Tags

Type your tag names separated by a space and hit enter

Nonsurgical interventions after mild traumatic brain injury: a systematic review. Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.
Arch Phys Med Rehabil. 2014 Mar; 95(3 Suppl):S257-64.AP

Abstract

OBJECTIVE

To synthesize the best available evidence regarding the impact of nonsurgical interventions on persistent symptoms after mild traumatic brain injury (MTBI).

DATA SOURCES

MEDLINE and other databases were searched (2001-2012) with terms including "rehabilitation." Inclusion criteria were original, peer-reviewed research published in English and other languages. References were also identified from the bibliographies of eligible articles.

STUDY SELECTION

Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 MTBI cases and assess nonsurgical interventions using clinically relevant outcomes such as self-rated recovery.

DATA EXTRACTION

Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed each study and extracted data from the admissible studies into evidence tables.

DATA SYNTHESIS

The evidence was synthesized qualitatively according to the modified SIGN criteria. Recommendations were linked to the evidence tables using a best-evidence synthesis. After 77,914 records were screened, only 2 of 7 studies related to nonsurgical interventions were found to have a low risk of bias. One studied the effect of a scheduled telephone intervention offering counseling and education on outcome and found a significantly better outcome for symptoms (6.6 difference in adjusted mean symptom score; 95% confidence interval, 1.2-12.0), but no difference in general health outcome at 6 months after MTBI. The other was a randomized controlled trial of the effectiveness of 6 days of bed rest on posttraumatic complaints 6 months postinjury, compared with no bed rest, and found no effect.

CONCLUSIONS

Some evidence suggests that early, reassuring educational information is beneficial after MTBI. Well-designed intervention studies are required to develop effective treatments and improve outcomes for adults and children at risk for persistent symptoms after MTBI.

Authors+Show Affiliations

Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden. Electronic address: catharina.nygren-deboussard@ds.se.Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

24581911

Citation

Nygren-de Boussard, Catharina, et al. "Nonsurgical Interventions After Mild Traumatic Brain Injury: a Systematic Review. Results of the International Collaboration On Mild Traumatic Brain Injury Prognosis." Archives of Physical Medicine and Rehabilitation, vol. 95, no. 3 Suppl, 2014, pp. S257-64.
Nygren-de Boussard C, Holm LW, Cancelliere C, et al. Nonsurgical interventions after mild traumatic brain injury: a systematic review. Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014;95(3 Suppl):S257-64.
Nygren-de Boussard, C., Holm, L. W., Cancelliere, C., Godbolt, A. K., Boyle, E., Stålnacke, B. M., Hincapié, C. A., Cassidy, J. D., & Borg, J. (2014). Nonsurgical interventions after mild traumatic brain injury: a systematic review. Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Archives of Physical Medicine and Rehabilitation, 95(3 Suppl), S257-64. https://doi.org/10.1016/j.apmr.2013.10.009
Nygren-de Boussard C, et al. Nonsurgical Interventions After Mild Traumatic Brain Injury: a Systematic Review. Results of the International Collaboration On Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014;95(3 Suppl):S257-64. PubMed PMID: 24581911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonsurgical interventions after mild traumatic brain injury: a systematic review. Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. AU - Nygren-de Boussard,Catharina, AU - Holm,Lena W, AU - Cancelliere,Carol, AU - Godbolt,Alison K, AU - Boyle,Eleanor, AU - Stålnacke,Britt-Marie, AU - Hincapié,Cesar A, AU - Cassidy,J David, AU - Borg,Jörgen, PY - 2013/02/04/received PY - 2013/10/11/revised PY - 2013/10/23/accepted PY - 2014/3/4/entrez PY - 2014/3/4/pubmed PY - 2014/4/30/medline KW - Craniocerebral trauma KW - Post-concussion syndrome KW - Rehabilitation KW - Review, systematic SP - S257 EP - 64 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 95 IS - 3 Suppl N2 - OBJECTIVE: To synthesize the best available evidence regarding the impact of nonsurgical interventions on persistent symptoms after mild traumatic brain injury (MTBI). DATA SOURCES: MEDLINE and other databases were searched (2001-2012) with terms including "rehabilitation." Inclusion criteria were original, peer-reviewed research published in English and other languages. References were also identified from the bibliographies of eligible articles. STUDY SELECTION: Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 MTBI cases and assess nonsurgical interventions using clinically relevant outcomes such as self-rated recovery. DATA EXTRACTION: Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed each study and extracted data from the admissible studies into evidence tables. DATA SYNTHESIS: The evidence was synthesized qualitatively according to the modified SIGN criteria. Recommendations were linked to the evidence tables using a best-evidence synthesis. After 77,914 records were screened, only 2 of 7 studies related to nonsurgical interventions were found to have a low risk of bias. One studied the effect of a scheduled telephone intervention offering counseling and education on outcome and found a significantly better outcome for symptoms (6.6 difference in adjusted mean symptom score; 95% confidence interval, 1.2-12.0), but no difference in general health outcome at 6 months after MTBI. The other was a randomized controlled trial of the effectiveness of 6 days of bed rest on posttraumatic complaints 6 months postinjury, compared with no bed rest, and found no effect. CONCLUSIONS: Some evidence suggests that early, reassuring educational information is beneficial after MTBI. Well-designed intervention studies are required to develop effective treatments and improve outcomes for adults and children at risk for persistent symptoms after MTBI. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/24581911/Nonsurgical_interventions_after_mild_traumatic_brain_injury:_a_systematic_review__Results_of_the_International_Collaboration_on_Mild_Traumatic_Brain_Injury_Prognosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(13)01064-2 DB - PRIME DP - Unbound Medicine ER -