NCT00540020

Brief Summary

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.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
360

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jul 1996

Longer than P75 for not_applicable

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

July 1, 1996

Completed
6.8 years until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2003

Completed
4.4 years until next milestone

First Submitted

Initial submission to the registry

October 4, 2007

Completed
1 day until next milestone

First Posted

Study publicly available on registry

October 5, 2007

Completed
Last Updated

October 5, 2007

Status Verified

October 1, 2007

First QC Date

October 4, 2007

Last Update Submit

October 4, 2007

Conditions

Keywords

Brain InjuriesCognitionRandomized TrialsRehabilitationTreatment Outcome

Outcome Measures

Primary Outcomes (1)

  • (1) Functional independence (i.e., ability to live independently with less than 3 hours of assistance per week) (2) Return to work/school (i.e., paid employment or school enrollment, either full or part time)

    One-year Follow-up

Secondary Outcomes (2)

  • The Functional Independence Measures (FIM)33, 34 consisting of motor and cognitive scores and the Disability Rating Scale Score (DRS)35 were measured.

    Discharge from Protocol Treatment

  • Quality of life, psychosocial function, behavioral, and mood state measures

    One-year Follow-up

Study Arms (2)

Cognitive-Didactic

EXPERIMENTAL

Developed by Sohlberg \& Mateer to target four cognitive domains often impaired by TBI: attention, memory, executive functions, and pragmatic communication. Subjects practiced progressively more difficult paper-and-pencil or computerized cognitive tasks in 1:1 cognitive therapy sessions (1.5-2.5 hours daily).

Other: Rehabilitation

Functional-Experiential

EXPERIMENTAL

The works of Giles and Clark-Wilson and Hartley guided the basic concepts and treatment of the functional-experiential arm (Functional). The objective of the functional protocol was to use real life performance situations and common tasks to remediate or compensate for functional deficits after brain injury. Functional protocol treatment interventions (1.5-2.5 hours daily) typically occurred in group settings and natural environments (hospital recreation areas, group rooms, simulated home environments in the dining room, community outings, etc.).

Other: Rehabilitation

Interventions

Cognitive-DidacticFunctional-Experiential

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • moderate-to-severe closed head injury, manifested by a post-resuscitation Glasgow Coma Scale (GCS) score of 12 or less, or coma of 12 hours or more , or posttraumatic amnesia (PTA) of 24 hours or more, and/or focal cerebral contusion or hemorrhage on computed tomography (CT) or magnetic resonance imaging (MRI)
  • documented traumatic brain injury within 6 months of randomization
  • Rancho Los Amigos Scale (RLAS) cognitive level of 5-7 at time of randomization
  • age 18 or older
  • active duty military member or veteran
  • anticipated length of needed acute interdisciplinary TBI rehabilitation of 30 days or more

You may not qualify if:

  • history of prior moderate to severe traumatic brain injury or other pre-injury severe neurologic or psychiatric condition, such as psychosis, stroke, multiple sclerosis, or spinal cord injury.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (1)

  • Vanderploeg RD, Schwab K, Walker WC, Fraser JA, Sigford BJ, Date ES, Scott SG, Curtiss G, Salazar AM, Warden DL; Defense and Veterans Brain Injury Center Study Group. Rehabilitation of traumatic brain injury in active duty military personnel and veterans: Defense and Veterans Brain Injury Center randomized controlled trial of two rehabilitation approaches. Arch Phys Med Rehabil. 2008 Dec;89(12):2227-38. doi: 10.1016/j.apmr.2008.06.015.

MeSH Terms

Conditions

Brain Injuries, TraumaticBrain Injuries

Interventions

Rehabilitation

Condition Hierarchy (Ancestors)

Brain DiseasesCentral Nervous System DiseasesNervous System DiseasesCraniocerebral TraumaTrauma, Nervous SystemWounds and Injuries

Intervention Hierarchy (Ancestors)

AftercareContinuity of Patient CarePatient CareTherapeuticsHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Deborah L. Warden, M.D.

    The Defense and Veterans Brain Injury Center

    PRINCIPAL INVESTIGATOR
  • Elaine Date, M.D.

    VA Palo Alto Health Care System

    PRINCIPAL INVESTIGATOR
  • Steven Scott, D.O.

    James A. Haley VA

    PRINCIPAL INVESTIGATOR
  • Barbara Sigford, M.D., Ph.D.

    Minneapolis VA

    PRINCIPAL INVESTIGATOR
  • William Walker, M.D.

    Hunter H. McGuire VAMC

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
FED

Study Record Dates

First Submitted

October 4, 2007

First Posted

October 5, 2007

Study Start

July 1, 1996

Study Completion

May 1, 2003

Last Updated

October 5, 2007

Record last verified: 2007-10