Symptom-targeted rehabilitation for cognitive complaints after concussion in Canadian Armed Forces and Royal Canadian Mounted Police Veterans: A feasibility, pilot, randomized controlled trial

Introduction: The aim of this study was to determine the feasibility of a virtually delivered, individual, cognitive rehabilitation protocol called Symptom-Targeted Rehabilitation for Cognitive Complaints after Concussion (STAR-C) for Canadian Armed Forces and Royal Canadian Mounted Police Veterans with mild traumatic brain injury (mTBI). Methods: A randomized controlled clinical trial was conducted comparing STAR-C to provision of self-management educational materials for mTBI. STAR-C was delivered by a speech-language pathologist or occupational therapist. Outcomes were recruitment numbers and participant and clinician ratings on a standard measure of acceptability, appropriateness, and feasibility of intervention. Results: Of 136 veterans who contacted the study coordinator, 56 were eligible and were randomized to either STAR-C (n = 28) or educational materials (Control group, n = 28). Of the 19 active group participants who completed all post-treatment measures, 17 gave high ratings of acceptability, appropriateness, and feasibility. Clinicians gave the intervention high ratings of appropriateness and feasibility for the active participants who completed the STAR-C treatment. The 20 control group participants gave a wider range of scores for the educational materials. Discussion: STAR-C was rated as acceptable, appropriate, and feasible by both participants who completed the study and clinicians, with significantly higher participant ratings for STAR-C versus control. There were significant challenges in recruitment, however, raising questions about feasibility and whether awareness-raising efforts might be needed prior to studying treatment efficacy and effectiveness.