{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T21:06:04Z","timestamp":1774731964144,"version":"3.50.1"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"7-8","license":[{"start":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T00:00:00Z","timestamp":1584316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"United States ArmyMedical Research and Materiel Command","award":["W81XWH-14-2-0002"],"award-info":[{"award-number":["W81XWH-14-2-0002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Treatment approaches for mild traumatic brain injury (mTBI) have evolved to focus on active and targeted therapies, but the effect of compliance with therapy has not been investigated. The purpose of this study was to examine the role of patient compliance with prescribed therapies on clinical outcomes following mTBI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Participants were aged 18-60\u00a0years with chronic (ie, 6+ months) mTBI symptoms who were previously recalcitrant (n\u00a0=\u00a066). Participants were diagnosed with a vestibular disorder and were prescribed vestibular and exertion therapies. Participants were instructed to continue the exercise regimen during the 6-month treatment phase at home. Participant compliance was evaluated by clinicians at patients\u2019 follow up visit as: (1) high, (2) moderate, or (3) low compliance based on patient report and clinician interview. High-compliance was compared to a combined low- and moderate-compliance group on the outcomes using a 2 (group)\u00a0\u00d7\u00a02 (time) analysis of variance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>39 of the 66 (59%) participants with vestibular disorder returned for a 6-month evaluation and were included in the analyses. Of these 39 participants, 16 (41%) were high-compliance (36.7\u00a0\u00b1\u00a010.9 years, 18.8% female), 17 (44%) were moderate-compliance (32.5\u00a0\u00b1\u00a05.5 years, 23.5% female), and 6 (15%) were low-compliance (32.7\u00a0\u00b1\u00a03.3 years, 0% female).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High compliance significantly reduced total Vestibular\/Ocular Motor Screening scores compared to low\/middle compliance (P\u00a0=\u00a0.005). Post-Concussion Symptom Scale was reduced by 48% and dizziness symptoms reduced by 31% in the high-compliance cohort. High compliance with prescribed exertion\/vestibular rehabilitation therapies enhanced clinical outcomes for previously recalcitrant patients with chronic mTBI-related vestibular disorders.<\/jats:p><\/jats:sec>","DOI":"10.1093\/milmed\/usaa025","type":"journal-article","created":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T09:57:34Z","timestamp":1584352654000},"page":"e1229-e1234","source":"Crossref","is-referenced-by-count":7,"title":["Effect of Patient Compliance With Treatment Recommendations on Clinical Outcomes in Chronic mTBI: A TEAM-TBI Study"],"prefix":"10.1093","volume":"185","author":[{"given":"Jessica L","family":"Galey","sequence":"first","affiliation":[{"name":"Feinberg School of Medicine Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 N. Michigan Ave., Suite 1100, Chicago, IL 60611"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn R","family":"Eagle","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Kaufmann Medical Building, Suite 1010, 347 Fifth Avenue, Pittsburgh, PA 15213"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas A","family":"Blaney","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Kaufmann Medical Building, Suite 1010, 347 Fifth Avenue, Pittsburgh, PA 15213"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia L","family":"Holland","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Kaufmann Medical Building, Suite 1010, 347 Fifth Avenue, Pittsburgh, PA 15213"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah B","family":"Bitzer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Kaufmann Medical Building, Suite 1010, 347 Fifth Avenue, Pittsburgh, PA 15213"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walt","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor, 210 S. Bouquet Street, Pittsburgh, PA 15260"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David O","family":"Okonkwo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh, 200 Lothrop St. Suite B-400, Pittsburgh, PA 15213"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Mucha","sequence":"additional","affiliation":[{"name":"Centers for Rehabilitation Services, 300 Halket St., Pittsburgh, PA, 15213"},{"name":"UPMC Sports Medicine Concussion Program, 3200 South Water St., Pittsburgh, PA 15203"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Kaufmann Medical Building, Suite 1010, 347 Fifth Avenue, Pittsburgh, PA 15213"},{"name":"UPMC Sports Medicine Concussion Program, 3200 South Water St., Pittsburgh, PA 15203"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony P","family":"Kontos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Kaufmann Medical Building, Suite 1010, 347 Fifth Avenue, Pittsburgh, PA 15213"},{"name":"UPMC Sports Medicine Concussion Program, 3200 South Water St., Pittsburgh, PA 15203"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,3,16]]},"reference":[{"issue":"4","key":"2020081705464873500_ref1","first-page":"213","article-title":"American Medical Society for Sports Medicine position statement on concussion in sport","volume":"53","author":"Harmon","year":"2019","journal-title":"Clin J Sport Med"},{"key":"2020081705464873500_ref2","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport\u2014the 5th international conference on concussion in 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