Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 12 , Pages 2227-2238 , December 2008

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

  • Rodney D. Vanderploeg, PhD

      Affiliations

    • Department of Mental Health and Behavioral Sciences, and Defense and Veterans Brain Injury Center, James A. Haley Veterans Affairs Medical Center, Tampa, FL
    • Department of Psychiatry and Behavioral Medicine, University of South Florida, Tampa, FL
    • Department of Psychology, University of South Florida, Tampa, FL
    • Corresponding Author InformationReprint requests to Rodney D. Vanderploeg, PhD, Mental Health and Behavioral Sciences—Psychology (116B), James A. Haley VAMC, 13000 N. Bruce B. Downs Blvd, Tampa, FL, 33612
  • ,
  • Karen Schwab, PhD

      Affiliations

    • Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC
    • Uniformed Services University of the Health Sciences, Bethesda, MD
  • ,
  • William C. Walker, MD

      Affiliations

    • Defense and Veterans Brain Injury Center, Hunter H. McGuire Veterans Affairs Medical Center, Richmond, VA
    • Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA
  • ,
  • Jamie A. Fraser, MPH

      Affiliations

    • Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC
  • ,
  • Barbara J. Sigford, MD, PhD

      Affiliations

    • Physical Medicine and Rehabilitation, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN; and Defense and Veterans Brain Injury Center
  • ,
  • Elaine S. Date, MD

      Affiliations

    • Comprehensive Rehabilitation Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA; and Defense and Veterans Brain Injury Center
    • Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA
  • ,
  • Steven G. Scott, DO

      Affiliations

    • Physical Medicine and Rehabilitation Service; Polytrauma Rehabilitation Center, James A. Haley Veterans Affairs Medical Center, Tampa, FL; and Defense and Veterans Brain Injury Center
    • Physical Medicine and Rehabilitation Section, Department of Internal Medicine, University of South Florida College of Medicine, Tampa, FL
  • ,
  • Glenn Curtiss, PhD

      Affiliations

    • Department of Mental Health and Behavioral Sciences, and Defense and Veterans Brain Injury Center, James A. Haley Veterans Affairs Medical Center, Tampa, FL
    • Department of Psychiatry and Behavioral Medicine, University of South Florida, Tampa, FL
  • ,
  • Andres M. Salazar, MD

      Affiliations

    • Oncovir Inc, Washington, DC
  • ,
  • Deborah L. Warden, MD

      Affiliations

    • Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC
    • Uniformed Services University of the Health Sciences, Bethesda, MD
  • ,
  • Defense and Veterans Brain Injury Center Study Group

References 

  1. Sosin DM, Sniezek JE, Thurman DJ. Incidence of mild and moderate brain injury in the United States 1991. Brain Inj. 1996;10:47–54
  2. Thurman DJ, Alverson C, Dunn KA, Guerrero J, Sniezek JE. Traumatic brain injury in the United States: a public health perspective. J Head Trauma Rehabil. 1999;14:602–615
  3. Traumatic Brain Injury (Incidence & Distribution-National Center for Injury Prevention and Control). http://www.cdc.gov/ncipc/factsheets/tbi.htmOctober 27, 2008
  4. Fann JR, Burington B, Leonetti A, Jaffe K, Katon WJ, Thompson RS. Psychiatric illness following traumatic brain injury in an adult health maintenance organization population. Arch Gen Psychiatry. 2004;61:53–61
  5. Rimel RW, Giordani B, Barth JT, Boll TJ, Jane JA. Disability caused by minor head injury. Neurosurgery. 1981;9:221–228
  6. Thornhill S, Teasdale GM, Murray GD, McEwen J, Roy CW, Penny KI. Disability in young people and adults one year after head injury: prospective cohort study. BMJ. 2000;320:1631–1635
  7. Will B, Galani R, Kelche C, Rosenzweig MR. Recovery from brain injury in animals: relative efficacy of environmental enrichment, physical exercise or formal training. Prog Neurobiol. 2004;72:167–182
  8. Aronow HU. Rehabilitation effectiveness with severe brain injury: translating research into policy. J Head Trauma Rehabil. 1987;2:24–36
  9. Cope DN, Cole JR, Hall KM, Barkan H. Brain injury: analysis of outcome in a post-acute rehabilitation system, part 1: general analysis. Brain Inj. 1991;5:111–125
  10. Cope DN, Hall K. Head injury rehabilitation: benefit of early intervention. Arch Phys Med Rehabil. 1982;63:433–437
  11. Haffey WJ, Abrams DL. Employment outcomes for participants in a brain injury work re-entry program: preliminary findings. J Head Trauma Rehabil. 1991;6:24–34
  12. Hall KM, Cope DN. The benefit of rehabilitation in traumatic brain injury: a literature review. J Head Trauma Rehabil. 1995;10:1–13
  13. Prigatano GP, Klonoff PS, O'Brian KP, et al. Productivity after neuropsychologically oriented millieu rehabilitation. J Head Trauma Rehabil. 1994;9:91–102
  14. Ruff RM, Niemann H. Cognitive rehabilitation versus day treatment in head-injured adults: is there an impact on emotional and psychosocial adjustment?. Brain Inj. 1990;4:339–347
  15. Chesnut RM, Carney N, Maynard H, Mann NC, Patterson P, Helfand M. Summary report: evidence for the effectiveness of rehabilitation for persons with traumatic brain injury. J Head Trauma Rehabil. 1999;14:176–188
  16. Evans RW, Ruff RM. Outcome and value: a perspective on rehabilitation outcomes achieved in acquired brain injury. J Head Trauma Rehabil. 1992;7:24–36
  17. High WM, Boake C, Lembkuhl LD. Critical analysis of studies evaluating the effectiveness of rehabilitation after traumatic brain injury. J Head Trauma Rehabil. 1995;10:14–26
  18. Levin HS. Cognitive rehabilitation: unproved but promising. Arch Neurol. 1990;47:223–224
  19. Prigatano G. Rehabilitation interventions after traumatic brain injury. In:  Bach-y-Rita P editors. Traumatic brain injury. New York: Demos; 1989;p. 175–190
  20. Volpe BT, McDowell FH. The efficacy of cognitive rehabilitation in patients with traumatic brain injury. Arch Neurol. 1990;47:220–222
  21. Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Arch Phys Med Rehabil. 2000;81:1596–1615
  22. Cicerone KD, Dahlberg C, Malec JF, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Arch Phys Med Rehabil. 2005;86:1681–1692
  23. Heinemann AW, Hamilton B, Linacre JM, Wright BD, Granger C. Functional status and therapeutic intensity during inpatient rehabilitation. Amer J Phys Med Rehabil. 1995;74:315–326
  24. Cifu DX, Kreutzer JS, Kolakowsky-Hayner SA, Marwitz JH, Englander J. The relationship between therapy intensity and rehabilitative outcomes after traumatic brain injury: a multicenter analysis. Arch Phys Med Rehabil. 2003;84:1441–1448
  25. Salazar AM, Warden DL, Schwab K, Spector J, Braverman S, Walter J, et al. Cognitive rehabilitation for traumatic brain injury: a randomized trial. Defense and Veterans Head Injury Program (DVHIP) Study Group. JAMA. 2000;283:3075–3081
  26. Bell KR, Temkin NR, Esselman PC, et al. The effect of a scheduled telephone intervention on outcome after moderate to severe traumatic brain injury: a randomized trial. Arch Phys Med Rehabil. 2005;86:851–856
  27. Novack TA, Caldwell SG, Duke LW, Bergquist TF, Gage RJ. Focused versus unstructured intervention for attention deficits after traumatic brain injury. J Head Trauma Rehabil. 1996;11:52–60
  28. Salazar AM, Zitnay GA, Warden DL, Schwab KA. Defense and Veterans Head Injury Program: background and overview. J Head Trauma Rehabil. 2000;15:1081–1091
  29. Vanderploeg RD, Collins RC, Sigford B, et al. Practical and theoretical considerations in designing rehabilitation trials: the DVBIC cognitive-didactic versus functional-experiential treatment study experience. J Head Trauma Rehabil. 2006;21:179–193
  30. Sohlberg MM, Mateer CA. Attention process training (APT). Puyallup (WA): Association for Neuropsychological Research and Development; 1986;
  31. Sohlberg MM, Mateer CA. Introduction to cognitive rehabilitation: theory & practice. New York: Guilford Pr; 1989;
  32. Sohlberg MM, Mateer CA. Cognitive rehabilitation: an integrative neuropsychological approach. New York: Guilford Pr; 2001;
  33. Giles GM, Clark-Wilson J. Brain injury rehabilitation: a neurofunctional approach. New York: Chapman and Hall; 1993;
  34. Giles GM, Clark-Wilson J. Rehabilitation of the severely brain-injured adult: a practical approach. Gloucestershire: Stanley Thornes Ltd; 1999;
  35. Giles GM, Manchester D. Two approaches to behavior disorder after traumatic brain injury. J Head Trauma Rehabil. 2006;21:168–178
  36. Hartley LL. Cognitive-communicative abilities following brain injury: a functional approach (neurogenic communication disorders). San Diego (CA): Singular; 1995;
  37. Granger CV. The emerging science of functional assessment: our tool for outcomes analysis. Arch Phys Med Rehabil. 1998;79:235–240
  38. Hamilton BB, Granger CV, Sherwin FS, Zielezny M, Tashman JS. A uniform national data system for medical rehabilitation. In:  Fuhrer M editors. Rehabilitation outcomes: analysis and measurement. Baltimore(MD): Brookes; 1987;p. 137–147
  39. Rappaport M, Hall KM, Hopkins HK, et al. Disability rating scale for severe head trauma: coma to community. Arch Phys Med Rehabil. 1982;63:118–123
  40. Wing JK, Cooper JE, Sartorius N. Present state examination. 9th ed. London: Medical Research Council; 1974;
  41. Marin RS. Apathy: concept, syndrome, neural mechanisms, and treatment. Semin Clin Neuropsychiatry. 1996;1:304–314
  42. Marin RS, Biedrzycki RC, Firinciogullari S. Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res. 1991;38:143–162
  43. Levin HS, High WM, Goethe KE, et al. The neurobehavioral rating scale: assessment of the behavioral sequelae of head injury by the clinician. J Neurol Neurosurg Psychiatry. 1987;50:183–193
  44. Spilker B. Guide to clinical trials. New York: Raven Pr; 1991;
  45. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–198
  46. Levine B, Robertson IH, Clare L, et al. Rehabilitation of executive functioning: an experimental-clinical validation of goal management training. J Int Neuropsychol Soc. 2000;6:299–312
  47. Sohlberg MM, Mateer CA. Effectiveness of an attention-training program. J Clin Exp Neuropsychol. 1987;9:117–130
  48. Sohlberg MM, Mateer CA. Training use of compensatory memory books: a three stage behavioral approach. J Clin Exp Neuropsychol. 1989;11:871–891
  49. Barrett AM, Levy CR, Gonzalez-Rothi LJ. Treatment innovation in the rehabilitation of cognitive and motor deficits after stroke and brain injury. Am J Phys Med Rehabil. 2007;6:423–425

 Supported by the Defense and Veterans Brain Injury Center, Uniformed Services University of the Health Sciences, Bethesda, MD, the Department of Veterans Affairs, Veterans Health Administration, and a Department of Defense award administered through the Henry Jackson Foundation (grant no. MDA 905-03-2-0003).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)01485-8

doi: 10.1016/j.apmr.2008.06.015

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 12 , Pages 2227-2238 , December 2008