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Evidence-Based Review of Randomized Controlled Trials of Interventions for Mental Health Management Post-Moderate to Severe Traumatic Brain Injury.

The Journal of head trauma rehabilitation
January 1, 1970
Cecilia Flores-Sandoval et al. (8 authors)
Journal ArticleSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness of walking as a nonpharmacological intervention for depression and stress in individuals with moderate to severe traumatic brain injury (post-MSTBI).

Results Summary

Walking was found to be effective for reducing depression and stress in post-MSTBI patients, alongside other nonpharmacological interventions like Tai Chi and dance.

Population

Individuals with moderate to severe traumatic brain injury (post-MSTBI).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (21)
InterventionDirectionEndpointPopulationDosageImpactClaim #
desipramine
decrease
mental health post-MSTBI
participants post-MSTBI
-
Effective pharmacological treatments included
#1
cerebrolysin
decrease
mental health post-MSTBI
participants post-MSTBI
-
Effective pharmacological treatments included
#2
methylphenidate
no change
mental health post-MSTBI
participants post-MSTBI
-
showed conflicting evidence
#3
rivastigmine
no change
mental health post-MSTBI
participants post-MSTBI
-
showed conflicting evidence
#4
Cognitive behavioral therapy (CBT)
decrease
hopelessness
participants post-MSTBI
-
was found to be effective for
#5
Cognitive behavioral therapy (CBT)
decrease
stress
participants post-MSTBI
-
was found to be effective for
#6
Cognitive behavioral therapy (CBT)
decrease
anxiety
participants post-MSTBI
-
was found to be effective for
#7
Cognitive behavioral therapy (CBT)
no change
depression
participants post-MSTBI
-
may be as effective as supportive psychotherapy for
#8
CBT combined with motivational interviewing
no change
depression
participants post-MSTBI
-
may be as effective as CBT combined with nondirective counseling for
#9
CBT combined with motivational interviewing
no change
stress
participants post-MSTBI
-
may be as effective as CBT combined with nondirective counseling for
#10
CBT combined with motivational interviewing
no change
anxiety
participants post-MSTBI
-
may be as effective as CBT combined with nondirective counseling for
#11
Acceptance and commitment therapy
decrease
anxiety
participants post-MSTBI
-
was effective for
#12
Acceptance and commitment therapy
decrease
stress
participants post-MSTBI
-
was effective for
#13
Acceptance and commitment therapy
decrease
depression
participants post-MSTBI
-
was effective for
#14
Tai Chi
decrease
depression
participants post-MSTBI
-
appeared to be effective for
#15
Tai Chi
decrease
stress
participants post-MSTBI
-
appeared to be effective for
#16
dance
decrease
depression
participants post-MSTBI
-
appeared to be effective for
#17
dance
decrease
stress
participants post-MSTBI
-
appeared to be effective for
#18
walking
decrease
depression
participants post-MSTBI
-
appeared to be effective for
#19
walking
decrease
stress
participants post-MSTBI
-
appeared to be effective for
#20
peer mentoring
no change
mental health post-MSTBI
participants post-MSTBI
-
showed limited effectiveness
#21
Abstract

OBJECTIVE: To present an evidence-based review of randomized controlled trials (RCTs) evaluating interventions for mental health post-moderate to severe traumatic brain injury (post-MSTBI), as part of an extensive database that has been conceptualized as a living systematic review. METHODS: Systematic searches were conducted for RCTs published in the English language in MEDLINE, PubMed, Scopus, CINAHL, EMBASE, and PsycINFO, up to and including December 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodological quality of RCTs was assessed using the Physiotherapy Evidence Database scale, and the level of evidence was assigned using a modified Sackett scale. RESULTS: Eighty-seven RCTs examining mental health interventions and outcome measures post-MSTBI were included. These studies collectively enrolled 6471 participants. A total of 41 RCTs (47.1%) were conducted in the United States and 56 studies (64.4%) were published after 2010. A total of 62 RCTs (71.3%) examined nonpharmacological interventions and 25 RCTs (28.7%) examined pharmacological interventions. Effective pharmacological treatments included desipramine and cerebrolysin; methylphenidate and rivastigmine showed conflicting evidence. Cognitive behavioral therapy (CBT) was found to be effective for hopelessness, stress, and anxiety, compared to usual care; however, it may be as effective as supportive psychotherapy for depression. CBT combined with motivational interviewing may be as effective as CBT combined with nondirective counseling for depression, stress, and anxiety. Acceptance and commitment therapy was effective for anxiety, stress, and depression. Tai Chi, dance, and walking appeared to be effective for depression and stress, while other nonpharmacological treatments such as peer mentoring showed limited effectiveness. CONCLUSION: This evidence-based review provides a comprehensive overview of the research landscape of RCTs addressing mental health post-MSTBI. The findings from these RCTs may be valuable for health care professionals, researchers, and policymakers involved in the field of mental health and neurorehabilitation.

Medical Subject Headings (MeSH)
HumansBrain Injuries, TraumaticRandomized Controlled Trials as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations4
Citations/Year4.0
Research Impact Scores
APT Score0.75
Weight Score1.61
Normalized Score0.67
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