@article{ref1,
title="Feasibility and potential benefits of a web-based intervention delivered acutely after mild traumatic brain injury in adolescents: a pilot study",
journal="Journal of head trauma rehabilitation",
year="2016",
author="Kurowski, Brad G. and Wade, Shari L. and Dexheimer, Judith W. and Dyas, Jenna and Zhang, Nanhua and Babcock, Lynn",
volume="31",
number="6",
pages="369-378",
abstract="BACKGROUND: There is a paucity of evidence-based interventions for mild traumatic brain injury (mTBI). <br><br>OBJECTIVE: To evaluate the feasibility and potential benefits of an interactive, Web-based intervention for mTBI. SETTING: Emergency department and outpatient settings. PARTICIPANTS: Of the 21 adolescents aged 11 to 18 years with mTBI recruited from November 2013 to June 2014 within 96 hours of injury, 13 completed the program. <br><br>DESIGN: Prospective, open pilot. INTERVENTION: The Web-based Self-Management Activity-restriction and Relaxation Training (SMART) program incorporates anticipatory guidance and psychoeducation, self-management and pacing of cognitive and physical activities, and cognitive-behavioral principles for early management of mTBI in adolescents. MAIN MEASURES: Primary: Daily Post-Concussion Symptom Scale (PCSS). Secondary: Daily self-reported ratings of activities and satisfaction survey. <br><br>RESULTS: Average time from injury to baseline testing was 14.0 (standard deviation = 16.7) hours. Baseline PCSS was 23.6 (range: 0-46), and daily activity was 1.8 (range: 0-5.75) hours. Repeated-measures, generalized linear mixed-effects model analysis demonstrated a significant decrease of PCSS at a rate of 2.0 points per day that stabilized after about 2 weeks. Daily activities, screen time, and physical activity increased by 0.06 (standard error [SE] = 0.04, P =.09), 0.04 (SE = 0.02, P =.15), and 0.03 (SE = 0.02, P =.05) hours per day, respectively, over the 4-week follow-up. Satisfaction was rated highly by parents and youth. <br><br>CONCLUSIONS: Self-Management Activity-restriction and Relaxation Training is feasible and reported to be helpful and enjoyable by participants. Future research will need to determine the comparative benefits of SMART and ideal target population.<p /> <p>Language: en</p>",
language="en",
issn="0885-9701",
doi="10.1097/HTR.0000000000000180",
url="http://dx.doi.org/10.1097/HTR.0000000000000180"
}