Combined Interdisciplinary Rehabilitation for Persisting Symptoms following a Mild Traumatic Brain Injury
Abstract
Mild traumatic brain injuries (mTBI’s) are the most frequently experienced form of traumatic brain injury. Certain demographic characteristics, including older age, female sex, and pre-existing mental health conditions, increase the risk of experiencing persisting symptoms beyond the acute injury phase. Care for individuals with an mTBI is limited by geography, non-standardized trajectories of care, and gaps in healthcare provider knowledge. An interdisciplinary outpatient intervention has been created to address these issues, but has not been evaluated. Accordingly, the overall purpose of this thesis was to investigate treatment outcomes of individuals with persisting symptoms following an mTBI after completing a combined outpatient physiotherapy and occupational therapy rehabilitation intervention. This question was investigated through three studies evaluating changes in subjective outcomes and how they are influenced by different demographics. The results demonstrated individuals improved in performance and satisfaction of self-identified goals after completing this intervention in-person, and most frequently chose productivity-based goals (Study 1). Additionally, age, baseline symptom and anxiety scores, sex, days since injury, education, and mechanism of injury did not influence change in satisfaction with self-identified goals (Study 2). Lastly, there may be no differences in subjective outcomes after completing a virtual version of this intervention, especially for females (Study 3). In conclusion, this study demonstrates the in-person version of this intervention improves performance and satisfaction of participant-identified goals for adults with persisting symptoms following an mTBI that require physiotherapy and occupational therapy services. Additionally, there may be no difference in subjective changes following participation between in-person or virtual mTBI rehabilitation, particularly in female participants. However, future work is necessary to expand on this work and evaluate whether these preliminary results are supported with a fully powered study.