Effects of a Goal-Oriented and Home-Based Intervention in the Chronic Phase of Traumatic Brain Injury

Abstract

<h3>Research Objectives</h3> To evaluate the efficacy of a goal-oriented and home-based rehabilitation intervention in the chronic phase of traumatic brain injury (TBI). As the expected sequelae after TBI are highly heterogeneous, there is a need to tailor rehabilitation interventions to meet the specific need of each patient. <h3>Design</h3> Parallel two-group randomized controlled trial. Pre-test at baseline (T1), follow-up immediately post-intervention (4-5 months; T2) and at 12 months post inclusion (T3). <h3>Setting</h3> Ambulatory resources (physiotherapist, medical doctor, neuropsychologist) from specialized health care services delivered in-home in South-Eastern Norway. <h3>Participants</h3> 120 participants were randomized 1:1 to either treatment or control groups. Inclusion criteria were a TBI diagnosis with radiologically verified intracranial abnormalities, age 18-72 years, time since injury ≥ 2 years and experiencing ongoing TBI-related cognitive, emotional, and/or physical problems, and/or reduced physical and mental health, and/or difficulties with participation in activities with family, friends, and/or in the community. <h3>Interventions</h3> An individualized, goal-oriented intervention delivered in-home or by videoconference, with eight intervention sessions delivered over a 4-month period. Main elements of the intervention were (i) identification of target problem areas, (ii) establishment of SMART-goals and Goal Attainment Scaling, and (iii) development of an action plan with evidence-based strategies to achieve goal and mitigate difficulties. The control group received standard care in the municipalities. <h3>Main Outcome Measures</h3> Primary outcomes were health-related quality of life (HRQoL) and participation. Secondary outcomes included difficulty handling target outcome areas, post-concussive symptoms, anxiety, depression, and functional competency. <h3>Results</h3> The intervention group displayed significantly higher HRQoL, as well as lower rates of post-concussive symptoms and anxiety-related symptoms at T3.The time X group model was not significant for other outcomes. Detailed results will be presented at the conference. <h3>Conclusions</h3> This intervention shows promise as a potential treatment option for a broad range of problem profiles found in the chronic phase of TBI. The intervention might be relevant for other acquired brain injuries, but more research is needed. <h3>Author(s) Disclosures</h3> The authors have nothing to disclose.