TABLE 11-1 Evidence Table: Multi-Modal/Comprehensive CRT

Study N TBI Severity Level Brief Narrative Comparator Outcome Measures Findings
RCT
Cicerone et al. 2008 68 Moderate-Severe Compared one format of comprehensive neuropsychologic (NP) CRT to another form of standard, multidisciplinary CRT to assess relative or comparative effectiveness of alternate comprehensive approaches. Y

Other CRT Content: Standard, multidisciplinary neuro- rehabilitation

•  Primary outcomes:


■  CIQ (community integration)


■  PQOL (life satisfaction)


•  Secondary outcomes:


■  NP functioning


•  Trail Making Test


•  Controlled Oral Word Association Test


•  Booklet Category Test


•  California Verbal Learning Test-II


•  Rey Complex Figure


■  Perceived self-efficacy


■  Community-based employment


•  Vocational Integration Scale

While both groups saw NP improvement, intensive CRT subjects, compared to the standard CRT group, saw greater improvement on the CIQ, PQOL, and self-efficacy for the management of symptoms. At 6-month follow-up, these gains were maintained. The standard CRT patients, however, showed increased productivity at 6 months, correlated with the need for continued remediation.
Ruff and Niemann 1990 24 NR The effectiveness of cognitive remediation versus day treatment was compared in this study of emotional and psychosocial adjustment in subjects. Y

Other CRT Content: Sessions emphasizing psychosocial adjustment, leisure, and activities of daily living
Katz Adjustment Scale (KAS) subscales:

•  Social Obstreperousness


•  Acute Psychoticism


•  Withdrawn Depression

There was no significant difference between groups, with both groups reporting decreased symptoms of psycho-emotional distress, i.e., lessened social withdrawal and depression.


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