{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T22:15:44Z","timestamp":1764713744876,"version":"3.40.5"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The objective was to investigate the effectiveness of a person-centred active rehabilitation programme on symptoms associated with suspected Chronic Traumatic Encephalopathy (CTE). This was accomplished by (1) assessing the effect that a person-centred active rehabilitation programme had on participant symptoms, and (2) exploring how temporal contextual factors affected the participants\u2019 experience with, and perceived effectiveness of, the active rehabilitation programme.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A twelve-month mixed-methods single case experimental research design was used with six cases (participants). Individual cases were involved in a 51-week study period including an initial interview and three-week baseline phase. Cases were then randomly allocated to one of two n-of-1 study designs (i.e., A-B, B-A, B-A, A-B or B-A, A-B, A-B, B-A) where A and B represent a non-intervention and intervention phase, respectively. Interviews were conducted regularly throughout the study whilst outcome measures were assessed at each follow-up. Analysis of the data included visual, statistical, and qualitative analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Visual and statistical analysis of cognitive and executive function, and mindful attention, demonstrated trivial-to-large effects with the summary reflecting positive or unclear results. A mixed picture was observed for mood and behaviour with effects considered trivial-to-large, and the summary demonstrating positive, unclear and negative effects. Qualitative analysis indicated a perceived improvement in outcome measures such as memory, attention, anxiety, and emotional control despite mixed quantitative findings whilst a clear impact of contextual factors, such as COVID-19, the political atmosphere, exercise tolerance, programme progression, and motivation were evident during the intervention.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study has provided primary-level evidence to suggest active rehabilitation as a potential intervention for the management of suspected CTE symptoms. This study has also demonstrated the benefit of a person-centred approach to both clinical research and practice, particularly by considering contextual factors for a better understanding of an intervention effect.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302260","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T17:30:50Z","timestamp":1717090250000},"page":"e0302260","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["The effects of person-centred active rehabilitation on symptoms of suspected Chronic Traumatic Encephalopathy: A mixed-methods single case design"],"prefix":"10.1371","volume":"19","author":[{"given":"Rachael","family":"Hearn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Selfe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria I.","family":"Cordero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7508-1683","authenticated-orcid":true,"given":"Nick","family":"Dobbin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"pone.0302260.ref001","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s00401-015-1515-z","article-title":"The first NINDS\/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy","volume":"131","author":"AC McKee","year":"2016","journal-title":"Acta Neuropathologica"},{"issue":"4","key":"pone.0302260.ref002","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s00401-023-02540-w","article-title":"Chronic traumatic encephalopathy (CTE): criteria for neuropathological diagnosis and relationship to repetitive head impacts.","volume":"145","author":"AC McKee","year":"2023","journal-title":"Acta Neuropathologica"},{"issue":"3","key":"pone.0302260.ref003","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1038\/s41582-018-0114-8","article-title":"Chronic traumatic encephalopathy\u2014confusion and controversies.","volume":"15","author":"DH Smith","year":"2015","journal-title":"Nat Rev Neurol"},{"issue":"10","key":"pone.0302260.ref004","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1080\/14737175.2019.1633916","article-title":"Management of chronic traumatic encephalopathy.","volume":"19","author":"R Cantu","year":"2019","journal-title":"Expert Rev Neurother"},{"issue":"18","key":"pone.0302260.ref005","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1212\/WNL.0000000000011850","article-title":"National Institute of Neurological Disorders and Stroke consensus diagnostic criteria for traumatic encephalopathy syndrome","volume":"96","author":"DI Katz","year":"2021","journal-title":"Neurol"},{"issue":"5","key":"pone.0302260.ref006","first-page":"1","article-title":"Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome.","volume":"6","author":"PH Montenigro","year":"2014","journal-title":"Alzheimer\u2019s Res Ther"},{"issue":"1","key":"pone.0302260.ref007","first-page":"202209003","article-title":"Management of Neuropsychiatric Symptoms for Chronic Traumatic Encephalopathy.","volume":"1","author":"A Fusco","year":"2022","journal-title":"MedPress Psychiatry Behav Sci"},{"issue":"13","key":"pone.0302260.ref008","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1080\/14656566.2023.2224501","article-title":"Emerging symptomatic treatment of Chronic Traumatic Encephalopathy (CTE): a narrative review.","volume":"24","author":"C Rossi","year":"2023","journal-title":"Expert Opin Pharmacother"},{"issue":"7","key":"pone.0302260.ref009","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1371\/journal.pone.0271213","article-title":"The effects of active rehabilitation on symptoms associated with tau pathology: An umbrella review. 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