Rehabilitation of Social Communication Skills in Patients With Acquired Brain Injury With Intensive and Standard Group Interactive Structured Treatment: A Randomized Controlled Trial

Silje Merethe Hansen Ingebretsen; Melanie Kirmess; Milada Cvancarova Småstuen; Lenore Hawley; Jody Newman; Jan Stubberud

doi:10.1016/j.apmr.2023.02.023

Rehabilitation of Social Communication Skills in Patients With Acquired Brain Injury With Intensive and Standard Group Interactive Structured Treatment: A Randomized Controlled Trial

Arch Phys Med Rehabil. 2023 Jul;104(7):1016-1025. doi: 10.1016/j.apmr.2023.02.023. Epub 2023 Mar 24.

Authors

Silje Merethe Hansen Ingebretsen¹, Melanie Kirmess², Milada Cvancarova Småstuen³, Lenore Hawley⁴, Jody Newman⁴, Jan Stubberud⁵

Affiliations

¹ Department of Special Needs Education, University of Oslo, Oslo, Norway; Sunnaas Rehabilitation Hospital, Akershus, Norway. Electronic address: s.m.h.ingebretsen@isp.uio.no.
² Department of Special Needs Education, University of Oslo, Oslo, Norway.
³ Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
⁴ Craig Hospital, Englewood, CO.
⁵ Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway.

PMID: 36966953
DOI: 10.1016/j.apmr.2023.02.023

Abstract

Objective: To determine the efficacy of group interactive structured treatment (standard GIST) for improving social communication difficulties in a wider acquired brain injury (ABI) population compared to a waitlist control (WL). Secondary objectives were to (a) explore GIST across delivery formats by comparing the results to an intensive inpatient version of GIST (intensive GIST) and (b) compare the within-subject results for WL and intensive GIST.

Design: Randomized controlled trial with WL and repeated measures (pre- and posttraining, 3- and 6-month follow-ups).

Setting: Community and rehabilitation hospital.

Participants: Forty-nine persons (27-74 years) with ABI and social communication difficulties (26.5% traumatic brain injury, 44.9% stroke, 28.6% other), minimum 12 months postinjury.

Intervention: Standard GIST (n=24) consisted of 12 weekly outpatient interactive group sessions (2.5 hours/session) and follow-up. Intensive GIST (n=18) consisted of 4 weeks with daily 4-hour inpatient group sessions (2 × 3 d/wk, 2 × 4 d/wk) and follow-up.

Main outcome measures: La Trobe Questionnaire, a self-report questionnaire measuring social communication. Secondary measures: Social Communication Skills Questionnaire-Adapted, Goal Attainment Scale, Mind in the Eyes test, and questionnaires addressing mental and cognitive health, self-efficacy, and quality of life.

Results: When comparing the standard GIST and WL results, a trend of improvement was found for the main outcome, La Trobe Questionnaire, and a statistically significant improvement was found for the secondary outcome Social Communication Skills Questionnaire-Adapted. Comparing standard GIST and intensive GIST, improvement in social communication skills after both treatments was detected and maintained at 6-month follow-up. No statistically significant difference was found between groups. Goal attainment was achieved and maintained during follow-up for both standard and intensive GIST.

Conclusions: Social communication skills were improved after both standard and intensive GIST, indicating that GIST can be delivered across treatment formats and to a wider ABI population.

Trial registration: ClinicalTrials.gov NCT03636399.

Keywords: Brain injuries; Evidence-based Practice; Rehabilitation; Social interaction.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Brain Injuries* / rehabilitation
Communication
Gastrointestinal Stromal Tumors* / complications
Humans
Quality of Life
Social Skills

Associated data

ClinicalTrials.gov/NCT03636399