Impact of Intensive Multidisciplinary Outpatient Care on Participation in Social Roles in Military Service Members with Mild Traumatic Brain Injury

Research Objectives: To investigate the effect of a two-week intensive outpatient program, specializing in cognitive rehabilitation and traumatic stress, on patients' self-reported satisfaction with and ability to engage in social roles.

Design: Participants completed self-report questionnaires assessing quality of life and functional outcomes before and after completing the 2-week treatment program.

Setting: Outpatient academic multidisciplinary rehabilitation clinic.

Participants: 202 military service members and veterans who completed an intensive outpatient treatment program for mild traumatic brain injury (mTBI). Participants were 88.6% male, 81.7% white, 10.4% Hispanic; mean age was 41 years (SD=8.66).

Interventions: 2-weeks of daily treatments including individual cognitive rehabilitation or cognitive behavioral therapy, physical therapy, cognitive and behavioral group therapies, expressive art therapies, fitness, peer support, and medical interventions.

Main Outcome Measures: Self report on PROMIS Satisfaction with Social Roles and PROMIS Ability to Participant in Social Roles.

Results: Following treatment, results showed a significant increase in satisfaction with participation in social roles (t(184)=-8.636, p< 0.001, d=-0.635), with a mean absolute change score of 5.0 (SD=7.8). In particular, there was a significant increase in satisfaction with work (t(186)=-8.203, p< 0.001, d=-0.600) and with family-related roles (t(187=-6.122, p< 0.001, d=-0.446). Results also indicated a statistically significant increase in participants’ ability to participate in social roles (t(185)=-4.430, p< 0.001, d=-0.325), with a mean absolute change score of 1.1 (SD=3.3). Specifically, there was a significant increase in reported ability to participate in work-related activities (t(186)=-4.712, p< 0.001, d=-0.345), and family activities (t(187)=-2.99, p=0.003, d=-0.218).

Conclusions: Results show that multidisciplinary rehabilitation for mTBI in an intensive two week format improved patients satisfaction with their social roles and, more modestly, their ability to perform those roles. Future research should try to understand mechanisms of change for these symptoms and the impact of potential comorbidities.

Author(s) Disclosures: The authors have no disclosures to report.