A Controlled Trial of an Acute Neurobehavioral and Cognitive Intervention Following TBI

Scientific Paper

Interventions

Wed, 6/15, 7:00 AM
Lincoln East

• Janet P. Niemeier, PhD, ABPP
  Virginia Commonwealth University Health System, Department of Physical Medicine and Rehabilitation
  jniemeier@mcvh-vcu.edu

• Attendees will be able to describe the design, methodology, outcomes and implications of finding of a controlled trial of an acute comprehensive, manualized interventions for persons with traumatic brain injury.

Primary objective: To evaluate the effectiveness of a brief acute neurobehavioral intervention. The First Steps Acute Neurobehavioral and Cognitive Intervention (FANCI), with persons who have traumatic brain injury (TBI).

Research design: Prospective, controlled, repeated measures design.

Methods and procedures: Seventy-two patients in acute TBI rehabilitation participated either as FANCI subjects or as control participants who watched digital video discs to control for time and attention. Study measures were the Neurobehavioral Rating Scale-Revised (NRS-R), Functional Independence Measure (FIMTM), a FANCI Learning Assessment (LA), and the Satification with Life Scale (SWLS).

Main outcomes and reesults: In comparison with controls, FANCI participants had significantly greater neurobehavioral (cognitive, emotional, and behavioral) [F(1, 59.33) = 19.77, p<0.0001] as well as FIM moteor [F (2,128)-4.03, p <0.0201] improvements. Significantly greater learning occurred and persisted over time for FANCI subjects as compared to controls participants [F92, 134.9) = 35.02, p<0.0001]. Pretreatement cognitive and neurobehavioral status, length of coma, and number of sessions completed were moderating variables for functional an cognitive outcomes.

Conclusions: Persons with TBI benefit from comprehensive, manualized neurobehavioral interventions over and above standard rehabilitation care, even during the acute phase of recovery.