbean (51%), followed by Sub-Saharan Africa (35%). Less than half (43%) identified as men. The majority (59%) screened positive for having experienced at least 1 TBI in their lifetime. Among those with a TBI history, nearly three-quarters (73%) had a mild TBI, and about a third (38%) had sustained a moderate-to-severe TBI. A majority (56%) had more than 1 TBI and about 40% had sustained a childhood TBI. The most common mechanisms of injury were interpersonal assault (55%) and blunt trauma by an object (46%). There were no significant statistical differences in demographics and TBI characteristics.</p><p><strong>Conclusion: </strong>Our findings demonstrate the feasibility and usability of the OSU-TBI-ID in a sample of refugees. We call for greater and improved detection of TBI among refugees to ensure they receive the optimal care they need.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E334-E339"},"PeriodicalIF":3.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On-TRACC Pilot Study: A Novel Intervention for Persistent Post-Concussive Cognitive Symptoms.","authors":"Kathleen F Pagulayan, Holly K Rau, David P Sheppard, Orli M Shulein, Emma Onstad-Hawes, Jeanne M Hoffman, Rhonda M Williams","doi":"10.1097/HTR.0000000000001014","DOIUrl":"10.1097/HTR.0000000000001014","url":null,"abstract":"<p><strong>Objective: </strong>To present the results of a pilot study of On-TRACC (Tools for Recovery and Clinical Care), a novel intervention for individuals experiencing persistent cognitive difficulties after mild traumatic brain injury (mTBI). On-TRACC is a 5-session, 1:1 manualized treatment that integrates psychoeducation, cognitive rehabilitation strategies, and self-management skills to target symptoms and increase understanding of the interaction between cognitive difficulties, injury history, and comorbid medical and psychological conditions. The primary study goals were to evaluate the feasibility, acceptability, and preliminary effectiveness of On-TRACC.</p><p><strong>Setting: </strong>Veterans Affairs medical center and an academic medical center.</p><p><strong>Participants: </strong>Veterans and civilian adults (n = 28) >3 months post-mTBI with current self-reported cognitive difficulties.</p><p><strong>Design: </strong>In this single-group, open-label pilot study, all participants received On-TRACC (5 sessions) via video-based telehealth.</p><p><strong>Main measures: </strong>Primary measures were feasibility (eg, session attendance and homework completion rate, dropout rate, and treatment fidelity) and acceptability (treatment satisfaction/helpfulness ratings). Preliminary effectiveness was explored by measuring pre- to post-intervention change in cognitive symptom level and attribution, perceived self-efficacy, use of compensatory strategies, daily functioning, quality of life, and planned future engagement in health care.</p><p><strong>Results: </strong>The On-TRACC completion rate for all enrolled participants was 79% (with 88% treatment completion rate for participants who started On-TRACC); homework was fully or partially completed for 98% of attended sessions. Treatment satisfaction ratings were high, with 95% satisfied with the information and skills learned. There were no adverse events. Positive pre- to posttreatment changes were seen in cognitive self-efficacy, symptom attribution, functional status, quality of life, and planned engagement in care for comorbid conditions.</p><p><strong>Conclusion: </strong>On-TRACC was a feasible and acceptable intervention for individuals with chronic cognitive difficulties following mTBI. Additional research, including a randomized clinical trial, is needed to evaluate the efficacy of this intervention and its long-term impact on outcomes in this clinical population.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E308-E319"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}