Traumatic Brain Injury Clinical Trial
Official title:
Rehabilitation of Traumatic Brain Injury in Active Duty Military Personnel and Veterans: DVBIC Randomized Clinical Trial of Two Rehabilitation Approaches
Context: Traumatic brain injury (TBI) is a common condition associated with significant
long-term cognitive, behavioral, and functional morbidities. There are minimal controlled
efficacy data of various acute rehabilitation intervention approaches.
Objective: To determine the relative efficacy of two different acute TBI rehabilitation
approaches - cognitive-didactic versus functional-experiential. Secondarily to determine
relative efficacy for different patient subpopulations based on baseline cognitive
functioning.
A randomly assigned, intent-to-treat model of two different comprehensive treatment programs
conducted between July 19 1996 and May 16, 2003 in 360 adult participants with moderate to
severe TBI treated in four participating Veterans Administration TBI rehabilitation centers.
All patients admitted to the Commission for Accreditation of Rehabilitation Facilities
(CARF) accredited acute inpatient rehabilitation brain injury programs at 4 participating
Veterans Administration Medical Centers (VAMCs) (Minneapolis, Palo Alto, Richmond, and
Tampa) during the study enrollment period were screened for eligibility.
The design was a randomized-controlled trial with two treatment arms (cognitive-didactic and
functional-experiential), both embedded within an interdisciplinary TBI rehabilitation
program. All treatment was hospital based. The interactive nature of the experimental
conditions precluded subject blinding. Since each participating site serves a wide
geographic area, the protocol permitted post-hospital outcome assessments by structured
telephonic interview, to minimize drop out.
Participants completed baseline assessment then received by random assignment one of the two
standardized protocol rehabilitation programs (summarized below and described in detail
elsewhere). Participants received 1.5 to 2.5 hours daily of protocol-specific therapy plus
another 2 to 2.5 hours daily of occupational and physical therapy. Independent teams of
therapists functioned at each site to deliver the separate treatments and by necessity were
not blinded to treatment. Protocol monitoring site visits, biweekly conference calls, and
biannual investigator meetings were conducted to ensure uniformity of protocol treatment
over time.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Supportive Care
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