Article

Traumatic brain injury (TBI) can result in cognitive impairments and persistent
postconcussive symptoms that limit functional recovery,
including return to work.
We evaluated a 12 wk compensatory cognitive training intervention (Cognitive
Symptom Management and Rehabilitation Therapy [CogSMART]) in the context of
supported employment for Veterans with mild to moderate TBI. Participants were
randomly assigned to receive 12 wk of supported employment plus CogSMART or
enhanced supported employment that controlled for therapist attention (control).
CogSMART sessions were delivered by the employment specialist and included
psychoeducation regarding TBI; strategies to improve sleep, fatigue, headaches,
and tension; and compensatory cognitive strategies in the domains of prospective
memory, attention, learning and memory, and executive functioning. Compared with
controls, those assigned to supported employment plus CogSMART demonstrated
significant reductions in postconcussive symptoms (Cohen d = 0.97) and
improvements in prospective memory functioning (Cohen d = 0.72). Effect sizes
favoring CogSMART for posttraumatic stress disorder symptom severity, depressive
symptom severity, and attainment of competitive work within 14 wk were in the
small to medium range (Cohen d = 0.35-0.49). Those who received CogSMART rated
the intervention highly. Results suggest that adding CogSMART to supported
employment may improve postconcussive symptoms and prospective memory. These
effects, as well as smaller effects on psychiatric symptoms and ability to return to work, warrant replication in a larger trial.

Langue : ANGLAIS