Graded exposure therapy for adults with persistent symptoms after mTBI: A historical comparison study

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.

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Publication Details

Journal
Neuropsychological Rehabilitation
Published
2024-09-27
DOI
https://doi.org/10.1080/09602011.2024.2403647
Citations
1
Primary Topic
Cardiovascular Syncope and Autonomic Disorders
Type
article
Field-Weighted Citation Impact
0.57
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article

Graded exposure therapy for adults with persistent symptoms after mTBI: A historical comparison study

Mathilde Rioux, Grant L. Iverson, Ana‐Maria Vranceanu, Deborah L. Snell et al.
1 citations
Neuropsychological Rehabilitation
Cardiovascular Syncope and Autonomic Disorders
0.57
article

Graded exposure therapy for adults with persistent symptoms after mTBI: A historical comparison study

Mathilde Rioux, Grant L. Iverson, Ana‐Maria Vranceanu, Deborah L. Snell, Keith Owen Yeates, Cindy Hunt, Penelope M. A. Brasher, William J. Panenka, Chantel T. Debert, Mark Theodore Bayley, Noah D. Silverberg, Molly Cairncross, Matthew J. Burke, Gabriel McKeown
article en
1 citations

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.

Neuropsychological RehabilitationVol. 35(7)
St. Michael's Hospital (CA), Sunnybrook Health Science Centre (CA), University Health Network (CA), Harvard University (US), Vancouver Coastal Health (CA), University of British Columbia (CA), University of Calgary (CA), Simon Fraser University (CA), University of Toronto (CA), Spaulding Rehabilitation Hospital (US), Toronto Rehabilitation Institute (CA), Spinal Cord Injury BC (CA), Alberta Children's Hospital (CA), Health Sciences Centre (CA), Health Net (US), Massachusetts General Hospital (US), Rehabilitation Research and Development Service (US), Sports Concussion Institute (US), BC Mental Health & Substance Use Services (CA), Public Health Ontario (CA), Vancouver Coastal Health Research Institute (CA), BC Children's Hospital (CA), Tech Foundation (US), Canterbury District Health Board (NZ), Sunnybrook Hospital (CA), Sunnybrook Research Institute, Hotchkiss Brain Institute (CA), Mass General Brigham (US), University of Otago (NZ)
Openalex Percentile: Top 29%
Cardiovascular Syncope and Autonomic Disorders
0.57
DOISourceOpenAlex
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