Traumatic Brain Injury Center of Excellence (TBICOE), Neurology Service, Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio, San Antonio, Texas (Dr Kennedy and Ms Shelton); Polytrauma Rehabilitation Center, Audie Murphy Veterans Hospital, and Departments of Psychiatry and Rehabilitation Medicine, UT Health San Antonio, San Antonio, Texas (Dr Cooper); Department of Psychology, University of South Florida, Tampa (Dr Curtiss); Brain Injury Rehabilitation Service, Department of Rehabilitation, Brooke Army Medical Center, Joint Base San Antonio, San Antonio, Texas (Dr Bowles); Department of Neurology, University of Utah School of Medicine, Salt Lake City (Dr Tate); Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, California (Dr Eapen); and Department of Psychiatry and Neurosciences, College of Medicine, University of South Florida, Tampa (Dr Vanderploeg).
J Head Trauma Rehabil. 2022;37(6):390-395. doi: 10.1097/HTR.0000000000000800. Epub 2022 Jul 20.
To examine the functioning of military service members 5 years after completing a randomized controlled trial (RCT) of cognitive rehabilitation for mild traumatic brain injury (mTBI).
Home-based telephonic interview and internet-based self-ratings.
Sixty-nine of the 126 (55%) active-duty service members who were enrolled in a 4-arm RCT of cognitive rehabilitation 3 to 24 months after mTBI and were successfully contacted by phone 5 years later. Original and 5-year follow-up participants in each of 4 RCT treatment arms included: psychoeducation ( n = 32 original, n = 17 follow-up), computer ( n = 30 original, n = 11 follow-up), therapist-directed ( n = 30 original, n = 23 follow-up), integrated ( n = 34 original, n = 18 follow-up).
Inception cohort evaluated 5 years after completion of an RCT of cognitive rehabilitation.
Postconcussion symptoms (Neurobehavioral Symptom Inventory total score), psychological distress (Symptom Checklist-90-revised Global Severity Index score), and functional cognitive/behavioral symptoms (Key Behaviors Change Inventory total average score).
Participants' postconcussive symptoms and psychological distress improved at the 5-year follow-up. Functional cognitive/behavioral symptoms were not significantly improved, but therapeutic gains were maintained across time, to 5 years after completing the RCT.
In this sample of military personnel, postconcussive symptoms and psychological distress significantly improved from posttreatment to 5 years after cognitive rehabilitation, regardless of treatment arm. Functional cognitive/behavioral symptoms significantly improved with treatment while treatment gains were maintained at the 5-year follow-up. Replication of these results with a larger sample and interim data between 18 weeks and 5 years post-treatment is needed.
研究参加轻度创伤性脑损伤（mTBI）认知康复随机对照试验（RCT）5 年后的现役军人的功能状况。
家庭电话访谈和基于互联网的自我评估。
共有 126 名现役军人参加了 mTBI 后 3 至 24 个月的 4 臂 RCT 认知康复研究，其中 69 名（55%）成功通过电话联系，并在 5 年后进行了电话随访。每个 RCT 治疗组的原始和 5 年随访参与者包括：心理教育（n = 32 例原始，n = 17 例随访）、计算机（n = 30 例原始，n = 11 例随访）、治疗师指导（n = 30 例原始，n = 23 例随访）、综合（n = 34 例原始，n = 18 例随访）。
完成 RCT 认知康复治疗后，评估患者 5 年。
脑震荡后症状（神经行为症状量表总分）、心理困扰（症状清单-90 修订版总体严重程度指数评分）和功能认知/行为症状（关键行为改变量表总分平均评分）。
随访 5 年后，患者的脑震荡后症状和心理困扰得到改善。功能认知/行为症状无显著改善，但治疗效果在时间上得以维持，直到完成 RCT 后 5 年。
在该军事人员样本中，无论治疗组如何，脑震荡后症状和心理困扰从治疗后到认知康复后 5 年显著改善。功能认知/行为症状在治疗时显著改善，而治疗效果在 5 年随访时得到维持。需要用更大的样本和治疗后 18 周至 5 年的中间数据来复制这些结果。
