{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:32:01Z","timestamp":1790379121351,"version":"4.1.0"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Traumatic brain injury (TBI) can cause long-lasting and heterogeneous difficulties that require an individually tailored approach to rehabilitation. However, high-quality studies of treatment options in the chronic phase of TBI are lacking.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the effect of a home-based, individualized, and goal-oriented rehabilitation intervention in the chronic phase of TBI.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This study was an intention-to-treat parallel-group assessor-blinded randomized clinical trial with 1:1 randomization to an intervention or control group. Participants included adults in southeastern Norway who had sustained a TBI more than 2 years earlier, lived at home, and had ongoing TBI-related difficulties. A population-based sample of 555 individuals were invited, and 120 were included. Participants were assessed at baseline, 4 months, and 12 months after inclusion. Specialized rehabilitation therapists provided the intervention in patients\u2019 homes or via video conference and telephone. Data collection was conducted between June 5, 2018, and December 14, 2021.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n The intervention group received an 8-session individually tailored and goal-oriented rehabilitation program over 4 months. The control group received usual care in their municipality.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Preestablished primary outcomes were disease-specific health-related quality of life (HRQOL; measured by the Quality of Life After Brain Injury [QOLIBRI] overall scale) and social participation (measured by the Participation Assessment With Recombined Tools\u2013Objective [PART-O] social subscale). Preestablished secondary outcomes included generic HRQOL (measured by the EuroQol 5-dimension 5-level [EQ-5D-5L] questionnaire), difficulty with TBI-related problem management (target outcomes; mean severity calculated across 3 main self-identified problem areas that were individually measured using a 4-point Likert scale), TBI symptoms (measured by the Rivermead Post Concussion Symptoms Questionnaire [RPQ]), psychological distress (depression and anxiety; measured by the Patient Health Questionnaire 9-item scale and the Generalized Anxiety Disorder 7-item scale [GAD-7], respectively), and functional competency (measured by the Patient Competency Rating Scale).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 120 participants in the chronic phase of TBI, the median (IQR) age was 47.5 (31.0-55.8) years, and the median (IQR) time since injury was 4 (3-6) years; 85 (70.8%) were male. A total of 60 participants were randomized to the intervention group, and 60 were randomized to the control group. Between baseline and 12 months, no significant between-group effects were found for the primary outcomes of disease-specific HRQOL (QOLIBRI overall scale score: 2.82; 97.5% CI, \u22123.23 to 8.88;\n P<\/jats:italic>\n \u2009=\u2009.30) or social participation (PART-O social subscale score: 0.12; 97.5% CI, \u22120.14 to 0.38;\n P<\/jats:italic>\n \u2009=\u2009.29). At 12 months, the intervention group (n\u2009=\u200957) had significantly higher generic HRQOL (EQ-5D-5L score: 0.05; 95% CI, 0.002-0.10;\n P<\/jats:italic>\n \u2009=\u2009.04) and fewer symptoms of TBI (RPQ total score: \u22123.54; 95% CI, \u22126.94 to \u22120.14;\n P<\/jats:italic>\n \u2009=\u2009.04) and anxiety (GAD-7 score: \u22121.39; 95% CI, \u22122.60 to \u22120.19;\n P<\/jats:italic>\n \u2009=\u2009.02) compared with the control group (n\u2009=\u200955). At 4 months only, the intervention group (n\u2009=\u200959) had significantly less difficulty managing TBI-related problems (target outcomes mean severity score: \u22120.46, 95% CI, \u22120.76 to \u22120.15;\n P<\/jats:italic>\n \u2009=\u2009.003) compared with the control group (n\u2009=\u200959). No adverse events were reported.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study, no significant results were observed for the primary outcomes of disease-specific HRQOL or social participation. However, the intervention group reported improvements in secondary outcomes (generic HRQOL and symptoms of TBI and anxiety) that were maintained at 12-month follow-up. These findings suggest that rehabilitation interventions could help patients even in the chronic phase of TBI.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT03545594<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.10821","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T11:30:52Z","timestamp":1683286252000},"page":"e2310821","source":"Crossref","is-referenced-by-count":24,"title":["Effect of an Individually Tailored and Home-Based Intervention in the Chronic Phase of Traumatic Brain Injury"],"prefix":"10.1001","volume":"6","author":[{"given":"Ida M. H.","family":"Borgen","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"L\u00f8vstad","sequence":"additional","affiliation":[{"name":"Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway"},{"name":"Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solveig L.","family":"Hauger","sequence":"additional","affiliation":[{"name":"Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway"},{"name":"Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit V.","family":"Forslund","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingerid","family":"Kleffelg\u00e5rd","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Andelic","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway"},{"name":"Center for Habilitation and Rehabilitation Models and Services, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unni","family":"Sveen","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway"},{"name":"Department for Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene L.","family":"S\u00f8berg","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway"},{"name":"Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solrun","family":"Sigurdardottir","sequence":"additional","affiliation":[{"name":"Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laraine","family":"Winter","sequence":"additional","affiliation":[{"name":"M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marte \u00d8rud","family":"Lindstad","sequence":"additional","affiliation":[{"name":"Department of Health Sciences in Gj\u00f8vik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gj\u00f8vik, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathrine","family":"Brunborg","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie","family":"R\u00f8e","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"issue":"6","key":"zoi230342r1","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1016\/j.apmr.2013.01.023","article-title":"Traumatic brain injury as a chronic health condition.","volume":"94","author":"Corrigan","year":"2013","journal-title":"Arch Phys Med Rehabil"},{"issue":"8","key":"zoi230342r2","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1089\/neu.2010.1358","article-title":"Traumatic brain injury: a disease process, not an event.","volume":"27","author":"Masel","year":"2010","journal-title":"J Neurotrauma"},{"issue":"2","key":"zoi230342r3","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.rehab.2015.10.009","article-title":"A comprehensive picture of 4-year outcome of severe brain injuries. results from the PariS-TBI study.","volume":"59","author":"Jourdan","year":"2016","journal-title":"Ann Phys Rehabil Med"},{"issue":"7","key":"zoi230342r4","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1016\/j.apmr.2014.02.002","article-title":"Health-related quality of life 3 years after moderate to severe traumatic brain injury: a prospective cohort study.","volume":"95","author":"Grauwmeijer","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"zoi230342r5","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1097\/HTR.0000000000000383","article-title":"Predicting the trajectory of participation after traumatic brain injury: a longitudinal analysis.","volume":"33","author":"Erler","year":"2018","journal-title":"J Head Trauma Rehabil"},{"issue":"5","key":"zoi230342r6","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.3390\/jcm10051035","article-title":"Unmet rehabilitation needs after traumatic brain injury across Europe: results from the CENTER-TBI study.","volume":"10","author":"Andelic","year":"2021","journal-title":"J Clin Med"},{"issue":"3","key":"zoi230342r7","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1097\/HTR.0000000000000629","article-title":"Rehabilitation needs at 5 years post\u2013traumatic brain injury: a VA TBI model systems study.","volume":"36","author":"Mahoney","year":"2021","journal-title":"J Head Trauma Rehabil"},{"issue":"3","key":"zoi230342r8","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2662","article-title":"Long-term follow-up of use of therapy services for patients with moderate-to-severe traumatic brain injury.","volume":"52","author":"Andelic","year":"2020","journal-title":"J Rehabil Med"},{"issue":"6","key":"zoi230342r10","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1016\/j.apmr.2003.07.019","article-title":"Community integration and satisfaction with functioning after intensive cognitive rehabilitation for traumatic brain injury.","volume":"85","author":"Cicerone","year":"2004","journal-title":"Arch Phys Med Rehabil"},{"issue":"5","key":"zoi230342r11","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1016\/j.apmr.2010.12.022","article-title":"A prospective study to evaluate a residential community reintegration program for patients with chronic acquired brain injury.","volume":"92","author":"Geurtsen","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"issue":"8","key":"zoi230342r12","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1016\/j.apmr.2019.02.011","article-title":"Evidence-based cognitive rehabilitation: systematic review of the literature from 2009 through 2014.","volume":"100","author":"Cicerone","year":"2019","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"zoi230342r13","doi-asserted-by":"publisher","first-page":"373","DOI":"10.3109\/02699052.2016.1144080","article-title":"Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: a randomized controlled trial.","volume":"30","author":"Winter","year":"2016","journal-title":"Brain Inj"},{"issue":"5","key":"zoi230342r14","doi-asserted-by":"publisher","first-page":"E355","DOI":"10.1097\/HTR.0000000000000765","article-title":"Community-based interventions after acquired brain injury\u2014a systematic review of intervention types and their effectiveness.","volume":"37","author":"Hauger","year":"2022","journal-title":"J Head Trauma Rehabil"},{"issue":"5","key":"zoi230342r15","doi-asserted-by":"publisher","first-page":"E336","DOI":"10.1097\/HTR.0000000000000744","article-title":"Patient-reported problem areas in chronic traumatic brain injury.","volume":"37","author":"Borgen","year":"2022","journal-title":"J Head Trauma Rehabil"},{"issue":"9","key":"zoi230342r16","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1177\/0269215506070791","article-title":"Is goal planning in rehabilitation effective? a systematic review.","volume":"20","author":"Levack","year":"2006","journal-title":"Clin Rehabil"},{"key":"zoi230342r17","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/1745-6215-11-32","article-title":"CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials.","volume":"11","author":"Schulz","year":"2010","journal-title":"Trials"},{"issue":"8","key":"zoi230342r18","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1089\/neu.1998.15.573","article-title":"Structured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale: guidelines for their use.","volume":"15","author":"Wilson","year":"1998","journal-title":"J Neurotrauma"},{"issue":"2","key":"zoi230342r19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2012-002353","article-title":"The Needs and Provision Complexity Scale: a multicentre prospective cohort analysis of met and unmet needs and their cost implications for patients with complex neurological disability.","volume":"3","author":"Turner-Stokes","year":"2013","journal-title":"BMJ Open"},{"issue":"6","key":"zoi230342r20","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/BF01530764","article-title":"Goal attainment scaling: a general method for evaluating comprehensive community mental health programs.","volume":"4","author":"Kiresuk","year":"1968","journal-title":"Community Ment Health J"},{"issue":"1","key":"zoi230342r21","doi-asserted-by":"publisher","DOI":"10.1080\/2331205X.2020.1731222","article-title":"Needs and treatment options in chronic traumatic brain injury: a feasibility trial of a community-based intervention.","volume":"7","author":"Borgen","year":"2020","journal-title":"Cogent Med"},{"issue":"11","key":"zoi230342r22","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1136\/jnnp-2012-302361","article-title":"QOLIBRI overall scale: a brief index of health-related quality of life after traumatic brain injury.","volume":"83","author":"von Steinbuechel","year":"2012","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"4","key":"zoi230342r23","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/j.apmr.2010.08.002","article-title":"Development of the Participation Assessment With Recombined Tools\u2013Objective for use after traumatic brain injury.","volume":"92","author":"Whiteneck","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"zoi230342r24","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/j.apmr.2010.11.014","article-title":"Comparison of scoring methods for the Participation Assessment With Recombined Tools\u2013Objective.","volume":"92","author":"Bogner","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"zoi230342r25","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/0168-8510(96)00822-6","article-title":"EuroQol: the current state of play.","volume":"37","author":"Brooks","year":"1996","journal-title":"Health Policy"},{"issue":"9","key":"zoi230342r26","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1007\/BF00868811","article-title":"The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability.","volume":"242","author":"King","year":"1995","journal-title":"J Neurol"},{"issue":"9","key":"zoi230342r27","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure.","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"10","key":"zoi230342r28","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7.","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"issue":"2","key":"zoi230342r30","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.","volume":"39","author":"Faul","year":"2007","journal-title":"Behav Res Methods"},{"issue":"12","key":"zoi230342r31","doi-asserted-by":"publisher","first-page":"S30","DOI":"10.1053\/apmr.2000.20621","article-title":"Health-related quality of life outcomes measures.","volume":"81","author":"Andresen","year":"2000","journal-title":"Arch Phys Med Rehabil"},{"issue":"10","key":"zoi230342r32","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.1089\/neu.2019.6627","article-title":"Differences in health-related quality of life after traumatic brain injury between varying patient groups: sensitivity of a disease-specific (QOLIBRI) and a generic (SF-36) instrument.","volume":"37","author":"von Steinb\u00fcchel","year":"2020","journal-title":"J Neurotrauma"},{"issue":"1","key":"zoi230342r33","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1186\/s13063-021-05765-w","article-title":"Perceived study-induced influence on the control group in a randomized controlled trial evaluating a complex intervention to promote psychosocial well-being after stroke: a process evaluation.","volume":"22","author":"Mangset","year":"2021","journal-title":"Trials"},{"issue":"4","key":"zoi230342r34","doi-asserted-by":"publisher","first-page":"958","DOI":"10.3390\/jcm11040958","article-title":"Goal attainment in an individually tailored and home-based intervention in the chronic phase after traumatic brain injury.","volume":"11","author":"Borgen","year":"2022","journal-title":"J Clin Med"},{"issue":"5","key":"zoi230342r35","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1097\/01.HTR.0000290970.56130.81","article-title":"Perceived self-efficacy and life satisfaction after traumatic brain injury.","volume":"22","author":"Cicerone","year":"2007","journal-title":"J Head Trauma Rehabil"},{"issue":"8","key":"zoi230342r36","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1111\/j.1532-5415.2010.02971.x","article-title":"Targeting and managing behavioral symptoms in individuals with dementia: a randomized trial of a nonpharmacological intervention.","volume":"58","author":"Gitlin","year":"2010","journal-title":"J Am Geriatr Soc"},{"key":"zoi230342r29","volume-title":"Neuropsychological Rehabilitation After Brain Injury","author":"Prigatano","year":"1986"},{"key":"zoi230342r9","unstructured":"World Health Organization. Rehabilitation 2030 Initiative. World Health Organization. 2017. Accessed November 14, 2021. https:\/\/www.who.int\/initiatives\/rehabilitation-2030"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2804559\/borgen_2023_oi_230342_1682627048.80591.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T11:30:56Z","timestamp":1683286256000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2804559"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2023,5,5]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.10821","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,5]]}}}