A - 34 i-RECOveR: Interdisciplinary Rehabilitation for Persisting Post-Concussion Symptoms in Recovery—Application in Sport-Related Concussion (SRC)

Abstract Purpose This pilot study aimed to explore the feasibility and preliminary efficacy of an interdisciplinary intervention for persistent post-concussion symptoms (PPCSs). Method A single-case experimental design (SCED) with randomisation to multiple baselines was repeated across 15 participants (53% female) (4% SRC) with mild traumatic brain injury (mean age 38.3 years, SD 15.7). The 12-week treatment incorporated psychology, physiotherapy, and medical interventions. Outcomes included feasibility, Rivermead Post-Concussion Symptoms Questionnaire (RPQ), mood, sleep and fatigue, physical functioning, health-related quality of life, illness perceptions, and goal attainment. Changes in PPCSs were evaluated using systematic visual analysis and Tau-U. Changes in secondary outcomes were explored descriptively. Results 16/26 individuals assessed for eligibility were enrolled (61% recruitment rate);15 completed the post-treatment follow-ups, and 13 completed the 1- and 3-month follow-ups (81% retention rate). High treatment adherence was observed. Moderate-large effect sizes for reducing PPCSs were observed in 12/15 cases, with 7/15 reaching statistical significance. Improvements were maintained at follow-up, along with improvements in fatigue, sleep, and mood. 81% of individual therapy goals were achieved. Conclusions Findings from the SCED highlight the benefit of individualized interdisciplinary treatments. For the subsequent i-RECOveR randomised controlled trial (RCT), additional considerations from the 2022 Concussion in Sport Consensus meeting, such as guidelines around return to play or return to learn, were incorporated for those with SRC (to date n = 20, 33%). The investigators aim to explore outcomes for the SRC-participants compared with non-SRC participants to identify ways in which the i-RECOveR treatment program could be successfully adapted for those with PPCS following SRC.