Results from a Defense Department study related to traumatic brain injury showed therapist-directed cognitive rehab therapy helps improve memory and attention in service members with concussions. The “Study of Cognitive Rehabilitation Effectiveness,” or SCORE, was led by Brooke Army Medical Center (BAMC) Brain Injury Rehabilitation Service and Defense and Veterans Brain Injury Center at Fort Sam Houston, Texas. The results were published this month in the “Journal of Head Trauma Rehabilitation.”
Goal of SCORE
The goal of the study, which started in late 2010, was to identify and validate rehabilitation interventions to improve the health and quality of life for service members with concussions.
“Cognitive rehabilitation has been examined in individuals at the severe end of the spectrum — with severe TBI or after a coma — and they found that ‘cog rehab’ can help certain aspects of cognitive function,” said Dr. Douglas Cooper, a DVBIC research neuropsychologist at BAMC and a principal investigator on the study. “However, this is the first study that looks at service members and veterans with mild traumatic brain injuries and provides some evidence that these interventions are effective.”
Cognitive Rehab Therapy
Cognitive rehab therapy programs are designed to help TBI patients manage specific problems with perception, memory, thinking and problem solving. Therapy interventions are based on a provider’s assessment and understanding of a patient’s unique challenges.
A variety of specialists (such as neuropsychologists and speech therapists) may work with a patient in different settings to practice skills and strategies to help improve functioning and independence. Developing habits such as writing everyday tasks down in a notebook, setting alarms or reminders, and asking for help are examples of what a patient may explore in therapy.
Researchers with SCORE looked at common methods used to deliver cognitive rehabilitation therapies. Of the methods studied, therapist-directed methods were most effective at improving functional cognitive abilities, including memory and attention.
A cautionary note: Because the average time from injury to treatment for participants in the study was 290 days, Cooper said their findings may not be the same for patients experiencing symptoms from much older injuries. He does believe, though, the results should give hope to those who’ve sustained concussions.
New Message of Hope
“I sometimes hear a lot of very negative connotations about sustaining a concussion or a brain injury. There’s a hopelessness that’s out there,” said Cooper. “I’m hopeful this will be part of the literature that will start to show people there are interventions that can help them, that can improve their symptoms and, most importantly, improve how they function in their families, their jobs and their communities. I believe SCORE will help push that new message.”
Dr. Amy Bowles, another principal investigator on the study and chief of BAMC Brain Injury Rehabilitation Service, recognized the dedication of all those who contributed to SCORE.
“Everyone who worked on this study believes in this work and hopes it will help improve concussion treatment for those who serve our country,” said Bowles. “But we couldn’t have completed it without the 143 service members who took part.”
More with iSCORE
The study of cognitive rehabilitation therapy continues with “Imaging Support of the Study of Cognitive Rehabilitation Effectiveness in Mild Traumatic Brain Injury (iSCORE).” With iSCORE, researchers will try to measure physical brain changes that may occur as a result of cognitive rehabilitation.
“The collaboration between DVBIC and BAMC highlights the Defense Department’s commitment to finding solutions for TBI care through state-of-the-science clinical care and innovative clinical research initiatives,” said Army Col. (Dr.) Geoffrey Grammer, DVBIC national director. “We are dedicated to ensuring those who’ve served receive the best, most up-to-date treatment possible.”