title: Multidisciplinary outpatient treatment in patients with mild traumatic brain injury: A randomised controlled intervention study.
abstract: To evaluate the efficacy of a multidisciplinary outpatient follow-up programme compared to follow-up by a general practitioner for patients being at-risk or sick-listed with persistent post-concussion symptoms two months after a mild traumatic brain injury.
  
  
  
  Randomised controlled trial.
  
  
  
  One hundred fifty-one patients, 16-56 years.
  
  
  
  Multidisciplinary outpatient rehabilitation with individual contacts and a psycho-educational group intervention at two outpatient rehabilitation clinics compared to follow-up by a general practitioner after the multidisciplinary examination. Primary outcome was sustainable return-to-work first year post-injury. Secondary outcomes were post-concussion symptoms, disability, the patient's impressions of change and psychological distress.
  
  
  
  Days to sustainable return-to-work was 90 in the intervention and 71 in the control group (p = 0.375). The number of post-concussion symptoms were fewer in the intervention (6) compared to the control group (8) at 12 months (p = 0.041). No group differences were observed for disability (p = 0.193), patients impression of change (p = 0.285) or psychological distress (p = 0.716).
  
  
  
  The multidisciplinary outpatient follow-up programme focusing on better understanding and reassurance of favourable outcome for mild traumatic brain injury did not improve return-to-work, but may have reduced the development of post-concussion symptoms. Additional studies should focus on which factors exhibit a direct impact on return-to-work.
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Haukeland University Hospital , Bergen , Norway.|b Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway.
authors.forename: Eirik
authors.initials: E
authors.lastname: Vikane
authors.affiliation: c Department of Physical Medicine and Rehabilitation , Oslo University Hospital , Oslo , Norway.
authors.forename: Torgeir
authors.initials: T
authors.lastname: Hellstrøm
authors.affiliation: c Department of Physical Medicine and Rehabilitation , Oslo University Hospital , Oslo , Norway.|d Faculty of Medicine , University of Oslo , Oslo , Norway.
authors.forename: Cecilie
authors.initials: C
authors.lastname: Røe
authors.affiliation: c Department of Physical Medicine and Rehabilitation , Oslo University Hospital , Oslo , Norway.|d Faculty of Medicine , University of Oslo , Oslo , Norway.
authors.forename: Erik
authors.initials: E
authors.lastname: Bautz-Holter
authors.affiliation: e Centre for Clinical Research , Haukeland University Hospital , Bergen , Norway.
authors.forename: Jörg
authors.initials: J
authors.lastname: Aßmus
authors.affiliation: a Department of Physical Medicine and Rehabilitation , Haukeland University Hospital , Bergen , Norway.|b Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway.
authors.forename: Jan Sture
authors.initials: JS
authors.lastname: Skouen
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D001924:Brain Concussion / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods*; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D016037:Single-Blind Method; D055815:Young Adult
keywords: Mild traumatic brain injury; post-concussion symptoms; randomised controlled trial; return-to-work; vocational rehabilitation