NO EFFECT OF AN EARLY INTERVENTION AFTER MILD TRAUMATIC BRAIN INJURY ON ACTIVITY AND PARTICIPATION: A RANDOMIZED CONTROLLED TRIAL

Objective: To evaluate measures of activity, participation and quality of life 3 months after mild traumatic brain injury and the effect of an early intervention for patients with an estimated high risk for problems after mild traumatic brain injury. Patients: Consecutive patients attending the emergency room with mild traumatic brain injury. Design: Randomized controlled trial. Methods: Patients reporting <3 symptoms after 10 days were considered to have a low risk for prolonged problems. Patients with >= 3 symptoms (high-risk patients) were randomized to a visit to a physician or treatment-as-usual. Data on self-reported limitations in activity, restrictions in participation, and quality of life were collected for all patients at 3 months. Results: At 3 months post-injury, low-risk patients reported good quality of life and significantly fewer problems in everyday life compared with high-risk patients. The intervention had no effect on activity, participation or quality of life. Conclusion: Patients who report few symptoms early after mild traumatic brain injury are likely to have a good outcome regarding activity and participation. The intervention offered in this study, focusing on reassurance of a good outcome and treatment of comorbidities, had no effect.