Combined Cognitive and Vocational Interventions After Mild-to-moderate TBI: a Randomized Controlled Trial

NCT ID: NCT03092713

Last Updated: 2021-10-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

121 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-02

Study Completion Date

2021-06-30

Brief Summary

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A considerable number of patients with mild and moderate traumatic brain injury (TBI) experience long-lasting somatic, cognitive, and emotional symptoms that may hamper their capacity to return to work (RTW). Although several studies have described medical, psychological and work-related factors that predict RTW after TBI, well-controlled intervention studies regarding RTW in this group are scarce. Furthermore, there have traditionally been weak collaborations among rehabilitation services in the health sector, the Labor and Welfare Administration (NAV), and the work-places.

The current project proposal describes an innovative randomized controlled trial (RCT) which will explore the effect of combined manualized cognitive rehabilitation efforts and supported employment in real-life competitive work settings for patients who have not returned to work 8 weeks post-injury. The project combines the rehabilitation and vocational science perspectives; it involves multidisciplinary collaboration, and explores the efficacy of increased cross-sectorial collaboration between specialized health care services and the welfare system. If the intervention proves efficient, the project will further describe the cost-effectiveness and utility of the program, and thereby provide important information of use for policy makers. In addition, the study aims at generating knowledge on the RTW-process both for the persons with TBI, and their workplaces, and to disseminate this knowledge in order to create new multidisciplinary and collaborative practices. The project has potential to generate knowledge of relevance for other patients with neurological deficit.

Detailed Description

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Please, see protocol article: https://www.ncbi.nlm.nih.gov/pubmed/29041954

Conditions

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Brain Injuries, Traumatic Cognitive Impairment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial with active treatment group compared to treatment as usual
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Particpant are blinded to Group allocation, and all assessments are blinded to Group allocation.

Study Groups

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Cognitive Intervention and Supported Employment (CCI-SE)

Combined cognitive and vocational rehabilitation in a mixed design.

Group Type ACTIVE_COMPARATOR

Combined cognitive (Compensatory Cognitive Training - CCT) and vocational rehabilitation (Supported Employment)

Intervention Type BEHAVIORAL

The CCI-SE Group receives a manualized Group-based cognitive psycho-educational intervention (10 sessions), combined with supported employment at their work-place.

Control group

Usual follow-up assessment and treatment provided by the multidisciplinary TBI rehabilitation team.

Group Type ACTIVE_COMPARATOR

Control Group

Intervention Type BEHAVIORAL

The Control Group receives usual assessment and treatment at Oslo University Hospital.

Interventions

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Combined cognitive (Compensatory Cognitive Training - CCT) and vocational rehabilitation (Supported Employment)

The CCI-SE Group receives a manualized Group-based cognitive psycho-educational intervention (10 sessions), combined with supported employment at their work-place.

Intervention Type BEHAVIORAL

Control Group

The Control Group receives usual assessment and treatment at Oslo University Hospital.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* reside in Oslo and Akershus counties in Norway
* mild-to-moderate TBI (Glasgow Coma scale score 10-15 at injury site). Confirmation of diagnosis of mild TBI will be done through documenting that acute symptoms adhere to the American Congress of Rehabilitation Medicine's (ACRM) definition of mild TBI.
* loss of consciousness \<24 hours
* posttraumatic amnesia (PTA) \<7 days
* employed in a minimum 50% position at the time of injury
* sick listed at the 50% or higher level due to post-concussive symptoms 2 months post-injury

Exclusion Criteria

* history of severe psychiatric or neurological illness
* active substance abuse
* inability to speak and read Norwegian
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Research Council of Norway

OTHER

Sponsor Role collaborator

Sunnaas Rehabilitation Hospital

OTHER

Sponsor Role collaborator

Oslo Metropolitan University

OTHER

Sponsor Role collaborator

Norwegian Labour and Welfare Administration

OTHER

Sponsor Role collaborator

Oslo University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Nada Andelic

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nada Andelic, MD; PhD

Role: PRINCIPAL_INVESTIGATOR

Oslo University Hospital/University of Oslo

Locations

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Oslo University Hospital, Dept. of physical medicine and rehabilitation

Oslo, , Norway

Site Status

Countries

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Norway

References

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Howe EI, Andelic N, Fure SCR, Roe C, Soberg HL, Hellstrom T, Spjelkavik O, Enehaug H, Lu J, Ugelstad H, Lovstad M, Aas E. Cost-effectiveness analysis of combined cognitive and vocational rehabilitation in patients with mild-to-moderate TBI: results from a randomized controlled trial. BMC Health Serv Res. 2022 Feb 12;22(1):185. doi: 10.1186/s12913-022-07585-3.

Reference Type DERIVED
PMID: 35151285 (View on PubMed)

Howe EI, Fure SCR, Lovstad M, Enehaug H, Sagstad K, Hellstrom T, Brunborg C, Roe C, Nordenmark TH, Soberg HL, Twamley E, Lu J, Andelic N. Effectiveness of Combining Compensatory Cognitive Training and Vocational Intervention vs. Treatment as Usual on Return to Work Following Mild-to-Moderate Traumatic Brain Injury: Interim Analysis at 3 and 6 Month Follow-Up. Front Neurol. 2020 Nov 10;11:561400. doi: 10.3389/fneur.2020.561400. eCollection 2020.

Reference Type DERIVED
PMID: 33240196 (View on PubMed)

Howe EI, Langlo KS, Terjesen HCA, Roe C, Schanke AK, Soberg HL, Sveen U, Aas E, Enehaug H, Alves DE, Klethagen P, Sagstad K, Moen CM, Torsteinsbrend K, Linnestad AM, Nordenmark TH, Rismyhr BS, Wangen G, Lu J, Ponsford J, Twamley EW, Ugelstad H, Spjelkavik O, Lovstad M, Andelic N. Combined cognitive and vocational interventions after mild to moderate traumatic brain injury: study protocol for a randomized controlled trial. Trials. 2017 Oct 17;18(1):483. doi: 10.1186/s13063-017-2218-7.

Reference Type DERIVED
PMID: 29041954 (View on PubMed)

Related Links

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Other Identifiers

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2016/2038

Identifier Type: -

Identifier Source: org_study_id