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- Åhman, Sara, et al.
(författare)
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Long-term follow-up of patients with mild traumatic brain injury : a mixed-methods study
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 45:8, s. 758-764
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To characterize the long-term consequences of mild traumatic brain injury regarding post-concussion symptoms, post-traumatic stress, and quality of life; and to investigate differences between men and women.DESIGN: Retrospective mixed-methods study.Subjects/patients and methods: Of 214 patients with mild traumatic brain injury seeking acute care, 163 answered questionnaires concerning post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire; RPQ), post-traumatic stress (Impact of Event Scale; IES), and quality of life (Short Form Health Survey; SF-36) 3 years post-injury. A total of 21 patients underwent a medical examination in connection with the survey. The patients were contacted 11 years later, and 10 were interviewed. Interview data were analysed with content analysis.RESULTS: The mean total RPQ score was 12.7 (standard deviation; SD 12.9); 10.5 (SD 11.9) for men and 15.9 (SD 13.8) for women (p = 0.006). The 5 most common symptoms were fatigue (53.4%), poor memory (52.5%), headache (50.9%), frustration (47.9%) and depression (47.2%). The mean total IES score was 9.6 (SD 12.9) 7.1 (SD 10.3) for men and 13.0 (SD 15.2) for women (p = 0.004). In general, the studied population had low scores on the Short Form Health Survey (SF-36). The interviews revealed that some patients still had disabling post-concussion symptoms and consequences in many areas of life 11 years after the injury event.CONCLUSION: Long-term consequences were present for approximately 50% of the patients 3 years after mild traumatic brain injury and were also reported 11 years after mild traumatic brain injury. This needs to be taken into account by healthcare professionals and society in general when dealing with people who have undergone mild traumatic brain injury.
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- Bergström, Margareta, et al.
(författare)
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One-year follow-up of body awareness and perceived health after participating in a multimodal pain rehabilitation programme : A pilot study
- 2014
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Ingår i: European Journal of Physiotherapy. - : Taylor & Francis Group. - 2167-9169 .- 2167-9177. ; 16:4, s. 246-254
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate body awareness and perceived health in patients with chronic pain after participation in a multimodal rehabilitation (MMR) programme and at 1-year follow-up.Method: Thirty-nine patients participated in a 5-week outpatient MMR programme. They were evaluated with the main outcome measures: the Body Awareness Scale (BAS) using an interview (BAS-I) and a movement test (BAS-Obs), the Nottingham Health Profile (NHP) and the Sense of Coherence (SOC). A subgroup analysis was conducted based on the BAS-Obs scores at the start of the MMR programme with cut-off at the upper quartile ≥ 26 point, classified as low body awareness; the three lower quartiles were classified as moderate/high body awareness.Results: All patients improved on the BAS-Obs and the BAS-I from the start to the end of the MMRP (p < 0.001) and at 1-year follow-up on four of the BAS-Obs subscales (p < 0.005). The moderate/high body awareness group improved on BAS-I, NHP and SOC (p < 0.01) and on two BAS-I subscales (p < 0.005), while the low body awareness group improved on one subscale (p = 0.003).Conclusion: Our results suggest that the use of the BAS-Obs assessment to identify patients with high or low levels of body awareness could play an important part in understanding the individual's clinical needs and be useful for developing an effective rehabilitation programme for patients with chronic pain.
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- Cancelliere, Carol, et al.
(författare)
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Protocol for a systematic review of prognosis after mild traumatic brain injury : an update of the WHO Collaborating Centre Task Force findings
- 2012
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Ingår i: Systematic Reviews. - : Springer Science and Business Media LLC. - 2046-4053. ; :1, s. 17-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mild traumatic brain injury (MTBI) is a major public-health concern and represents 70-90% of all treated traumatic brain injuries. The last best-evidence synthesis, conducted by the WHO Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation in 2002, found few quality studies on prognosis. The objective of this review is to update these findings. Specifically, we aim to describe the course, identify modifiable prognostic factors, determine long-term sequelae, and identify effects of interventions for MTBI. Finally, we will identify gaps in the literature, and make recommendations for future research.Methods: The databases MEDLINE, PsychINFO, Embase, CINAHL and SPORTDiscus were systematically searched (2001 to date). The search terms included 'traumatic brain injury', 'craniocerebral trauma', 'prognosis', and 'recovery of function'. Reference lists of eligible papers were also searched. Studies were screened according to pre-defined inclusion and exclusion criteria. Inclusion criteria included original, published peer-reviewed research reports in English, French, Swedish, Norwegian, Danish and Spanish, and human participants of all ages with an accepted definition of MTBI. Exclusion criteria included publication types other than systematic reviews, meta-analyses, randomized controlled trials, cohort studies, and case-control studies; as well as cadaveric, biomechanical, and laboratory studies. All eligible papers were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers performed independent, in-depth reviews of each eligible study, and a third reviewer was consulted for disagreements. Data from accepted papers were extracted into evidence tables, and the evidence was synthesized according to the modified SIGN criteria.Conclusion: The results of this study form the basis for a better understanding of recovery after MTBI, and will allow development of prediction tools and recommendation of interventions, as well as informing health policy and setting a future research agenda.
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- Cancelliere, Carol, et al.
(författare)
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Systematic review of prognosis and return to play after sport concussion : results of the international collaboration on mild traumatic brain injury prognosis
- 2014
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier. - 0003-9993 .- 1532-821X. ; 95:3, Suppl, s. S210-S229
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Forskningsöversikt (refereegranskat)abstract
- ObjectiveTo synthesize the best available evidence on prognosis after sport concussion.Data SourcesMEDLINE and other databases were searched (2001–2012) with terms including “craniocerebral trauma” and “sports.” Reference lists of eligible articles were also searched.Study SelectionRandomized controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 concussion cases.Data ExtractionEligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables.Data SynthesisEvidence was synthesized qualitatively according to modified SIGN criteria, and studies were categorized as exploratory or confirmatory based on the strength of their design and evidence. After 77,914 records were screened, 52 articles were eligible for this review, and 24 articles (representing 19 studies) with a low risk of bias were accepted. Our findings are based on exploratory studies of predominantly male football players at the high school, collegiate, and professional levels. Most athletes recover within days to a few weeks, and American and Australian professional football players return to play quickly after mild traumatic brain injury. Delayed recovery appears more likely in high school athletes, in those with a history of previous concussion, and in those with a higher number and duration of postconcussion symptoms.ConclusionsThe evidence concerning sports concussion course and prognosis is very preliminary, and there is no evidence on the effect of return-to-play guidelines on prognosis. Our findings have implications for further research. Well-designed, confirmatory studies are urgently needed to understand the consequences of sport concussion, including recurrent concussion, across different athletic populations and sports.
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- Cancelliere, Carol, et al.
(författare)
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Systematic review of return to work after mild traumatic brain injury : results of the international collaboration on mild traumatic brain injury prognosis
- 2014
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier. - 0003-9993 .- 1532-821X. ; 95:3, Suppl, s. S201-S209
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Forskningsöversikt (refereegranskat)abstract
- ObjectiveTo synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI).Data SourcesMEDLINE and other databases were searched (2001–2012) with terms including “craniocerebral trauma” and “employment.” Reference lists of eligible articles were also searched.Study SelectionControlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases.Data ExtractionEligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables.Data SynthesisEvidence was synthesized qualitatively according to modified Scottish Intercollegiate Guidelines Network criteria and prioritized according to design as exploratory or confirmatory. After 77,914 records were screened, 299 articles were found eligible and reviewed; 101 (34%) of these with a low risk of bias were accepted as scientifically admissible, and 4 of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3 to 6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11y of formal education), nausea or vomiting on hospital admission, extracranial injuries, severe head/bodily pain early after injury, and limited job independence and decision-making latitude.ConclusionsOur findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2y post-MTBI).
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