Dataset Information

Interdisciplinary Rehabilitation for Concussion Recovery (i-RECOveR): protocol of an investigator-blinded, randomised, case series with multiple baseline design to evaluate the feasibility and preliminary efficacy of a 12-week treatment for persistent post-concussion symptoms.

ABSTRACT:

Background

Up to 25% of concussed individuals experience persistent post-concussion symptoms (PPCSs) which may interfere with the return to pre-injury activities and cause significant stress. Given that multiple etiological factors are thought to contribute to PPCSs, an interdisciplinary approach is recommended. This pilot study aims to primarily investigate the feasibility of a novel interdisciplinary treatment for PPCSs. Given this intervention is novel, uncertainty exists in terms of potential recruitment and retention rates, adverse events, and treatment adherence and fidelity. These factors will be explored to inform the feasibility of a phase-2 randomised controlled trial. Preliminary efficacy of this intervention will also be explored.

Methods

Fifteen individuals with mild traumatic brain injury and PPCSs will receive up to 12 weeks of interdisciplinary treatments including psychology, physiotherapy, and medical interventions. Primary feasibility outcomes including data on recruitment and retention rates and treatment adherence will be explored descriptively. The cognitive therapy rating scale will be used to assess treatment fidelity. A single-case series with multiple baseline design will be used to explore preliminary efficacy. Participants will be randomly assigned to baseline phases of 2, 4, or 6 weeks. Regarding patient-centred secondary outcomes, the Rivermead Post-Concussion Symptoms Questionnaire will be assessed three times a week during baseline and treatment phases. Secondary outcomes also include measures of mood, sleep and fatigue, physical functioning, return to activity, and health-related quality of life. Patient-centred outcomes will be assessed at baseline, pretreatment, post-treatment, and one- and three-month follow-up. Thematic analysis of participant experiences will be explored through qualitative interviews.

Discussion

Results from this trial will inform the feasibility and preliminary efficacy of this interdisciplinary concussion intervention and whether proceeding to a future definitive phase-2 randomised controlled trial is worthwhile. Understanding the end-user perspective of the treatment will also enable modifications to the treatment protocol for future trials to best suit the needs of individuals with PPCSs after mTBI. Outcomes from this trial can be directly translated into community rehabilitation programmes.

Trial registration

ANZCTR, ACTRN12620001111965. Registered 27 October 2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379118.

SUBMITTER: Nguyen JVK

PROVIDER: S-EPMC9441831 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Interdisciplinary Rehabilitation for Concussion Recovery (i-RECOveR): protocol of an investigator-blinded, randomised, case series with multiple baseline design to evaluate the feasibility and preliminary efficacy of a 12-week treatment for persistent post-concussion symptoms.

Nguyen Jack V K JVK McKay Adam A Ponsford Jennie J Davies Katie K Makdissi Michael M Drummond Sean P A SPA Reyes Jonathan J Willmott Catherine C

Pilot and feasibility studies 20220905 1

<h4>Background</h4>Up to 25% of concussed individuals experience persistent post-concussion symptoms (PPCSs) which may interfere with the return to pre-injury activities and cause significant stress. Given that multiple etiological factors are thought to contribute to PPCSs, an interdisciplinary approach is recommended. This pilot study aims to primarily investigate the feasibility of a novel interdisciplinary treatment for PPCSs. Given this intervention is novel, uncertainty exists in terms of ...[more]

PMID: 36064489

Similar Datasets

Project description:BackgroundPersistent concussion symptoms (PCS) negatively affects common activities of daily living including deficits in both single and dual-task (DT) gait. DT gait deficits are present post-concussion; however, task prioritization and the effects of differing cognitive challenge remain unexplored in the PCS population.Research questionThe purpose of this study was to investigate single and dual-task gait performance in individuals with persistent concussion symptoms and to identify task priorization strategies during DT trials.MethodsFifteen adults with PCS (age: 43.9+11.7 y.o.) and 23 healthy control participants (age: 42.1+10.3 y.o.) completed five trials of single task gait followed by fifteen trials of dual task gait along a 10-m walkway. The cognitive challenges consisted of five trials each of visual stroop, verbal fluency, and working memory cognitive challenges. Groups were compared on DT cost stepping characteristics with independent samples t-test or Mann-Whitney U tests.ResultsThere were significant overall gait Dual Task Cost (DTC)difference between groups for gait speed (p = 0.009, d=0.92) and step length (p = 0.023, d=0.76). Specific to each DT challenge, PCS participants were slower during Verbal Fluency (0.98 + 0.15 m/s and 1.12 + 0.12 m/s, p = 0.008; d=1.03), Visual Stroop (1.06 + 0.19 m/s and 1.20 + 0.12 m/s, p = 0.012, d=0.88), and Working Memory (1.02 + 0.15 m/s and 1.16 + 0.14 m/s, p = 0.006, d=0.96). There were significant cognitive DTC differences between groups for WM accuracy (p = 0.008, d=0.96), but not for VS accuracy (p = 0.841, d=0.061) or VF total words (p = 0.112, d=0.56).SignificanceThe PCS participants displayed a posture-second strategy whereby gait performance generally decreased in the absence of cognitive changes. However, during the Working Memory DT, PCS participants had a mutual interference response whereby both motor and cognitive performance decreased suggesting the cognitive task plays a key role in the DT gait performance of PCS patients.

Project description:BackgroundConcussion in children is a significant public health burden in the United States with 2.3 million children under the age of 17 years sustaining a concussion in 2022 alone. Children post-concussion experience a wide range of symptoms of vestibular dysfunction. Vestibular rehabilitation therapy (VRT) has been shown to substantially decrease dizziness and improve gait and balance function in adults post-concussion, but limited information is available for children. Purpose: The purpose of this systematic review was to determine the effectiveness of VRT on improving vestibular function, postural control, and gait in children post-concussion.Study designSystematic review.MethodsAn electronic search of MEDLINE and CINAHL was conducted in October 2022 and later updated in April 2024 using MeSH terms and keywords related to vestibular rehabilitation, concussion, and children. Quality appraisal was conducted independently by two reviewers using the Joanna Briggs Institute checklist, the Critical Appraisal Skills Programme checklist and Cochrane risk of bias assessment tool. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were utilized for screening and data extraction.ResultsOverall, twelve studies (three randomized controlled trials, five cohort studies, two case series and two case reports) were included in the review. The Dizziness Handicap Inventory (DHI) was the most frequently utilized measure (five studies). Three studies reported a statistically significant improvement in DHI (change scores = 19-25, p < 0.05), gait speed (F = 38.3, p < 0.001), Balance Error Scoring System (BESS) (change score percentage 12.1 - 52%, p < 0.01), and Activities-specific Balance Confidence (ABC) scale (change = 20-29 points, p <0.01).ConclusionVRT shows promise and may result in symptom improvements in children post-concussion when used as part of a multimodal intervention plan. Further research with larger samples is recommended to make informed decisions about dosage and long-term functional outcomes in children post-concussion.Level of evidence3.

Dataset Information

Interdisciplinary Rehabilitation for Concussion Recovery (i-RECOveR): protocol of an investigator-blinded, randomised, case series with multiple baseline design to evaluate the feasibility and preliminary efficacy of a 12-week treatment for persistent post-concussion symptoms.

Background

Methods

Discussion

Trial registration

Publications

Interdisciplinary Rehabilitation for Concussion Recovery (i-RECOveR): protocol of an investigator-blinded, randomised, case series with multiple baseline design to evaluate the feasibility and preliminary efficacy of a 12-week treatment for persistent post-concussion symptoms.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets