{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T22:45:11Z","timestamp":1774651511248,"version":"3.50.1"},"reference-count":81,"publisher":"BMJ","issue":"9","funder":[{"name":"Malaysian Ministry of Science and Innovation (MOSTI) grant","award":["(MOSTI Flagship Project FP0911F001)"],"award-info":[{"award-number":["(MOSTI Flagship Project FP0911F001)"]}]},{"name":"High Impact Research Grant","award":["UM.C\/625\/1\/HIR\/MOHE\/CHAN\/12"],"award-info":[{"award-number":["UM.C\/625\/1\/HIR\/MOHE\/CHAN\/12"]}]},{"name":"Post Graduate Research Grant","award":["PPPC\/C1-2016\/DGJ\/01"],"award-info":[{"award-number":["PPPC\/C1-2016\/DGJ\/01"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,8,20]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To measure the clinical, structural and functional changes of an individualised structured cognitive rehabilitation in mild traumatic brain injury (mTBI) population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A single centre study, Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults aged between 18 and 60 years with mTBI as a result of road traffic accident, with no previous history of head trauma, minimum of 9\u2009years education and abnormal cognition at 3\u2009months will be included. The exclusion criteria include pre-existing chronic illness or neurological\/psychiatric condition, long-term medication that affects cognitive\/psychological status, clinical evidence of substance intoxication at the time of injury and major polytrauma. Based on multiple estimated calculations, the minimum intended sample size is 50 participants (Cohen\u2019s d effect size=0.35; alpha level of 0.05; 85% power to detect statistical significance; 40% attrition rate).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Intervention group will receive individualised structured cognitive rehabilitation. Control group will receive the best patient-centred care for attention disorders. Therapy frequency for both groups will be 1\u2009hour per week for 12 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Primary:<\/jats:bold>\n                      Neuropsychological Assessment Battery-Screening Module (S-NAB) scores.\n                      <jats:bold>Secondary:<\/jats:bold>\n                      Diffusion Tensor Imaging (DTI) parameters and Goal Attainment Scaling score (GAS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results will include descriptive statistics of population demographics, CogniPlus cognitive program and metacognitive strategies. The effect of intervention will be the effect size of S-NAB scores and mean GAS T scores. DTI parameters will be compared between groups via repeated measure analysis. Correlation analysis of outcome measures will be calculated using Pearson\u2019s correlation coefficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This is a complex clinical intervention with multiple outcome measures to provide a comprehensive evidence-based treatment model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study protocol was approved by the Medical Research Ethics Committee UMMC (MREC ID NO: 2016928\u20134293). The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03237676\">NCT03237676<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-028711","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T07:35:13Z","timestamp":1568878513000},"page":"e028711","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Randomised controlled clinical trial of a structured cognitive rehabilitation in patients with attention deficit following mild traumatic brain injury: study protocol"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03237676","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9062-3820","authenticated-orcid":false,"given":"Norhamizan","family":"Hamzah","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vairavan","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norlisah","family":"Ramli","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nor Atikah","family":"Mustapha","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nor Adibah","family":"Mohammad Tahir","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6912-172X","authenticated-orcid":false,"given":"Li Kuo","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5014-5684","authenticated-orcid":false,"given":"Mahmoud","family":"Danaee","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nor Asiah","family":"Muhamad","sequence":"additional","affiliation":[{"name":"Institute for Public Health, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avril","family":"Drummond","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8143-7893","authenticated-orcid":false,"given":"Roshan","family":"das Nair","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham, United Kingdom"},{"name":"Institute of Mental Health, Nottinghamshire Healthcare Trust, Nottingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sing Yau","family":"Goh","sequence":"additional","affiliation":[{"name":"Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Sungai Long Campus, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazlina","family":"Mazlan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"key":"2025121411034877000_9.9.e028711.1","doi-asserted-by":"publisher","DOI":"10.1080\/16501970510027321"},{"key":"2025121411034877000_9.9.e028711.2","unstructured":"World Health Organization (WHO) . 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